Effects of Adaptations in an Interdisciplinary Follow-Up Clinic for People with Spinal Cord Injury in the Chronic Phase: A Prospective Cohort Study

Abstract

People with spinal cord injury (SCI) often experience secondary health conditions (SHCs), which are addressed during interdisciplinary follow-up clinics. We adapted the design of our clinic, by introducing a questionnaire concerning functioning and SHCs, additional measurements of blood pressure and saturation, and participants were seen by either a specialized nurse or rehabilitation physician. In this study, we investigated the effects of these adaptations and the experienced satisfaction of the participants. The results showed an increased number of recommendations in the adapted design, compared to the initial design. Further, the nature of the recommendations shifted from somatic issues to recommendations regarding psychosocial functioning and regarding (the use of) devices. The added measurements revealed an average high systolic blood pressure, which led to more referrals to the general practitioner. The clinical weight and pulmonary functions stayed stable over time. The current adaptations in design expanded and optimized the number and nature of recommendations regarding SHCs to participants. The questionnaire helps the participant to prepare for the clinic and the professionals to tailor their recommendations, resulting in highly satisfied participants.

Keywords: ambulatory care; follow-up care; interdisciplinary; prevention; secondary health conditions; spinal cord injuries.

Figure 1

Total number of recommendations in four domains given in both designs of the follow-up clinic. (N = 139, * p < 0.001 according to a paired samples t-test).

Figure 2

Proportions (%) of scorings on the separate questions of the Spinal Cord Injury Secondary Condition Scale. N = 176. Abbreviations: SCI-SCS, Spinal cord injury secondary condition scale. # N = 103 because the questions were added later.