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Perceptions of Person-Centered Care Following Spinal Cord Injury

  • Allen W. Heinemann
    Correspondence
    Corresponding author Allen W. Heinemann, PhD, Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, 345 E Superior St, Chicago, IL 60611.
    Affiliations
    Center for Healthcare Studies, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL

    Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL

    Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL
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  • Sherri L. LaVela
    Affiliations
    Center for Healthcare Studies, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL

    Health Services Research and Development, Department of Veterans Affairs, Edward Hines, Jr. Veterans Administration Hospital, Hines, IL

    Center for Evaluation of Practices and Experiences of Patient-Centered Care, Department of Veterans Affairs, Hines, IL
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  • Bella Etingen
    Affiliations
    Health Services Research and Development, Department of Veterans Affairs, Edward Hines, Jr. Veterans Administration Hospital, Hines, IL

    Center for Evaluation of Practices and Experiences of Patient-Centered Care, Department of Veterans Affairs, Hines, IL
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  • Ana Miskovic
    Affiliations
    Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL
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  • Sara M. Locatelli
    Affiliations
    Health Services Research and Development, Department of Veterans Affairs, Edward Hines, Jr. Veterans Administration Hospital, Hines, IL

    Center for Evaluation of Practices and Experiences of Patient-Centered Care, Department of Veterans Affairs, Hines, IL
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  • Holly DeMark Neumann
    Affiliations
    RTI International, Chicago, IL
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  • David Chen
    Affiliations
    Center for Healthcare Studies, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL

    Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL
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Published:April 21, 2016DOI:https://doi.org/10.1016/j.apmr.2016.03.016

      Abstract

      Objectives

      To (1) evaluate perceptions of person-centered care (PCC) in individuals with traumatic spinal cord injury (SCI); and (2) examine perceived differences in PCC concepts between patients continuing to receive any services from a Spinal Cord Injury Model Systems (SCIMS) facility and those who are not.

      Design

      We used a cross-sectional design, mailed a paper survey, and followed up with a second mailing to nonrespondents after 4 weeks.

      Setting

      Community.

      Participants

      Individuals (N=326) who received initial rehabilitation at an SCIMS facility and agreed to participate in this research study. We distinguished respondents who received any SCIMS outpatient services in the past 2 years (SCIMS users, n=137) or longer ago (SCIMS nonusers, n=189).

      Interventions

      Not applicable.

      Main Outcome Measures

      Participants completed the Patient Activation Measure (PAM), the Patient Assessment of Chronic Illness Care, the Global Practice Experience measure, and 5 Press-Ganey questions that assessed key elements of patient- and family-centered care.

      Results

      Patient perspectives of chronic illness care were more positive in the SCIMS users than nonusers (3.15 vs 2.91, P<.05); the difference is attributable primarily to higher subscale scores on goal setting and tailoring. The SCIMS users and nonusers did not differ in terms of PAM overall score or activation stage, Global Practice Experience, or Press-Ganey scores.

      Conclusions

      SCIMS users and nonusers differed on perceptions of chronic illness care (largely the goal-setting and tailoring component), which were more favorable for Model System users than nonusers. Results can guide strategies to enhance PCC practices after inpatient rehabilitation.

      Keywords

      List of abbreviations:

      CI (confidence interval), PACIC (Patient Assessment of Chronic Illness Care), PAM (Patient Activation Measure), PCC (patient-centered care), RIC (Rehabilitation Institute of Chicago), SCI (spinal cord injury), SCIMS (Spinal Cord Injury Model Systems)
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