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      Isolated and anxious: A qualitative exploration of the impact of the COVID-19 pandemic on individuals living with spinal cord injury in the UK

      research-article
      1 , 2 , 3
      The Journal of Spinal Cord Medicine
      Taylor & Francis
      SCI, COVID-19, Pandemic, Infection, Isolation, Thematic analysis

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          Abstract

          Objective

          People living with spinal cord injury (SCI) are often immunocompromised, and at increased risk of respiratory infection. Given the restrictions in response to the COVID-19 pandemic, those with SCI may be at increased risk of health deterioration, though how this is experienced is poorly understood. This study explored the experiences of people living with SCI during the COVID-19 pandemic.

          Design

          Participants completed an online survey consisting of demographic questions, and open-ended qualitative questions pertaining to their experiences during the pandemic. Thematic analysis was utilized for the analytical approach.

          Setting

          Community-based sample in the UK.

          Participants

          Participants were recruited via social media outlets of UK-based SCI-specific support charities, and snowball sampling ( N = 42, F = 34, M = 8).

          Results

          Key themes included: (1) lost access to health services and support, capturing concerns surrounding barriers to healthcare and rehabilitation, which intensified secondary consequences of SCI such as spasm and pain; (2) health anxiety, which was perpetuated by perceived heightened vulnerabilities to respiratory complications; (3) social isolation, with significantly reduced social contact, even with care providers, compounding health experiences.

          Conclusion

          People living with SCI during the COVID-19 pandemic experienced a variety of personal physical, psychological, and social challenges, each of which could disrupt daily functioning and quality of life. Increased utilization of telehealth is recommended to support continued engagement in rehabilitation, and foster connection and community amongst others with SCI and health professionals.

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          Most cited references19

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          Reflecting on reflexive thematic analysis

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            The online survey as a qualitative research tool

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              Adverse effects of isolation in hospitalised patients: a systematic review

              Summary The use of transmission precautions such as contact isolation in patients known to be colonised or infected with multidrug-resistant organisms is recommended in healthcare institutions. Although essential for infection control, contact isolation has recently been associated with adverse effects in patients. We undertook a systematic review to determine whether contact isolation leads to psychological or physical problems for patients. Studies were included if (1) hospitalised patients were placed under isolation precautions for an underlying medical indication, and (2) any adverse events related to the isolation were evaluated. We found 16 studies that reported data regarding the impact of isolation on patient mental well-being, patient satisfaction, patient safety or time spent by healthcare workers in direct patient care. The majority showed a negative impact on patient mental well-being and behaviour, including higher scores for depression, anxiety and anger among isolated patients. A few studies also found that healthcare workers spent less time with patients in isolation. Patient satisfaction was adversely affected by isolation if patients were kept uninformed of their healthcare. Patient safety was also negatively affected, leading to an eight-fold increase in adverse events related to supportive care failures. We found that contact isolation may negatively impact several dimensions of patient care. Well-validated tools are necessary to investigate these results further. Large studies examining a number of safety indicators to assess the adverse effects of isolation are needed. Patient education may be an important step to mitigate the adverse psychological effects of isolation and is recommended.
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                Author and article information

                Journal
                J Spinal Cord Med
                J Spinal Cord Med
                The Journal of Spinal Cord Medicine
                Taylor & Francis
                1079-0268
                2045-7723
                22 July 2021
                2022
                22 July 2021
                : 45
                : 5
                : 691-699
                Affiliations
                [1 ]The Department of Psychology, Manchester Metropolitan University , Manchester, UK
                [2 ]The Department of Interdisciplinary Health Sciences, Oakland University , Rochester, Michigan, USA
                [3 ]The Department of Rehabilitation Medicine, University of Minnesota Medical School , Minneapolis, Minnesota, USA
                Author notes
                Correspondence to: Jasmine Heath Hearn, Department of Psychology, Manchester Metropolitan University , Bonsall Street, Manchester M15 6GX, UK. Email: j.hearn@ 123456mmu.ac.uk
                Author information
                https://orcid.org/0000-0001-5988-5278
                https://orcid.org/0000-0002-6092-2301
                https://orcid.org/0000-0002-5207-0452
                Article
                1949562
                10.1080/10790268.2021.1949562
                9542803
                34292136
                c701400f-c3d8-40c7-b106-c8e9b7cffbc3
                © 2021 The Author(s). Published with license by Taylor & Francis Group, LLC

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License ( http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.

                History
                Page count
                Figures: 0, Tables: 3, Equations: 0, References: 22, Pages: 9
                Categories
                Research Articles
                Research Article

                Neurology
                sci,covid-19,pandemic,infection,isolation,thematic analysis
                Neurology
                sci, covid-19, pandemic, infection, isolation, thematic analysis

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