Prevalence of and factors associated with expressed and unmet service needs reported by persons with spinal cord injury living in the community

Abstract

Study design

Observational study.

Objectives

To determine the prevalence, predictors, and consequences of self-reported service needs among community-dwelling persons with SCI.

Setting

Community-based, Switzerland.

Methods

Participants were 490 people who took part in the health services module of the Swiss Spinal Cord Injury Cohort Study (SwiSCI) 2012 community survey. We determined the prevalence of 20 service needs and the extent to which they were unmet. Predictors and consequences of service needs were examined with multiple regression analyses.

Results

High-prevalence needs (e.g., general health care, accessible housing) exhibited a high level of fulfillment. Conversely, less prevalent service needs (e.g., peer support, support for family caregivers) showed lower levels of fulfillment. Across three specific service domains (peer support, support for family caregivers, sports activities), lower household income predicted most consistently a higher likelihood of unmet needs. The total number of expressed needs was higher in non-Swiss nationals, persons with complete para- or tetraplegia and lower income individuals. Being female, French language region and lower household income predicted more total unmet needs. Increased expressed and unmet service needs were associated with lower life satisfaction.

Conclusions

Service needs with a high prevalence seem to be adequately met by the current service provision system. However, rehabilitation professionals should remain alert to clients’ specific and cumulative unmet needs, in particular with respect to less common ones, and their impact on successful community reintegration and life satisfaction.

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Acknowledgements

We are grateful to all the participants of the SwiSCI survey for their time and effort spent in responding to the questions. We further thank the personnel of the SwiSCI study center and the SwiSCI Steering Committee whose members are: Xavier Jordan, Bertrand Léger (Clinique Romande de Réadaptation, Sion); Michael Baumberger, Hans Peter Gmünder (Swiss Paraplegic Center, Nottwil); Armin Curt, Martin Schubert (University Clinic Balgrist, Zürich); Margret Hund-Georgiadis, Kerstin Hug (REHAB Basel, Basel); Thomas Troger (Swiss Paraplegic Association, Nottwil); Daniel Joggi (Swiss Paraplegic Foundation, Nottwil); Hardy Landolt (Representative of persons with SCI, Glarus); Nadja Münzel (Parahelp, Nottwil); Mirjam Brach, Gerold Stucki (Swiss Paraplegic Research, Nottwil); Christine Fekete (SwiSCI Coordination Group at Swiss Paraplegic Research, Nottwil).

Funding

The study was financed in the framework of the Swiss Spinal Cord Injury Cohort Study (SwiSCI, www.swisci.ch), supported by the Swiss Paraplegic Foundation.

Author contributions

BT, MB, and MP designed the study. BT conducted the data analysis and prepared the article. AG, MB and MP contributed to the data interpretation and article preparation.

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Correspondence to Bruno Trezzini.

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The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the ethics committees of the four Swiss cantons with SCI-specialized centers (Lucerne, Zurich, Basel-Stadt and Valais) [18].

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Trezzini, B., Brach, M., Post, M. et al. Prevalence of and factors associated with expressed and unmet service needs reported by persons with spinal cord injury living in the community. Spinal Cord 57, 490–500 (2019). https://doi.org/10.1038/s41393-019-0243-y

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