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Geyh S.,Swiss Paraplegic Research AG | Geyh S.,University of Lucerne | Muller R.,Swiss Paraplegic Research AG | Peter C.,Swiss Paraplegic Research AG | And 11 more authors.
American Journal of Physical Medicine and Rehabilitation | Year: 2011

Objective: The overall objective of this study was to illustrate a systematic approach for capturing the psychologic-personal perspective in International Classification of Functioning, Disability and Health-based comprehensive research on spinal cord injury (SCI) in terms of what and how to measure. The specific aims were to identify (1) relevant areas of research for capturing the psychologic-personal factors in a study that is planned and conceptualized according to the comprehensive context of the International Classification of Functioning, Disability and Health, using SCI as a case in point; (2) a set of domains relevant for SCI research from a psychologic-personal perspective; and (3) suitable measurement instruments that can be considered for the assessment of those identified domains based on a set of predefined guiding principles. Design: The psychologic-personal factor structure was developed based on an item pool of 1246 entries from secondary analyses of available data from SCI studies. The domain set for psychologic-personal factors was identified through reviewing the scientific literature in PubMed and PsycInfo. The set of measurement instruments was collected using available measurement reviews, searches in the literature, instrument databases, and further sources and was selected using guiding principles. Results: Forty specific psychologic-personal factors, subdivided into seven areas of research, were identified: (1) sociodemographic personal characteristics, (2) the position in the immediate social and physical context, (3) personal history and biography, (4) feelings, (5) thoughts and beliefs, (6) motives, and (7) patterns of experience and behavior. The psychologic-personal factors domain set contains both cross-cutting outcome domains, namely quality-of-life, life satisfaction, subjective well-being, and sociodemographic personal characteristics, life events, positive and negative affect, perceived stress, locus of control, self-efficacy, purpose in life, coping, lifestyle, and personality. For each of the identified domains, a pool of measurement instruments was listed, and the application of predefined guiding principles for measurement instrument selection was exemplified for self-efficacy. It resulted in the selection of the General Self-Efficacy Scale by Schwarzer and Jerusalem (Measures in Health Psychology: A User's Portfolio. Causal and Control Beliefs. pp. 35-37; 1995). Conclusions: The results of the current article contributed to creating a transparent protocol for the Swiss Spinal Cord Injury Cohort study, coordinated by the Swiss Paraplegic Research in Nottwil, Switzerland. This article also stresses the relevance of the comprehensive approach to SCI and the consideration of the psychologic-personal perspective in this approach. The study, therefore, hopes to encourage scientists to use the International Classification of Functioning, Disability and Health and the psychologic-personal perspective as a frame of reference for their research. Furthermore, the research reported in this article can inform the World Health Organization's future development of the personal factors classification in the International Classification of Functioning, Disability and Health. Copyright © 2011 by Lippincott Williams & Wilkins. Source


Scheel-Sailer A.,Clinic Swiss Paraplegic Center | Wyss A.,Clinic Swiss Paraplegic Center | Boldt C.,Munich University of Applied Sciences | Boldt C.,Swiss Paraplegic Research | And 4 more authors.
Spinal Cord | Year: 2013

Study design:This was a prospective cohort study.Objectives:The objective was to describe the incidence, prevalence, characteristics of pressure ulcers (PUs) and the association with specific patient characteristics in a consecutive sample of in-patients with a spinal cord injury (SCI).Setting:An acute care and rehabilitation clinic specialized in SCIs in Switzerland.Methods:The presence and characteristics of PUs for all adult patients with a SCI admitted to the clinic from 1 September 2009 to 28 February 2010 were recorded on a daily basis during their complete hospitalization. Risk factors were analyzed in univariate and multivariate logistic regression models.Results:A total of 185 patients were included in the study and observed for the entirety of their hospitalization. The prevalence of at least one PU was 49.2% in all patients, compared with 25.4% in the group of patients admitted without PUs. The incidence was 2.2 per person and year. In 91 patients, a total of 219 PUs were observed. PUs were most frequently located on the foot (36.1%), and the coccyx/sacrum (15.1%). The risk for occurrence of a PU increased with age (odds ratio (OR)=1.04) and post SCI (OR=1.03). In the multivariate analyses, the risk for PUs was lower for patients with the American Spinal Injury Association (ASIA) Impairment Scale (AIS) of C or D (OR C =0.25, OR D =0.28) compared with patients with an AIS of A.Conclusion:Using a daily documentation system, PUs were detected as a frequent complication of SCIs. Completeness of injury, age and time since injury were significant risk factors for PUs. The foot was a region at high risk for PUs. © 2013 International Spinal Cord Society All rights reserved. Source


Kirchberger I.,Ludwig Maximilians University of Munich | Cieza A.,Ludwig Maximilians University of Munich | Cieza A.,Swiss Paraplegic Research | Biering-Sorensen F.,Copenhagen University | And 10 more authors.
Spinal Cord | Year: 2010

Study design:A formal decision-making and consensus process integrating evidence gathered from preparatory studies was followed.Objectives:The aim of this study was to report on the results of the consensus process to develop the first version of a Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set and a Brief ICF Core Set for individuals with spinal cord injury (SCI) in the early post-acute context.Setting:The consensus conference took place in Switzerland. Preparatory studies were performed worldwide.Methods:Preparatory studies included an expert survey, a systematic literature review, a qualitative study and empirical data collection involving people with SCI. ICF categories were identified in a formal consensus process by international experts from different backgrounds.Results:The preparatory studies identified a set of 531 ICF categories at the second, third and fourth levels. From 30 countries, 33 SCI experts attended the consensus conference (11 physicians, 6 physical therapists, 5 occupational therapists, 6 nurses, 3 psychologists and 2 social workers). Altogether 162 second-, third- or fourth-level categories were included in the Comprehensive ICF Core Sets with 63 categories from the component Body Functions, 14 from Body Structures, 53 from Activities and Participation and 32 from Environmental Factors. The Brief Core Set included a total of 25 second-level categories with 8 on Body Functions, 3 on Body Structures, 9 on Activities and Participation, and 5 on Environmental Factors.Conclusion:A formal consensus process-integrating evidence and expert opinion based on the ICF led to the ICF Core Sets for individuals with SCI in the early post-acute context. Further validation of this first version is needed. © 2010 International Spinal Cord Society All rights reserved. Source


Cieza A.,Ludwig Maximilians University of Munich | Kirchberger I.,Ludwig Maximilians University of Munich | Kirchberger I.,Swiss Paraplegic Research | Biering-Sorensen F.,Copenhagen University | And 10 more authors.
Spinal Cord | Year: 2010

Study design:A formal decision-making and consensus process integrating evidence gathered from preparatory studies was followed.Objectives:The objective of the study was to report on the results of the consensus process to develop the first version of a Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set, and a Brief ICF Core Set for individuals with spinal cord injury (SCI) in the long-term context.Setting:The consensus conference took place in Switzerland. Preparatory studies were performed worldwide.Methods:Preparatory studies included an expert survey, a systematic literature review, a qualitative study and empirical data collection involving people with SCI. Relevant ICF categories were identified in a formal consensus process by international experts from different backgrounds.Results: The preparatory studies identified a set of 595 ICF categories at the second, third or fourth level. A total of 34 experts from 31 countries attended the consensus conference (12 physicians, 6 physical therapists, 5 occupational therapists, 6 nurses, 3 psychologists and 2 social workers). Altogether, 168 second-, third- or fourth-level categories were included in the Comprehensive ICF Core with 44 categories from body functions, 19 from body structures, 64 from activities and participation and 41 from environmental factors. The Brief Core Set included a total of 33 second-level categories with 9 on body functions, 4 on body structures, 11 on activities and participation and 9 on environmental factors.Conclusion:A formal consensus process integrating evidence and expert opinion based on the ICF led to the definition of the ICF Core Sets for individuals with SCI in the long-term context. Further validation of this first version is needed. © 2010 International Spinal Cord Society All rights reserved. Source


Charlifue S.,Craig Hospital | Post M.W.,Rudolf Magnus Institute for Neuroscience | Biering-Sorensen F.,Neuroscience Center | Biering-Sorensen F.,Copenhagen University | And 9 more authors.
Spinal Cord | Year: 2012

Study design: Survey of expert opinion, feedback, and development of final consensus. Objective: Present the background, purpose, development process and results for the International Spinal Cord Injury (SCI) Quality of Life (QoL) Basic Data Set. Setting: International. Methods: A committee of experts was established to select and define data elements to be included in an International SCI QoL Basic Data Set. A draft data set was developed and disseminated to appropriate organizations for comment. All suggested revisions were considered, and a final version of the QoL data set was completed. Results: The QoL data set consists of 3 variables: ratings of satisfaction with general quality of life, satisfaction with physical health, and satisfaction with psychological health. All variables are rated on a scale ranging from 0 (completely dissatisfied) to 10 (completely satisfied). Conclusion: Collection of the International SCI QoL Basic Data Set variables should be a part of all future studies of SCI QoL to facilitate comparison of results across published studies from around the world. Additional standardized instruments to assess other aspects of QoL can be administered based on the purpose of a particular study. © 2012 International Spinal Cord Society All rights reserved. Source

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