DOES THE LEVEL AND SEVERITY OF INJURY AFFECT PATIENT SATISFACTION IN PATIENTS WITH CHRONIC SPINAL CORD INJURY UNDERGOING INPATIENT REHABILITATION ?

Abstract

OBJECTIVE: This study aimed to investigate whether the level of satisfaction differed regarding the level and severity of injury in patients with chronic spinal cord injury (SCI) treated on an in-patient setting and whether patients with different satisfaction levels had distinct functional independence and health related quality of life (HRQoL) measures.MATERIAL AND METHODS: The SCI level (cervical, thoracic, lumbosacral) of the patients was recorded, and the severity of SCI (incomplete,complete) was determined according to the American Spinal Cord Injury Association (ASIA) Impairment Scale. The degree of functional independence of the patients was determined using the Functional Independence Measure (FIM) motor score. HRQoL was assessed using the Short Form-36 (SF-36). Satisfaction was assessed using a questionnaire instituted to evaluate patient satisfaction. Satisfaction with the physician, nurse, physiotherapist, catering, cleaning service, technical equipment categories and the overall satisfaction were questioned and satisfaction levels were determined as ”very satisfied, satisfied, dissatisfied, very dissatisfied”.RESULTS: 84 patients with chronic SCI were included in this cross-sectional study. Regarding the level of SCI, 19 patients had cervical (mean age:36.3±14.5, 78.9% male), 52 had thoracic (mean age: 32.1±13.6, 61.5% male), 13 had lumbosacral SCI (mean age: 38.8±20, 61.5% male). Regarding the severity of SCI, 36 patients had complete (mean age: 34±13, 77.7% male), 48 had incomplete (mean age: 35±15, 56.2% male) injury. There was no significant difference between cervical, thoracic and lumbosacral SCI groups in satisfaction categories. However, when the groups were compared in regard to the severity of SCI, patients with incomplete SCI had higher rates for satisfaction with the physician and technical equipment (p=0.03 and p=0.02, respectively). No significant difference was found in the other categories. Regarding the overall satisfaction, there was no significant difference in HRQoL and functional independence of the patients grouped according to their satisfaction levels.CONCLUSIONS:Patients with incomplete SCI had higher satisfaction level with the physician and technical equipment. Although characteristics of injury are distinct, if the expectations are met similar satisfaction rates may be obtained in patients with chronic SCI. More comprehensive studies are needed in terms of other patient-related variables that affect patient satisfaction.