Impact of Patient Counseling and Socioeconomic Factors on Initiation of Rehabilitation Program in Spinal Cord Injury Patients Presenting to a Tertiary Spine Unit in India

Asian Spine Journal, 2021 · DOI: 10.31616/asj.2020.0008 · Published: June 1, 2021

Spinal Cord Injury Rehabilitation Public Health

Simple Explanation

This study examines how factors like education, income, job status, and counseling affect when spinal cord injury (SCI) patients start rehabilitation. Early rehabilitation is crucial for better recovery after SCI. The study compared two groups: those receiving early counseling at a trauma unit (Group A) and those directly seeking rehabilitation (Group B). The aim was to see if counseling impacts the time it takes for patients to enroll in rehab programs. The findings suggest that early counseling significantly reduces the time to rehabilitation enrollment, even for patients with challenging socioeconomic backgrounds. This highlights the importance of integrating counseling into acute SCI care.

Study Duration

12-month period

Participants

153 patients with spinal cord injury

Evidence Level

Prospective case series

Key Findings

1
Patients receiving early counseling (Group A) started rehabilitation significantly sooner (mean 28 days) compared to those presenting directly for rehabilitation (Group B, mean 149 days).
2
A higher percentage of patients in Group A (85.2%) enrolled in rehabilitation within 6 weeks of injury compared to Group B (38.7%), indicating the effectiveness of early counseling.
3
Socioeconomic status, as measured by the modified Kuppuswamy score (MKSS), did not significantly differ between those who enrolled early versus late in either group, suggesting counseling can overcome socioeconomic barriers.

Research Summary

This study investigated the impact of patient counseling and socioeconomic factors on the timing of enrolment in a spinal cord injury (SCI) rehabilitation program in India. The study found that early patient counseling during acute care significantly reduces the time to rehabilitation enrollment, irrespective of socioeconomic status. The findings highlight the importance of integrating counseling into acute SCI care to improve rehabilitation outcomes, especially in developing countries with socioeconomic disparities.

Practical Implications

Implement Early Counseling Programs

Hospitals and trauma centers should implement early counseling programs for SCI patients to encourage timely enrollment in rehabilitation.

Address Logistical Barriers

Strategies should be developed to address logistical barriers, such as transportation, that hinder access to rehabilitation, especially for patients from distant locations.

Multidisciplinary Approach

A multidisciplinary team approach involving physicians, therapists, psychologists, and family members is crucial for effective patient counseling and rehabilitation planning.

Study Limitations

1
Selection bias due to the study being conducted at a tertiary care spine trauma unit.
2
The socioeconomic profile of patients may not represent the broader population, as the sample was from a narrow socioeconomic spectrum.
3
Limited number of SCI rehabilitation centers in India may bias the sample population due to transportation challenges.

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