Starting a new conversation: Engaging Veterans with spinal cord injury in discussions of what function means to them, the barriers/facilitators they encounter, and the adaptations they use to optimize function

Jennifer N. Hill; Salva Balbale; Keshonna Lones; Sherri L. LaVela

doi:10.1016/j.dhjo.2016.05.012

Starting a new conversation: Engaging Veterans with spinal cord injury in discussions of what function means to them, the barriers/facilitators they encounter, and the adaptations they use to optimize function

Jennifer N. Hill^*, Salva Balbale, Keshonna Lones, Sherri L. LaVela

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

11 Scopus citations

Abstract

Background Assessments of function in persons with spinal cord injury (SCI) often utilize pre-defined constructs and measures without consideration of patient context, including how patients define function and what matters to them. Objectives/hypothesis We utilized photovoice to understand how individuals define function, facilitators and barriers to function, and adaptations to support functioning. Methods Veterans with SCI were provided with cameras and guidelines to take photographs of things that: (1) help with functioning, (2) are barriers to function, and (3) represent adaptations used to support functioning. Interviews to discuss photographs followed and were audio-recorded, transcribed, and analyzed using grounded-thematic coding. Nvivo 8 was used to store and organize data. Results Participants (n = 9) were male (89%), Caucasian (67%), had paraplegia (75%), averaged 64 years of age, and were injured, on average, for 22 years. Function was described in several ways: the concept of ‘normalcy,’ aspects of daily living, and ability to be independent. Facilitators included: helpful tools, physical therapy/therapists, transportation, and caregivers. Barriers included: wheelchair-related issues and interior/exterior barriers both in the community and in the hospital. Examples of adaptations included: traditional examples like ramps, and also creative examples like the use of rubber bands on a can to help with grip. Conclusion(s) Patient-perspectives elicited in-depth information that expanded the common definition of function by highlighting the concept of “normality,” facilitators and barriers to function, and adaptations to optimize function. These insights emphasize function within a patient-context, emphasizing a holistic definition of function that can be used to develop personalized, patient-driven care plans.

Original language	English (US)
Pages (from-to)	114-122
Number of pages	9
Journal	Disability and Health Journal
Volume	10
Issue number	1
DOIs	https://doi.org/10.1016/j.dhjo.2016.05.012
State	Published - Jan 1 2017

Funding

Sources of support: This study was funded the Department of Veterans Affairs HSR&D , QUERI study RRP 13-248 , PI: LaVela. The views expressed in this presentation are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.

Keywords

Function
Photovoice
Spinal cord injury

ASJC Scopus subject areas

Public Health, Environmental and Occupational Health

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10.1016/j.dhjo.2016.05.012

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title = "Starting a new conversation: Engaging Veterans with spinal cord injury in discussions of what function means to them, the barriers/facilitators they encounter, and the adaptations they use to optimize function",

abstract = "Background Assessments of function in persons with spinal cord injury (SCI) often utilize pre-defined constructs and measures without consideration of patient context, including how patients define function and what matters to them. Objectives/hypothesis We utilized photovoice to understand how individuals define function, facilitators and barriers to function, and adaptations to support functioning. Methods Veterans with SCI were provided with cameras and guidelines to take photographs of things that: (1) help with functioning, (2) are barriers to function, and (3) represent adaptations used to support functioning. Interviews to discuss photographs followed and were audio-recorded, transcribed, and analyzed using grounded-thematic coding. Nvivo 8 was used to store and organize data. Results Participants (n = 9) were male (89%), Caucasian (67%), had paraplegia (75%), averaged 64 years of age, and were injured, on average, for 22 years. Function was described in several ways: the concept of {\textquoteleft}normalcy,{\textquoteright} aspects of daily living, and ability to be independent. Facilitators included: helpful tools, physical therapy/therapists, transportation, and caregivers. Barriers included: wheelchair-related issues and interior/exterior barriers both in the community and in the hospital. Examples of adaptations included: traditional examples like ramps, and also creative examples like the use of rubber bands on a can to help with grip. Conclusion(s) Patient-perspectives elicited in-depth information that expanded the common definition of function by highlighting the concept of “normality,” facilitators and barriers to function, and adaptations to optimize function. These insights emphasize function within a patient-context, emphasizing a holistic definition of function that can be used to develop personalized, patient-driven care plans.",

keywords = "Function, Photovoice, Spinal cord injury",

author = "Hill, {Jennifer N.} and Salva Balbale and Keshonna Lones and LaVela, {Sherri L.}",

note = "Funding Information: Sources of support: This study was funded the Department of Veterans Affairs HSR&D , QUERI study RRP 13-248 , PI: LaVela. The views expressed in this presentation are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government. Publisher Copyright: {\textcopyright} 2016",

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Starting a new conversation: Engaging Veterans with spinal cord injury in discussions of what function means to them, the barriers/facilitators they encounter, and the adaptations they use to optimize function. / Hill, Jennifer N.; Balbale, Salva; Lones, Keshonna et al.
In: Disability and Health Journal, Vol. 10, No. 1, 01.01.2017, p. 114-122.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

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T2 - Engaging Veterans with spinal cord injury in discussions of what function means to them, the barriers/facilitators they encounter, and the adaptations they use to optimize function

AU - Hill, Jennifer N.

AU - Balbale, Salva

AU - Lones, Keshonna

AU - LaVela, Sherri L.

N1 - Funding Information: Sources of support: This study was funded the Department of Veterans Affairs HSR&D , QUERI study RRP 13-248 , PI: LaVela. The views expressed in this presentation are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government. Publisher Copyright: © 2016

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background Assessments of function in persons with spinal cord injury (SCI) often utilize pre-defined constructs and measures without consideration of patient context, including how patients define function and what matters to them. Objectives/hypothesis We utilized photovoice to understand how individuals define function, facilitators and barriers to function, and adaptations to support functioning. Methods Veterans with SCI were provided with cameras and guidelines to take photographs of things that: (1) help with functioning, (2) are barriers to function, and (3) represent adaptations used to support functioning. Interviews to discuss photographs followed and were audio-recorded, transcribed, and analyzed using grounded-thematic coding. Nvivo 8 was used to store and organize data. Results Participants (n = 9) were male (89%), Caucasian (67%), had paraplegia (75%), averaged 64 years of age, and were injured, on average, for 22 years. Function was described in several ways: the concept of ‘normalcy,’ aspects of daily living, and ability to be independent. Facilitators included: helpful tools, physical therapy/therapists, transportation, and caregivers. Barriers included: wheelchair-related issues and interior/exterior barriers both in the community and in the hospital. Examples of adaptations included: traditional examples like ramps, and also creative examples like the use of rubber bands on a can to help with grip. Conclusion(s) Patient-perspectives elicited in-depth information that expanded the common definition of function by highlighting the concept of “normality,” facilitators and barriers to function, and adaptations to optimize function. These insights emphasize function within a patient-context, emphasizing a holistic definition of function that can be used to develop personalized, patient-driven care plans.

AB - Background Assessments of function in persons with spinal cord injury (SCI) often utilize pre-defined constructs and measures without consideration of patient context, including how patients define function and what matters to them. Objectives/hypothesis We utilized photovoice to understand how individuals define function, facilitators and barriers to function, and adaptations to support functioning. Methods Veterans with SCI were provided with cameras and guidelines to take photographs of things that: (1) help with functioning, (2) are barriers to function, and (3) represent adaptations used to support functioning. Interviews to discuss photographs followed and were audio-recorded, transcribed, and analyzed using grounded-thematic coding. Nvivo 8 was used to store and organize data. Results Participants (n = 9) were male (89%), Caucasian (67%), had paraplegia (75%), averaged 64 years of age, and were injured, on average, for 22 years. Function was described in several ways: the concept of ‘normalcy,’ aspects of daily living, and ability to be independent. Facilitators included: helpful tools, physical therapy/therapists, transportation, and caregivers. Barriers included: wheelchair-related issues and interior/exterior barriers both in the community and in the hospital. Examples of adaptations included: traditional examples like ramps, and also creative examples like the use of rubber bands on a can to help with grip. Conclusion(s) Patient-perspectives elicited in-depth information that expanded the common definition of function by highlighting the concept of “normality,” facilitators and barriers to function, and adaptations to optimize function. These insights emphasize function within a patient-context, emphasizing a holistic definition of function that can be used to develop personalized, patient-driven care plans.

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KW - Photovoice

KW - Spinal cord injury

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Starting a new conversation: Engaging Veterans with spinal cord injury in discussions of what function means to them, the barriers/facilitators they encounter, and the adaptations they use to optimize function

Abstract

Funding

Keywords

ASJC Scopus subject areas

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