Interdisciplinary care for spinal cord injured refugees

Spinal Cord Series and Cases, 2020 · DOI: https://doi.org/10.1038/s41394-020-0272-y · Published: March 11, 2020

Spinal Cord Injury Rehabilitation Public Health

Simple Explanation

This case series highlights the challenges of caring for international refugees with SCI. The care offered to these individuals highlights the beneﬁts that an interdisciplinary SCI rehabilitation approach can provide to comprehensively care for this vulnerable population. The standard interdisciplinary rehabilitation approach offered to this cohort had to be tailored to meet their unique needs. The rehabilitation team’s main goals were to help these men acquire basic education about their injuries, to establish appropriate medical care and to prevent secondary medical complications. All team members battled language, cultural, and educational barriers. Even with the existence of a strong institutional interpreter system, team members struggled with needing longer encounters to account for interpretation time and at times, having to rely on telephone interpreters, which can make hands-on bowel and bladder education and training more difﬁcult.

Study Duration

Not specified

Participants

Six refugees with SCI

Evidence Level

Case series

Key Findings

1
Language, cultural, and educational barriers significantly impacted the delivery of standard rehabilitation care.
2
Many refugees focused on curative treatments, making it challenging to manage expectations and educate them about chronic SCI rehabilitation.
3
Limited resources, including therapy and equipment benefits, affected the provision of rehabilitation care.

Research Summary

This case series showcases the challenges of caring for international refugees with SCI. Through proactive communication and inter-disciplinary care, we succeeded in helping these individuals achieve improved functional mobility, acquire appropriate adaptive equipment, and gain greater independence with self-care including improved bowel and bladder management. There are myriad challenges that arose in assuming the care of refugees with SCI who resettled in the USA, the greatest of which included language and cultural barriers, ﬁnancial limitations and managing expectations for curative treatments.

Practical Implications

Culturally Specific Peer Support

Offering culturally-specific peer support may aid in adjustment to disability and goal setting.

Comprehensive Case Management

Adding comprehensive case management can help refugees navigate the healthcare system.

Provider Education

Ongoing education for other specialties is needed to highlight the role of Rehabilitation Medicine in refugee care.

Study Limitations

1
Small sample size of six refugees.
2
Lack of a control group for comparison.
3
Limited generalizability due to the specific context of the rehabilitation clinic.

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