Article

OBJECTIVES: To identify from whom individuals with spinal cord injury (SCI) seek
health care, the percentage who receive preventative care screenings, and the
frequency and types of barriers they encounter when accessing primary and
specialty care services; and to examine how sociodemographic factors affect
access to care and receipt of preventative screenings.
DESIGN: Cross-sectional,
observational study using an Internet-based survey. SETTING: Internet based.
PARTICIPANTS: Adults (N=108) with SCI who use a wheelchair as their primary means
of mobility in the community. INTERVENTIONS: Not applicable. MAIN OUTCOME
MEASURES: Health care utilization during the past year, barriers encountered when
accessing health care facilities, and receipt of routine care and preventative
screenings. RESULTS: All but 1 participant had visited a primary care provider
within the past 12 months, and 85% had had >/= 1 visit to specialty care
providers. Accessibility barriers were encountered during both primary care
(91.1%) and specialty care (80.2%) visits; most barriers were clustered in the
examination room. The most prevalent barriers were inaccessible examination
tables (primary care=76.9%; specialty care=51.4%) and lack of transfer aids
(primary care=69.4%; specialty care=60.8%). Most participants had not been
weighed during their visit (89%) and had remained seated in their wheelchair
during their examinations (85.2%). Over one third of individuals aged >/= 50
years had not received a screening colonoscopy, 60% of women aged >/= 50 years
had not had a mammogram within the past year, 39.58% of women had not received a
Papanicolaou smear within the previous 3 years, and only 45.37% of respondents
had ever received bone density testing. CONCLUSIONS: Individuals with SCI face
remediable obstacles to care and receive fewer preventative care screenings than
their nondisabled counterparts. We recommend that clinics conduct Americans with
Disabilities Act self-assessments, ensure that their clinical staff are properly
trained in assisting individuals with mobility disabilities, and take a proactive
approach in discussing preventative care screenings with their patients who have
SCI.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS