OBJECTIVES:To test the reliability and validity of a physical activity instrument adapted for individuals with spinal cord injuries (SCI), the Physical Activity Instrument-SCI (PAI-SCI).METHODS:Eligible participants completed the adapted PAI-SCI questionnaire at baseline and 1 week later. At baseline, they were also given an Actical accelerometer to wear on their wrist for 1 week.RESULTS:Forty-three male subjects completed the study. There was a moderate relationship between total score on the PAI-SCI and total activity count determined by accelerometry (r = 0.42, P = 0.036). The PAI-SCI was able to differentiate between people with upper and lower level injuries (P = 0.05). Test-retest reliability was supported for the exercise and the general activity/self care subscales and not supported for the light household or the outdoor/gardening subscales.CONCLUSION:The PAI-SCI was able to distinguish between physical activity amongst those with upper level and lower level injuries. More research is needed before the PAI-SCI can be recommended for use in clinical trials.
A pre-test, post-test study was used to evaluate outcomes of implementing the ThinkFirst For Teens program to students at three Chicago suburban high schools. Results showed an increase in knowledge related to potential for injury and the importance of safety belt use, bicycle helmet use, avoiding violence, driving sober and generally making safe choices. An increase in coinciding stated safe behavior choices was also seen. Sixty-seven percent of students stated they were most influenced to make safe choices by hearing from someone who had been injured, while 26% were influenced by facts on injury prevention and 7% were influenced by the potential for being ticketed. A qualitative posttest was administered three months later that determined lasting positive impact. Background of the Problem There are three common statements used when teaching injury prevention: 1) Injury is the leading cause of death for ages 1 through 44. 2) Teens and young adults, age 15-24 are in the highest risk group for injuries. 3) Most of these injuries are preventable.
Bladder and bowel management can be one of the most challenging aspects of daily life after spinal cord injury (SCI). Children are especially unique due to their ever-changing growth and developmental considerations. Continence is crucial for children who are still developing self-confidence and self-esteem. Proper bladder and bowel management can impact long-term health and well-being and can also affect quality of life. Providing education and implementation of bladder and bowel management programs are essential for children with SCI. This article will provide a general overview of common bladder and bowel management options for children with SCI. Age-appropriate expectations will be described, as well as patient and family educational strategies, to promote independence when implementing bladder and bowel programs.
Publishing in SCI Nursing is a rewarding experience in terms of professional growth and contributing to the body of knowledge of SCI nurses. "Guidelines for Contributors" are on the back, inside cover of each issue of SCI Nursing and on the AASCIN Web site. Collaborate with nursing colleagues, or interdisciplinary team members, to begin your manuscript today.
The importance of family involvement in spinal cord injury (SCI) rehabilitation is well-documented, but little is known about the needs of children in these families. This study surveyed persons with SCI at a national rehabilitation center to establish the number who had close relatives who were children, gain their views on facilities available for visiting children, and determine the impact of SCI on children. Thirty-two inpatients provided details of any close relatives who were children, and 17 participants supplied further information in a semi-structured interview. Twenty-six participants (81%) had close relatives under age 18, for a total of 88 children. Most children had visited participants at the centre, but levels of satisfaction with facilities were low. Participants also commented on children's understanding of SCI and coping strategies. The results suggest that rehabilitation teams could consider children's needs more fully, provide appropriate physical facilities, and facilitate understanding and emotional adjustment of children.
Women have had their share of difficulties climbing the corporate ladder in their chosen professional roles. Excellent role models exist for nurses to look up to as role models for leadership and executive level positions. Nurses and women must strive to achieve their goals of attaining executive/management level positions in their respective organizations. The glass ceiling still exists; however, women are slowly eroding that glass barrier and reaching their professional goals. In reviewing the struggles that men in nursing have encountered in a predominantly female profession, one realizes that stereotypical attitudes do cross gender lines. The authors conclude that executive level positions need to be opened more to women, just as the nursing profession must be more welcoming to men. The profession of nursing will only become stronger with gender diversity. Women encounter barriers when aspiring to executive level positions. In the next issue of SCI Nursing, the authors will report on what the evidence says about women in leadership roles, and the challenges they have and will continue to face.
While clinical practice guidelines (CPGs) were designed as a tool to improve patient outcomes, decrease practice variation, and optimize resource utilization, providers often encounter significant barriers to integrating these into clinical practice. A study was conducted at six spinal cord injury (SCI) centers in the Department of Veterans Affairs (VA) to improve provider adherence and patient outcomes of two CPGs: Prevention of Thromboembolism in Spinal Cord Injury and Neurogenic Bowel Management in Adults With Spinal Cord Injury. To design effective implementation strategies, focus groups were conducted to identify provider-perceived barriers and facilitators to implementing recommendations for each of the SCI guidelines. Based on this information, four guideline implementation strategies were designed: (a) use of local opinion leaders ("clinical champions"), (b) patient-mediated interventions, (c) standardized documentation template/standing orders, and (d) social marketing/outreach visits. These strategies were implemented at each site. This article identifies "lessons learned" during the process of trying to get these CPGs embedded into clinical practice.
This article presents "lessons learned" about using a computerized clinical reminder (CCR) for influenza in spinal cord injury (SCI) centers in the Veterans Health Administration (VHA). Although research has shown that use of a CCR increases adherence to preventive care measures, technical and administrative issues affect its use by nurses. CCR is a term for a reminder in a patient's electronic medical record to initiate a preventive care activity. Qualitative data about using the CCR for influenza were collected from staff using semi-structured interviews, e-mail questionnaires, and telephone calls. Once issues were identified, follow-up activities included discussions with local and national experts and problem-solving activities. The investigators identified two national issues about the CCR for influenza: the taxonomy to identify patients with SCI, and the "due date" for influenza vaccine. Local issues included authorization for nurses to use the CCR, ease of use of the CCR for inpatients and outpatients, connectivity of the medication tracking program for inpatients with the electronic medical record, configuration of the CCR in the electronic medical record, training, and technical support.
