Evidence based recommendations for health professionals to improve care of people with spinal cord injury and cognitive impairment: an update to the psychosocial care practice guide
摘要
Guidelines update.
ObjectivesTo provide management recommendations and strategies for cognitive impairment (CI) in people with spinal cord injury (SCI) for healthcare professionals (HCPs).
SettingSCI Units, NSW, Australia.
MethodsThe development encompassed multiple stages, commencing with establishment of the multidisciplinary advisory committee, followed by expert consultations. A rapid review and e-Delphi surveys were undertaken for the seven identified themes to achieve consensus for a new section on CI in an existing psychosocial guide. The intended primary end-user for this guide consists of the HCPs providing treatment to people with SCI in the acute, rehabilitation, and community settings. The secondary end-user includes consumer organisations, health planners, and policy makers.
ResultsThe expert consultation resulted in developing seven key themes to provide a foundational structure to the guidance about CI. For the first round of the Delphi survey, 40 (out of 49) statements received agreement levels exceeding 95% and were accepted without revisions. In the second round, two statements were deleted, and seven statements were amended based on the feedback received. After the final round, a total of 47 statements were accepted and formed 20 recommendations under seven themes as the final version of the cognitive guide.
ConclusionThis updated guidance for managing CI in people with SCI emphasises the importance of person-centred care and the identification of barriers and facilitators for improved communication between the multidisciplinary HCPs and patients with SCI and their family members. This will ultimately enhance overall rehabilitation outcomes including self-efficacy, adjustment, and quality of life.