Strengthening health systems for persons with traumatic spinal cord injury in South Africa and Sweden: a protocol for a longitudinal study of processes and outcomes

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dc.contributor.authorConradsson, David
dc.contributor.authorRhoda, Anthea
dc.contributor.authorMlenzana, Nondwe
dc.contributor.authorWikmar, Lena Nilsson
dc.contributor.authorWahman, Kerstin
dc.contributor.authorHultling, Claes
dc.contributor.authorJoseph, Conran
dc.date.accessioned2018-07-13T09:34:19Z
dc.date.available2018-07-13T09:34:19Z
dc.date.issued2018
dc.description.abstractBACKGROUND: The provision of specialized care in a time-sensitive manner has shown to be crucial for survival and recovery of functioning after a traumatic spinal cord injury (TSCI). However, little is known about the provision of TSCI care in different international contexts; information which is required for strengthening policy and practice. AIMS: The overarching aim of this study will be to explore health care processes and outcomes of TSCI care in South Africa and Sweden. Specific aims will be to: (1) describe acute processes of TSCI care, (2) determine acute- and long-term outcomes of TSCI care, and (3) identify predictors for survival, secondary complications, and functioning 12 months post-injury. METHODS: A prospective (regional), population-based cohort study where adults with an acute TSCI will be recruited over at least a 1-year period from the City of Cape Town, South Africa, and Stockholm, Sweden. The anticipated sample size inclusive of both international contexts will be 200 participants—based on a power calculation for detecting differences in mortality. Information on the nature and timing of processes of acute care (e.g., transfer logistics, spinal surgery, and specialized SCI care) will be collected on acute care admission and discharge using a standardized form. Survival status, secondary complications, neurological symptoms, functional status, activity, and participation as well as health-related quality of life will be collected at discharge from SCI acute care and at 12-months post-injury. Secondary complications and functioning will be compared between South Africa and Sweden using inferential statistics. To address mortality specifically, the indirect standardization method for differences in mortality between contexts will be used whereby Stockholm will serve as standard for specialize care. For the assessment of factors related to mortality and other outcomes (e.g., neurological and secondary health conditions) multivariate regression analyses will be used to determine independent risk factors.CONCLUSION: This study offers a unique investigation of the relationship between health care processes and outcomes of TSCI care with the aim of strengthening management guidelines for SCI in South Africa and Sweden.en_US
dc.identifier.citationConradsson, D. et al. (2018). Strengthening health systems for persons with traumatic spinal cord injury in South Africa and Sweden: a protocol for a longitudinal study of processes and outcomes. Frontiers in Neurology, 9:453.en_US
dc.identifier.issn1664-2295
dc.identifier.urihttp://dx.doi.org/10.3389/fneur.2018.00453
dc.identifier.urihttp://hdl.handle.net/10566/3883
dc.language.isoenen_US
dc.privacy.showsubmitterFALSE
dc.publisherFrontiers Mediaen_US
dc.rightsCopyright © 2018 Conradsson, Rhoda, Mlenzana, Nilsson Wikmar, Wahman, Hultling and Joseph. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
dc.status.ispeerreviewedTRUE
dc.subjectTraumatic spinal cord injuryen_US
dc.subjectSpecialized careen_US
dc.subjectHealth systemsen_US
dc.subjectAcute careen_US
dc.subjectOutcomesen_US
dc.subjectSouth Africaen_US
dc.subjectSwedenen_US
dc.titleStrengthening health systems for persons with traumatic spinal cord injury in South Africa and Sweden: a protocol for a longitudinal study of processes and outcomesen_US
dc.typeArticleen_US

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