Identification of activities critical to examine the need for personal attendant care for individuals with spinal cord injury.

摘要

The purpose of this study was to determine the necessary items and constructs to be included in a measure of personal attendant care (PAC) for individuals with spinal cord injuries (SCI). Currently, there are between 219,000 and 279,000 individuals with SCI in the United States. Approximately half of those individuals require some type of personal assistance with daily care. Attendant care can include personal assistance, domestic services, community services, home nursing, home maintenance, childcare services, educational support and respite care. The Functional Independence Measure (FIM) has most often been selected as the instrument of choice to predict the total PAC needs of individuals with SCI. While the FIM has been shown to be effective in predicting activities of daily living (ADL) of individuals with neurological conditions, rehabilitation professionals tend to use this assessment to predict the entire range of attendant care for individuals with SCI. This research was intended to identify a full range of activities that should be included in a comprehensive assessment of PAC needs. Using the Delphi method, 25 life care planners, experienced in determining PAC services identified specific activities to be considered when assessing the need for PAC. Additionally, qualitative interviews were conducted with veterans with SCI to understand their perspective regarding the activities that should be considered when making PAC recommendations. The study resulted in 191 activities to be considered by professionals when recommending PAC services. These results covered a wide range of activities relating to ADL's, home/yard maintenance, employment, education, and hobbies/leisure. Implications for future development of comprehensive measures of PAC needs were discussed as well as the impact of this research on public policy and clinical practice.