Impact of Blood Pressure Dysregulation on Health-Related Quality of Life in Persons With Spinal Cord Injury: Development of a Conceptual Model

Arch Phys Med Rehabil, 2013 · DOI: 10.1016/j.apmr.2013.02.024 · Published: September 1, 2013

Spinal Cord Injury Participation Cardiovascular Science

Simple Explanation

This study explores how blood pressure dysregulation (BPD) affects the quality of life for individuals with spinal cord injuries (SCI). It aims to create a conceptual framework based on input from SCI patients and healthcare providers to guide the development of a patient-reported outcome measure specific to BPD. The research involved focus groups with both SCI patients and their providers. These groups discussed how blood pressure issues influence health-related quality of life (HRQOL) in SCI patients. The discussions covered symptoms, causes, prevention, and corrective actions related to BPD. The study found that BPD significantly impacts HRQOL in SCI patients. While both patients and providers recognized the symptoms, providers offered more detailed information on the causes and prevention of BPD. The findings highlight the need for a tool to assess the impact of BPD on HRQOL in SCI patients.

Study Duration

Not specified

Participants

27 individuals with SCI and 25 clinical providers

Evidence Level

Not specified

Key Findings

1
The most frequent topic discussed in focus groups was symptoms of BPD, followed by precipitators/causes, preventative actions, corrective actions, and impact on social/emotional functioning.
2
Patients with SCI often have difficulty distinguishing between the specific blood pressure domains (OH, hypertension, hypotension) associated with a particular symptom.
3
A conceptual model was developed reflecting the potential causes, preventative actions, and corrective actions that influence, and are influenced by, HRQOL in individuals with SCI.

Research Summary

This study aimed to identify medically relevant aspects of blood pressure dysregulation (BPD) related to quality of life in individuals with spinal cord injury (SCI) and propose an integrated conceptual framework. Three focus groups with individuals with SCI and three groups with SCI providers were analyzed using grounded-theory based qualitative analysis to ascertain how blood pressure impacts health-related quality of life (HRQOL) in individuals with SCI. The results suggest that BPD uniquely and adversely impacts HRQOL in persons with SCI, highlighting the need for a validated and sensitive clinical measurement tool.

Practical Implications

Clinical Assessment

The study underscores the necessity for a validated clinical tool to accurately assess the impact of BPD on HRQOL in SCI patients, enabling better monitoring and management of blood pressure issues.

Patient Education

The findings emphasize the importance of educating SCI patients about the subtle signs and symptoms of BPD and empowering them to take preventative and corrective actions.

Intervention Strategies

The conceptual model developed in this study can be used to design targeted interventions to address the specific causes, symptoms, and consequences of BPD in SCI patients, ultimately improving their HRQOL.

Study Limitations

1
Most patients in the focus groups were more than 18 months post-injury, making it difficult to generalize findings to individuals in the acute and subacute period post-injury.
2
The focus groups were relatively small, consisting of a convenience sample, and most of the subjects with SCI were white men; therefore, extrapolation to other specialized SCI samples, women and those of other races, may not be relevant.
3
Data regarding the BPD status of participants was not collected; therefore, subjective self-reports of the impact that BPD has on HRQOL cannot be related to objective measures of BPD.

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