Poster 152 Pain and Women With Spinal Cord Injury, Multiple Sclerosis, Joint Connective Tissue...
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Disclosure: None disclosed. Objectives: Psychosocial well-being, including happiness, is rarely studied in people with disabilities, despite the potential for such research to expand our understanding of the full range of functioning in the context of aging with a disability. This study aims to answer the following questions: (1) Where do people with disabilities fall on a happiness scale overall and across age groups (by disability group)? (2) How do they compare to community samples without disability? (3) What are the correlates of happiness in people aging with physical disability? Design: Cross-sectional postal survey. Setting: Commu- nity. Participants: 1862 adults (63.3% female) with muscular dystro- phy, multiple sclerosis, post-polio syndrome, or spinal cord injury. Interventions: Not applicable. Main Outcome Measure: The Sub- jective Happiness Scale (Lyubomirksy & Lepper, 1999) was used to assess happiness. The total score ranges from 1 (lowest) to 7 (highest). Results: Analyses examined levels of happiness for the total sample and for each disability condition individually across four age cohorts: 18-44, 45-64, 65-74, and 75 years. The sample’s mean happiness level varied between 5.04 (SD: 1.26) for those age 45-64 and 5.6 (SD: 1.16) for those age 65-74. Levels of happiness across different age cohorts and disability conditions were comparable to levels of happi- ness reported in other samples of adults without physical disabilities. Happiness differed significantly by disability condition and by age; older cohorts were happier than younger cohorts. Pain, vision loss, and falls were negatively correlated with happiness. Conclusions: Study- ing the full spectrum of psychosocial functioning, including happiness, may broaden our understanding of successful aging with physical disability. Key Words: Spinal cord injury; Mental health; Epidemi- ology and Outcomes research; Rehabilitation. Poster 152 Pain and Women With Spinal Cord Injury, Multiple Sclerosis, Joint Connective Tissue Disorders and Other Physical Disabilities. Heather B. Taylor (TIRR Memorial Hermann and UTHealth, Houston, TX). Disclosure: None disclosed. Objectives: To compare the frequency and severity of pain (sf-36) between women with physical disabilities and women in the US population by age group, identify correlates of pain among women with disabilities, and determine impact of pain on depression among women with disabilities. Design: Correlational using cross-sectional data. Setting: Outpatient clinics. Participants: Women (n 415) with physical disabilities. Main Outcome Measures: Bodily Pain Subscale. CESD. Results: Women with disabilities reported signifi- cantly more pain frequency and severity on the bodily pain subscale than US national norms for women regardless of age group and US norms of people with osteoarthritis and musculoskeletal problems. Correlates of pain included household income, physical functioning, employment, need for personal assistance with activities of daily living, and disability type. In multiple regression analyses, bodily pain contributed to depression above and beyond demographic and disabil- ity variables. Additional analyses, breaking pain into pain severity and pain interference indicated that pain interference contributed to de- pression above and beyond pain severity. Conclusion: Women with disabilities report significantly more pain than national norms on measures of bodily pain and may be at greater risk for depression due to pain interference. Key Words: Spinal cord injury; Physical dis- abling conditions; Health and wellness; Clinical practice; Rehabilitation. Poster 153 Factors Influencing Quality of Life Following a Multisite Trial for Major Depression Disorder in SCI. Denise G. Tate (University of Michigan, Ann Arbor, MI), Charles Bombardier, Allen Heine- mann, Jesse Fann, Jason Barber, Martin Forchheimer. Disclosure: None disclosed. Objectives: Quality of life (QOL) is an important outcome follow- ing SCI. RCT studies that relate QOL to major depressive disorder are often rare. This study is based on an existing trial to evaluate the effectiveness of Venlafaxine XR to treat MDD and focused on exam- ining the relationship of depression to QOL pre and post-treatment. Second, we examined other factors that influence this relationship. Design/Intervention/Outcomes: Multi-site, randomized, double- blind, placebo-controlled trial (Project to Improve Symptoms and Mood after SCI, PRISMS). Inclusion criteria: 18-64 years old, 1 month post-SCI, at least moderately severe MDD or dysthymia. Out- comes: Hamilton Depression Rating Scale at 12 weeks. QOL mea- sured by: SF-12 and Satisfaction with Life Scale (SWLS). Correla- tions, test of means, plots and regressions were conducted. Setting: Community based samples from six SCI Model Systems. Partici- pants/Results: One hundred sixteen people completed the trial so far. 70% achieved 150 mg/day of Venlafaxine XR for at least six weeks. Depression was inversely associated with QOL after treatment with significant results as QOL assessed mental health functioning and life satisfaction. Other significant factors included social support and in- terference with life events. Results show dramatic improvements be- tween pre and post-test scores. Conclusion: Contrary to expectations, QOL was only associated with depression post-treatment. Numerous potential moderating factors were identified. It is unclear why QOL and depression were not associated at baseline. It is possible that these measures correlate differently at opposite ends of the scale. Complete trial results will be available for this ACRM presentation. Support: NIDRR SCI Model System Collaborative grant H133A060107. Key Words: Spinal cord injury; MDD; Mental health; Clinical practice; Rehabilitation. Poster 154 Reporting Issues Related to Pressure Ulcers in Inpatient Rehabil- itation Facilities. Amit Kumar (University of Texas Medical Branch Galveston, Galveston, TX), Amol Karmarkar, James Gra- ham, Kenneth J. Ottenbacher. Disclosure: None disclosed. Objective: Compare prevalence of pressure ulcers identified by quality-indicator and comorbidity variables among patients with spinal cord injury. Study Design: Retrospective study. Methods: Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI) and Medicare Provider Analysis and Review (MedPAR) records for pa- tients receiving inpatient rehabilitation for spinal cord injury in 2008 and 2009 were obtained from the Centers for Medicare and Medicaid Services (CMS). We calculated the percentage of patients with pres- sure ulcers using the voluntary quality-indicator variable in the IRF- PAI file and ICD-9 code comorbidity variables in both the IRF-PAI and MedPAR files. Results: The sample included 22,411 patients. The number of facility reported pressure ulcers was 383 (1.7%) compared to 1,771 (7.9%) patients with pressure ulcers listed as comorbidities: 6.4% in IRF-PAI and 5.8% in MedPAR. Conclusion: Quality report- ing of pressure ulcers will be required of IRFs beginning in October 2012. Our findings demonstrate current inconsistencies in the number of quality indicator- versus comorbidity-based pressure ulcers. Key Words: Spinal cord injury; Pressure ulcers; Inpatient rehabilitation; Medicare; Motor function; Epidemiology and outcomes research; Rehabilitation. Poster 155 Aging With Spinal Cord Injury/Disease: Recommendations for Future Research. Denise G. Tate (University of Michigan, Ann Arbor, MI), Susan Charlifue, Suzanne Groah, Martin Forch- heimer, Ivan Molton, Mark Jensen, Anthony Chiodo, James Krause. Disclosure: None disclosed. Objectives: People with SCI/D are surviving longer than before due to medical advances. More people are getting diagnosed with SCI/D when older due to co-morbidities such as cancer, and traumatic injuries, especially related to falls. Yet, research about complications E57 2012 ACRM–ASNR Annual Conference Abstracts Arch Phys Med Rehabil Vol 93, October 2012
Transcript of Poster 152 Pain and Women With Spinal Cord Injury, Multiple Sclerosis, Joint Connective Tissue...
E572012 ACRM–ASNR Annual Conference Abstracts
Disclosure: None disclosed.
Objectives: Psychosocial well-being, including happiness, is rarelystudied in people with disabilities, despite the potential for suchresearch to expand our understanding of the full range of functioningin the context of aging with a disability. This study aims to answer thefollowing questions: (1) Where do people with disabilities fall on ahappiness scale overall and across age groups (by disability group)?(2) How do they compare to community samples without disability?(3) What are the correlates of happiness in people aging with physicaldisability? Design: Cross-sectional postal survey. Setting: Commu-nity. Participants: 1862 adults (63.3% female) with muscular dystro-phy, multiple sclerosis, post-polio syndrome, or spinal cord injury.Interventions: Not applicable. Main Outcome Measure: The Sub-jective Happiness Scale (Lyubomirksy & Lepper, 1999) was used toassess happiness. The total score ranges from 1 (lowest) to 7 (highest).Results: Analyses examined levels of happiness for the total sampleand for each disability condition individually across four age cohorts:18-44, 45-64, 65-74, and 75� years. The sample’s mean happinesslevel varied between 5.04 (SD: 1.26) for those age 45-64 and 5.6 (SD:1.16) for those age 65-74. Levels of happiness across different agecohorts and disability conditions were comparable to levels of happi-ness reported in other samples of adults without physical disabilities.Happiness differed significantly by disability condition and by age;older cohorts were happier than younger cohorts. Pain, vision loss, andfalls were negatively correlated with happiness. Conclusions: Study-ing the full spectrum of psychosocial functioning, including happiness,may broaden our understanding of successful aging with physicaldisability. Key Words: Spinal cord injury; Mental health; Epidemi-ology and Outcomes research; Rehabilitation.
Poster 152Pain and Women With Spinal Cord Injury, Multiple Sclerosis,Joint Connective Tissue Disorders and Other PhysicalDisabilities. Heather B. Taylor (TIRR Memorial Hermann andUTHealth, Houston, TX).
Disclosure: None disclosed.Objectives: To compare the frequency and severity of pain (sf-36)
between women with physical disabilities and women in the USpopulation by age group, identify correlates of pain among womenwith disabilities, and determine impact of pain on depression amongwomen with disabilities. Design: Correlational using cross-sectionaldata. Setting: Outpatient clinics. Participants: Women (n � 415)with physical disabilities. Main Outcome Measures: Bodily PainSubscale. CESD. Results: Women with disabilities reported signifi-cantly more pain frequency and severity on the bodily pain subscalethan US national norms for women regardless of age group and USnorms of people with osteoarthritis and musculoskeletal problems.Correlates of pain included household income, physical functioning,employment, need for personal assistance with activities of dailyliving, and disability type. In multiple regression analyses, bodily paincontributed to depression above and beyond demographic and disabil-ity variables. Additional analyses, breaking pain into pain severity andpain interference indicated that pain interference contributed to de-pression above and beyond pain severity. Conclusion: Women withdisabilities report significantly more pain than national norms onmeasures of bodily pain and may be at greater risk for depression dueto pain interference. Key Words: Spinal cord injury; Physical dis-abling conditions; Health and wellness; Clinical practice;Rehabilitation.
Poster 153Factors Influencing Quality of Life Following a Multisite Trial forMajor Depression Disorder in SCI. Denise G. Tate (University ofMichigan, Ann Arbor, MI), Charles Bombardier, Allen Heine-mann, Jesse Fann, Jason Barber, Martin Forchheimer.
Disclosure: None disclosed.
Objectives: Quality of life (QOL) is an important outcome follow-ing SCI. RCT studies that relate QOL to major depressive disorder areoften rare. This study is based on an existing trial to evaluate theeffectiveness of Venlafaxine XR to treat MDD and focused on exam-ining the relationship of depression to QOL pre and post-treatment.Second, we examined other factors that influence this relationship.Design/Intervention/Outcomes: Multi-site, randomized, double-blind, placebo-controlled trial (Project to Improve Symptoms andMood after SCI, PRISMS). Inclusion criteria: 18-64 years old, �1month post-SCI, at least moderately severe MDD or dysthymia. Out-comes: Hamilton Depression Rating Scale at 12 weeks. QOL mea-sured by: SF-12 and Satisfaction with Life Scale (SWLS). Correla-tions, test of means, plots and regressions were conducted. Setting:Community based samples from six SCI Model Systems. Partici-pants/Results: One hundred sixteen people completed the trial so far.70% achieved �150 mg/day of Venlafaxine XR for at least six weeks.Depression was inversely associated with QOL after treatment withsignificant results as QOL assessed mental health functioning and lifesatisfaction. Other significant factors included social support and in-terference with life events. Results show dramatic improvements be-tween pre and post-test scores. Conclusion: Contrary to expectations,QOL was only associated with depression post-treatment. Numerouspotential moderating factors were identified. It is unclear why QOLand depression were not associated at baseline. It is possible that thesemeasures correlate differently at opposite ends of the scale. Completetrial results will be available for this ACRM presentation. Support:NIDRR SCI Model System Collaborative grant H133A060107. KeyWords: Spinal cord injury; MDD; Mental health; Clinical practice;Rehabilitation.
Poster 154Reporting Issues Related to Pressure Ulcers in Inpatient Rehabil-itation Facilities. Amit Kumar (University of Texas MedicalBranch Galveston, Galveston, TX), Amol Karmarkar, James Gra-ham, Kenneth J. Ottenbacher.
Disclosure: None disclosed.Objective: Compare prevalence of pressure ulcers identified by
quality-indicator and comorbidity variables among patients with spinalcord injury. Study Design: Retrospective study. Methods: InpatientRehabilitation Facility-Patient Assessment Instrument (IRF-PAI) andMedicare Provider Analysis and Review (MedPAR) records for pa-tients receiving inpatient rehabilitation for spinal cord injury in 2008and 2009 were obtained from the Centers for Medicare and MedicaidServices (CMS). We calculated the percentage of patients with pres-sure ulcers using the voluntary quality-indicator variable in the IRF-PAI file and ICD-9 code comorbidity variables in both the IRF-PAIand MedPAR files. Results: The sample included 22,411 patients. Thenumber of facility reported pressure ulcers was 383 (1.7%) comparedto 1,771 (7.9%) patients with pressure ulcers listed as comorbidities:6.4% in IRF-PAI and 5.8% in MedPAR. Conclusion: Quality report-ing of pressure ulcers will be required of IRFs beginning in October2012. Our findings demonstrate current inconsistencies in the numberof quality indicator- versus comorbidity-based pressure ulcers. KeyWords: Spinal cord injury; Pressure ulcers; Inpatient rehabilitation;Medicare; Motor function; Epidemiology and outcomes research;Rehabilitation.
Poster 155Aging With Spinal Cord Injury/Disease: Recommendations forFuture Research. Denise G. Tate (University of Michigan, AnnArbor, MI), Susan Charlifue, Suzanne Groah, Martin Forch-heimer, Ivan Molton, Mark Jensen, Anthony Chiodo, JamesKrause.
Disclosure: None disclosed.Objectives: People with SCI/D are surviving longer than before
due to medical advances. More people are getting diagnosed with
SCI/D when older due to co-morbidities such as cancer, and traumaticinjuries, especially related to falls. Yet, research about complicationsArch Phys Med Rehabil Vol 93, October 2012
