Effectiveness of Psycho-emotional Support in Acute Spinal Cord Injury. ESPELMA Project

Not Applicable

Completed

• Conditions: Spinal Cord Injury, Acute; Professional-Patient Relations; Satisfaction; Patient Non-Compliance; Sensitivity Training Groups
• Interventions: Behavioral: Training for professionals (Spinal Cord Injury Unit staff).

• Registration Number: NCT01889940
• Lead Sponsor: Hospital Universitari Vall d'Hebron Research Institute

Brief Summary

The purposes of the ESPELMA project are twofold: 1) To increase acute spinal cord injury patients' satisfaction with treatment while hospitalization and 2) To increase mastery among rehabilitation professionals with regard to the clinical management of patients' psychological distress.

For these purposes, a tailored training for professionals will be designed and offered.

It is hypothesized that building capacity among professionals will serve to better management of patients' distress and a greater ability to commit them to the rehabilitation process. Thus, it is expected to lead to better and faster functional recovery and consequently to higher perceived satisfaction with treatment.

Detailed Description

Background: Acute spinal cord injury leaves patients severely impaired and consequently, generates high levels of psychological distress among them and their families. This psychological distress can cause patients and their families to take a less active role in rehabilitation, which leads to lower and slower levels of functional recovery and to less perceived satisfaction with the results. In addition, rehabilitation professionals that deal with this psychological distress could ultimately experience higher stress and more risk of burnout. The aim of ESPELMA project is to train rehabilitation professionals in the clinical management of acute spinal cord injury associated psychological distress, and to measure the impact of this training on the patients' perceived satisfaction with treatment. It is hypothesized that rehabilitation professionals trained in psychological distress management will foster greater psychological well-being during hospitalization among acute spinal cord injury patients and their families, and will secure greater commitment from them to participate in the rehabilitation process. Thus, it is expected to lead to better and faster functional recovery and consequently to higher perceived satisfaction with treatment.

Methods/Design: The study follows a pre-post control group design. Participants are a sample of acute spinal cord injury patients consecutively admitted to a tertiary hospital spinal cord injury unit, their relatives, and the spinal cord injury unit staff. All participants completed a baseline survey before the intervention. Training of rehabilitation professionals comprises biweekly 6-hour sessions followed by 6-months of optional on-demand coaching. Contents of the training are customized according to focus groups. Once the training sessions end, all participants are assessed again.

Discussion: To our knowledge, no studies have yet evaluated the effectiveness of training professionals to manage psychological distress of acute spinal cord injury patients by means of motivational interviewing principles. If this training proves to be effective, several benefits could be achieved: e.g. higher job content and less burnout among professionals, as well as better patient compliance and satisfaction with treatment.

Keywords Acute Spinal Cord Injury; Patient Satisfaction; Psychological Distress; Rehabilitation; Training Professionals; Burnout; Job Content.

Study Timeline

• Study Start: 2012-02
• Study First Submitted: 2013-05-27
• Study First Submitted QC: 2013-06-28
• Study First Posted: 2013-07-01
• Primary Completion: 2014-09
• Study Completion: 2015-02
• Status Verified: 2015-06
• Last Update Submitted: 2015-06-15
• Last Update Posted: 2015-06-16

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 90

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Post-intervention group.	Training for professionals (Spinal Cord Injury Unit staff).	Once intervention and coaching period for professionals has ended, post-intervention sample (patients, family and professionals) is assessed with the same time criteria than the pre-intervention sample.

Primary Outcome Measures

Name	Time	Method
Picker Patient Experience Questionnaire (PPE-33)	At discharge (an expected average of 8 weeks after admission).	Satisfaction with care received, the main outcome measure of the study, is evaluated with the Spanish version of the Picker Patient Experience Questionnaire (PPE).

Secondary Outcome Measures

Name	Time	Method
HADS	Within the first week of admission (plus 7-10 days).	Psychological distress (anxiety and depression) is evaluated using the Hospital Anxiety and Depression Scale.
SCIM-III Questionnaire	Within the first week of admission.	Patient functional status is measured with the third version of the Spinal Cord Independence Measure (SCIM-III) questionnaire.
Resilience Scale (RS-25)	At discharge (an expected average of 8 weeks after admission).	Resilience is evaluated with the Spanish version of the Resilience Scale (RS-25).
Biomedical and demographics	Within the first week of admission and updated at discharge (an expected average of 8 weeks after admission).	Medical and demographical data of patients is collected according to standard procedures.
WHOQoL-BREF (26 items)	At discharge (an expected average of 8 weeks after admission).	Quality of life is evaluated with the WHOQOL-BREF test developed by the World Health Organization.
ASIA Classification	Within the first week of admission.	International Standards for Neurological Classification of SCI, developed by the American Spinal Injury Association.

Trial Locations

Locations (1)

Hospital Universitari Vall d'Hebron; 🇪🇸 Barcelona, Spain