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Describing Functioning in People Living With Spinal Cord Injury in Switzerland: A Graphical Modeling Approach

      Abstract

      Objective

      To describe functioning in people living with spinal cord injuries (SCI) in Switzerland.

      Design

      Secondary analysis of cross-sectional survey data.

      Setting

      Community, Switzerland.

      Participants

      Individuals (N=1549) 16 years of age or older with a history of traumatic or nontraumatic SCI and permanently residing in Switzerland.

      Interventions

      Not applicable.

      Main Outcome Measures

      Functioning was operationalized through 4 domains: (1) impairments in body functions; (2) impairments in mental functions; (3) independence in performing activities; and (4) performance problems in participation.

      Results

      Univariate analysis indicated a high prevalence of problems in 5 areas: (1) housework; (2) climbing stairs; (3) tiredness; (4) spasticity; and (5) chronic pain. Graphical modeling showed a strong association among the four domains of functioning. Moreover, we found that the differences in the dependence structures were significant between the paraplegia SCI population and the tetraplegia SCI population.

      Conclusions

      This study is a first study in the epidemiology of functioning of people living with SCI in Switzerland. Using univariate and graphical modeling approaches, we proposed an empirical foundation for developing hypotheses on functioning in each domain and category that could inform health systems on people’s health needs.

      Keywords

      List of abbreviations:

      DAG (directed acyclic graph), ICF (International Classification of Functioning, Disability and Health), SCI (spinal cord injuries), SCIM-SR (Spinal Cord Injury Independence Measure Self-Report), SwiSCI (Swiss Spinal Cord Injury Cohort Study)
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