Xiaoping Su, Qian Liu, Jiawen Wang, Jiangyan Song, Xiangxiang Tang
{"title":"脊髓损伤康复开始后的前6个月患者激活:一项队列研究。","authors":"Xiaoping Su, Qian Liu, Jiawen Wang, Jiangyan Song, Xiangxiang Tang","doi":"10.23736/S1973-9087.25.08758-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Spinal cord injury (SCI) is a serious injury that leads to motor and sensory disorders and ultimately affects people's physiological, psychological, and social well-being.</p><p><strong>Aim: </strong>To test patient activation from discharge from the department of spinal surgery until 6-month follow-up.</p><p><strong>Design: </strong>Longitudinal inception cohort study.</p><p><strong>Setting: </strong>This study was conducted at the Spinal Surgery Department of the Third Affiliated Hospital of Soochow University in China.</p><p><strong>Population: </strong>A total of 367 participants with traumatic SCI received community-based or hospital-based rehabilitation between October 2020 and November 2023 and were recruited using convenience sampling.</p><p><strong>Methods: </strong>Patient activation was evaluated using the short version of the Patient Activation Measure (PAM). Assessments were conducted at baseline, 3-month, and 6-month follow-up.</p><p><strong>Results: </strong>At baseline, the mean PAM score was 53.2, with the number of participants in PAM levels 1, 2, 3, and 4 being 92, 142, 114, and 19, respectively. Between baseline and 6-month, 164 participants remained at the same PAM level, 85 participants increased, 86 participants decreased. The multivariate mixed-effects model analysis showed that the PAM score decreased significantly over time (P=0.007). Older age had a positive effect on improvement over time (P=0.023). Higher self-efficacy, resilience, health literacy, and Modified Barthel Index (MBI) remained significantly related with higher PAM scores over time (P<0.001, P<0.001, P<0.001, and P=0.010, respectively). Fewer symptoms of depression remained significantly related with higher PAM scores over time (P<0.001).</p><p><strong>Conclusions: </strong>PAM scores decreased slightly over time from the start of rehabilitation up to the 6-month follow-up. Furthermore, about two-third of participants remained at low levels of patient activation, which suggests that patient-centered care interventions during rehabilitation to improve patient activation might be of value.</p><p><strong>Clinical rehabilitation impact: </strong>This study examined the course of patient activation from the start of SCI rehabilitation to the 6-month follow-up period. These findings provide the necessary basis for the development and evaluation of effective interventions to promote patient activation levels and enhance self-management in people with SCI.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"250-262"},"PeriodicalIF":3.4000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Patient activation during the first 6 months after the start of spinal cord injury rehabilitation: a cohort study.\",\"authors\":\"Xiaoping Su, Qian Liu, Jiawen Wang, Jiangyan Song, Xiangxiang Tang\",\"doi\":\"10.23736/S1973-9087.25.08758-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Spinal cord injury (SCI) is a serious injury that leads to motor and sensory disorders and ultimately affects people's physiological, psychological, and social well-being.</p><p><strong>Aim: </strong>To test patient activation from discharge from the department of spinal surgery until 6-month follow-up.</p><p><strong>Design: </strong>Longitudinal inception cohort study.</p><p><strong>Setting: </strong>This study was conducted at the Spinal Surgery Department of the Third Affiliated Hospital of Soochow University in China.</p><p><strong>Population: </strong>A total of 367 participants with traumatic SCI received community-based or hospital-based rehabilitation between October 2020 and November 2023 and were recruited using convenience sampling.</p><p><strong>Methods: </strong>Patient activation was evaluated using the short version of the Patient Activation Measure (PAM). Assessments were conducted at baseline, 3-month, and 6-month follow-up.</p><p><strong>Results: </strong>At baseline, the mean PAM score was 53.2, with the number of participants in PAM levels 1, 2, 3, and 4 being 92, 142, 114, and 19, respectively. Between baseline and 6-month, 164 participants remained at the same PAM level, 85 participants increased, 86 participants decreased. The multivariate mixed-effects model analysis showed that the PAM score decreased significantly over time (P=0.007). Older age had a positive effect on improvement over time (P=0.023). Higher self-efficacy, resilience, health literacy, and Modified Barthel Index (MBI) remained significantly related with higher PAM scores over time (P<0.001, P<0.001, P<0.001, and P=0.010, respectively). Fewer symptoms of depression remained significantly related with higher PAM scores over time (P<0.001).</p><p><strong>Conclusions: </strong>PAM scores decreased slightly over time from the start of rehabilitation up to the 6-month follow-up. Furthermore, about two-third of participants remained at low levels of patient activation, which suggests that patient-centered care interventions during rehabilitation to improve patient activation might be of value.</p><p><strong>Clinical rehabilitation impact: </strong>This study examined the course of patient activation from the start of SCI rehabilitation to the 6-month follow-up period. These findings provide the necessary basis for the development and evaluation of effective interventions to promote patient activation levels and enhance self-management in people with SCI.</p>\",\"PeriodicalId\":12044,\"journal\":{\"name\":\"European journal of physical and rehabilitation medicine\",\"volume\":\" \",\"pages\":\"250-262\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European journal of physical and rehabilitation medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.23736/S1973-9087.25.08758-1\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/9 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European journal of physical and rehabilitation medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.23736/S1973-9087.25.08758-1","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/9 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
Patient activation during the first 6 months after the start of spinal cord injury rehabilitation: a cohort study.
Background: Spinal cord injury (SCI) is a serious injury that leads to motor and sensory disorders and ultimately affects people's physiological, psychological, and social well-being.
Aim: To test patient activation from discharge from the department of spinal surgery until 6-month follow-up.
Design: Longitudinal inception cohort study.
Setting: This study was conducted at the Spinal Surgery Department of the Third Affiliated Hospital of Soochow University in China.
Population: A total of 367 participants with traumatic SCI received community-based or hospital-based rehabilitation between October 2020 and November 2023 and were recruited using convenience sampling.
Methods: Patient activation was evaluated using the short version of the Patient Activation Measure (PAM). Assessments were conducted at baseline, 3-month, and 6-month follow-up.
Results: At baseline, the mean PAM score was 53.2, with the number of participants in PAM levels 1, 2, 3, and 4 being 92, 142, 114, and 19, respectively. Between baseline and 6-month, 164 participants remained at the same PAM level, 85 participants increased, 86 participants decreased. The multivariate mixed-effects model analysis showed that the PAM score decreased significantly over time (P=0.007). Older age had a positive effect on improvement over time (P=0.023). Higher self-efficacy, resilience, health literacy, and Modified Barthel Index (MBI) remained significantly related with higher PAM scores over time (P<0.001, P<0.001, P<0.001, and P=0.010, respectively). Fewer symptoms of depression remained significantly related with higher PAM scores over time (P<0.001).
Conclusions: PAM scores decreased slightly over time from the start of rehabilitation up to the 6-month follow-up. Furthermore, about two-third of participants remained at low levels of patient activation, which suggests that patient-centered care interventions during rehabilitation to improve patient activation might be of value.
Clinical rehabilitation impact: This study examined the course of patient activation from the start of SCI rehabilitation to the 6-month follow-up period. These findings provide the necessary basis for the development and evaluation of effective interventions to promote patient activation levels and enhance self-management in people with SCI.