TY  - JOUR
PY  - 2024//
TI  - Community integration after spinal cord injury rehabilitation: predictors and causal mediators
JO  - Journal of spinal cord medicine
A1  - García-Rudolph, Alejandro
A1  - Cusso, Hector
A1  - Carbonell, Carola
A1  - Lopez, Sandra
A1  - Pla, Laura
A1  - Sabaté, Marina
A1  - Vazquez, Pilar
A1  - Opisso, Eloy
A1  - Hervas, Angels
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - CONTEXT/OBJECTIVE: Community integration (CI) is a crucial rehabilitation goal after spinal cord injury (SCI). There is a pressing need to enhance our understanding of the factors associated with CI for individuals with traumatic or non-traumatic etiologies, with the latter being notably understudied. Accordingly, our research explores the associations and potential mediators influencing CI across these populations. SETTING: Specialized neurological rehabilitation center. PARTICIPANTS: Community-dwelling individuals who were admitted as inpatients within 3 months post-injury (n = 431, 51.9% traumatic, 48.1% non-traumatic), assessed in relation to community integration within 1-3 years after discharge. OUTCOME MEASURE: Community Integration Questionnaire (CIQ). Covariates: American Spinal Injury Association Impairment Scale (AIS), Functional Independence Measure (FIM) and Hospital Anxiety and Depression Scale (HADS). <br><br>RESULTS: Multiple linear regression yielded age, B AIS grade, educational level (< 6 years and <12 years), time since injury to admission, length of stay, HADS-depression at discharge, total FIM at discharge and three social work interventions (support in financial, legal and transportation services) as significant predictors of total CIQ score (Adjusted R(2) = 41.4). Multiple logistic regression identified age, traumatic etiology, educational level (< 6 years and <12 years), length of stay, HADS depression at discharge, total FIM at discharge and one social work intervention (transportation support) as significant predictors of good community integration, AUC (95% CI): 0.82 (0.75-0.89), Sensitivity:0.76, Specificity:0.73. We identified motor FIM at discharge and motor FIM efficiency as causal mediators of total CIQ. <br><br>CONCLUSIONS: We identified modifiable factors during rehabilitation-functional independence, depression, and social work interventions-that are associated with CI.<p />  <p>Language: en</p>
LA  - en
SN  - 1079-0268
UR  - http://dx.doi.org/10.1080/10790268.2024.2386738
ID  - ref1
ER  -