t. glott. sunnaas rehabilitation hospital r. nilsen, g. aasen. sophies minde ortopediteknikk as

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T. Glott. Sunnaas Rehabilitation Hospital R. Nilsen, G. Aasen. Sophies Minde Ortopediteknikk AS. Health problems and quality of life in women with spinal cord injury – a comparison between Norway and Cambodia. Cambodia. Battambang. Inhabitants approx 15 million Monarchy - PowerPoint PPT Presentation

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  • Health problems and quality of life in women with spinal cord injury a comparison between Norway and CambodiaT. Glott. Sunnaas Rehabilitation Hospital R. Nilsen, G. Aasen. Sophies Minde Ortopediteknikk AS

    NOSCOS Gteborg 2011

  • NOSCOS Gteborg 2011CambodiaBattambangInhabitants approx 15 millionMonarchyElections (prime minister Hun Sen)Capital Phnom PenhGDP pr capita 2006 USD 513Corruption is common 3rd most corrupt in Asia

    NOSCOS Gteborg 2011

  • NOSCOS Gteborg 2011Spinal center in BattambangSathia Kim, Cambodian Trust Dr Sokhom ChanBuilt 1991Supported by European UnionResponsible Handicap International FranceFunding gradually decreased from 2006Responsible authority: Ministry of Veterans Affairs

    NOSCOS Gteborg 2011

  • NOSCOS Gteborg 2011EpidemiologyIncidence of injuries unknownA low estimate: 200-300 Mortality - unknownSurvival/ complication rates unknown15-20 beds for rehabilitation

    NOSCOS Gteborg 2011

    Diagram1

    27

    29

    10

    3

    2

    18

    Sheet1

    Cervical23

    Thoracic35

    Lumbar23

    81

    Traffic27

    Fall29

    Crush10

    Violence3

    Pott's2

    Others/unknown18

    89

    Sheet1

    Sheet2

    Sheet3

  • NOSCOS Gteborg 2011WHOQOL-BREFThe WHOQOL-BREF contains a total of 26 questions in four domains:1. Physical health Activities of daily livingDependence on medicinal substances and medical aidsEnergy and fatigueMobilityPain and discomfortSleep and restWork Capacity2. Psychological Bodily image and appearanceNegative feelingsPositive feelingsSelf-esteemSpirituality / Religion / Personal beliefsThinking, learning, memory and concentration3. Social relationships Personal relationshipsSocial supportSexual activity4. Environment Financial resourcesFreedom, physical safety and securityHealth and social care: accessibility and qualityHome environmentOpportunities for acquiring new information and skillsParticipation in and opportunities for recreation / leisure activitiesPhysical environment (pollution / noise / traffic / climate)Transport

    NOSCOS Gteborg 2011

  • NOSCOS Gteborg 2011Methods and participants27 women with spinal cord injury were interviewed by female Khmer and compared to able bodied womenIn subjects with spinal cord injury mean age was 35 age (range 13 to 53 years), and all were paraplegic60 % was marriedMean time since injury was 10 years (0-25 years)Injury 78 % AIS A15 % AIS B7 % AIS CThoracic level 80 %Lumbar level 20 %Norwegian women with spinal cord injury (n=25) part of other study

    NOSCOS Gteborg 2011

  • NOSCOS Gteborg 2011

    ISCOS data set and WHOQOL-BREF translation into khmer

    NOSCOS Gteborg 2011

  • NOSCOS Gteborg 2011WHOQOL-BREF: Comparison across groups and domainsDifference between all domains paraplegics vs control group in Cambodia (p
  • NOSCOS Gteborg 2011Bladder problems48 % experienced severe incontinence more than once a daySingle use catheters and other equipment were not available Urinary tract infections were prevalentAntibiotics were not readily available for patientsIf treated quinolones were a common choiceDip stick slides often showed difficult restitance pattern

    NOSCOS Gteborg 2011

  • NOSCOS Gteborg 2011Pain78 % reported pain once or more during the dayMedication for pain not readily available Often located at site of injuryMost patients had never done any radiological examinationScoliosis was a common finding.

    NOSCOS Gteborg 2011

  • NOSCOS Gteborg 2011Pressure sores30 % had ulcers grade 3 or 4Basic equpiment for pressure sore prevention was lacking (mattresses etc)

    NOSCOS Gteborg 2011

  • NOSCOS Gteborg 2011Quality of life There was no correlation in any of the domain between quality of life and marital status, pain or incontinenceLimitied number of patientsThe validity of WHOQOL-BREF in Cambodia?Are the general living conditions more important for quality of life than social status or medical complications?

    NOSCOS Gteborg 2011

  • NOSCOS Gteborg 2011ConclusionComparative studies between countries and cultures can be an approach to assess impacts of different factors for quality of life after spinal cord injury The results may be important for developing services for persons with spinal cord injury for health personell and authoritiesLow-cost and feasible project that promotes cooperationProvides knowledge about outcome

    NOSCOS Gteborg 2011

    NOSCOS 2011*NOSCOS 2011