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| ID | Type | Description | Link |
|---|---|---|---|
| ESPELMA | Other Grant/Funding Number | Fundació La Marató de TV3 (ref.112910) |
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| Name | Class |
|---|---|
| Fundació La Marató de TV3 | OTHER |
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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pre-intervention group. | No Intervention | The initial assessment includes pre-intervention measures (baseline) for the patient, his/her relative (or main caregiver) and the rehabilitation staff. Patients are assessed during the first week (or ≥ 10 days of SCI Unit admission) and at discharge (an expected average of 8 weeks). At the time of each patient's discharge, their family or main caregiver is also surveyed. Lastly, rehabilitation team members are also assessed across the pre-intervention phase. | |
| Post-intervention group. | Other | 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. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Training for professionals (Spinal Cord Injury Unit staff). | Behavioral | Prior to the training, separate focus groups for professionals, patients & families are conducted to determine each party's needs and worries. Tailored training for professionals (customized according to focus groups contents) consists of 12 hours distributed in 2 days (1 day per week). It includes theoretical and practical exercises on early detection of PD, communication skills, management of psycho-emotional reactions, family interventions and teamwork alternatives. Standard motivational interviewing techniques for improving empathy skills and communication styles are employed. Additionally, optional on-demand small group or individual coaching sessions (after training) will be offered (50-60 minutes per session) during a 6-months period. |
| Measure | Description | Time Frame |
|---|---|---|
| Picker Patient Experience Questionnaire (PPE-33) | Satisfaction with care received, the main outcome measure of the study, is evaluated with the Spanish version of the Picker Patient Experience Questionnaire (PPE). | At discharge (an expected average of 8 weeks after admission). |
| Measure | Description | Time Frame |
|---|---|---|
| Resilience Scale (RS-25) | Resilience is evaluated with the Spanish version of the Resilience Scale (RS-25). | At discharge (an expected average of 8 weeks after admission). |
| WHOQoL-BREF (26 items) |
| Measure | Description | Time Frame |
|---|---|---|
| VAS for family/caregivers' satisfaction with care. | Family/caregivers' satisfaction is assessed according to the relative who acts as the main caregiver of the patient. It is rated using a 4-point Likert scale (scoring from 1 [very unsatisfied] to 4 [very satisfied]). On open question to add any other relevant information with regard to satisfaction with care is also administered. | At discharge (an expected average of 8 weeks after admission); (tool for family/caregivers). |
Inclusion criteria for patients are:
Exclusion criteria for patients are:
One relative or main caregiver per patient is assessed.
Finally, all SCI Unit staff (rehabilitative doctors, nurses, assistant nurses, physiotherapists, physical activity instructors, the occupational therapist, social workers and hospital attendants)is also assessed.
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| Name | Affiliation | Role |
|---|---|---|
| Pilar Lusilla-Palacios, MD, PhD | Hospital Universitari Vall d'Hebron de Barcelona, Spain | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital Universitari Vall d'Hebron | Barcelona | Barcelona | 08035 | Spain |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | Consultation-Liaison Psychiatry in a Spinal Cord Injury Unit: Theoretical Elements [Interconsulta y PsiquiatrÃa de Enlace en una Unidad de Lesión Medular: Aspectos teóricos] Lusilla-Palacios, P., Castellano-Tejedor, C., Navarro-Marfisis, M.C., González-Viejo, M. A. Cuadernos de Medicina Psicosomática y PsiquiatrÃa de Enlace, 2013, 106, (accepted). | ||
| 26770827 | Derived | Lusilla-Palacios P, Castellano-Tejedor C. Training a Spinal Cord Injury Rehabilitation Team in Motivational Interviewing. Rehabil Res Pract. 2015;2015:358151. doi: 10.1155/2015/358151. Epub 2015 Dec 6. | |
| 26706812 |
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Quality of life is evaluated with the WHOQOL-BREF test developed by the World Health Organization.
| At discharge (an expected average of 8 weeks after admission). |
| Biomedical and demographics | Medical and demographical data of patients is collected according to standard procedures. | Within the first week of admission and updated at discharge (an expected average of 8 weeks after admission). |
| SCIM-III Questionnaire | Patient functional status is measured with the third version of the Spinal Cord Independence Measure (SCIM-III) questionnaire. | Within the first week of admission. |
| ASIA Classification | International Standards for Neurological Classification of SCI, developed by the American Spinal Injury Association. | Within the first week of admission. |
| HADS | Psychological distress (anxiety and depression) is evaluated using the Hospital Anxiety and Depression Scale. | Within the first week of admission (plus 7-10 days). |
| Resilience Scale (RS-25) | Family/caregivers' resilience. | At discharge (an expected average of 8 weeks after admission); (tool for family/caregivers). |
| Jefferson Scale for Professionals Empathy (JSPE) | Rehabilitation professionals' empathy skills is rated with the Jefferson Scale for Professionals Empathy (JSPE). | Baseline (during the first year of the project, months 6 to 10) and post-intervention measure (during the third year of the project, months 6 to 10); (tool for professionals). |
| Maslach Burn-out Inventory (MBI-22) | Burn-out is rated with the Maslach Burnout Inventory (MBI). | Baseline (during the first year of the project, months 6 to 10) and post-intervention measure (during the third year of the project, months 6 to 10); (tool for professionals). |
| Resilience Scale (RS-25). | Resilience is evaluated with the Spanish version of the Resilience Scale (RS-25). | Baseline (during the first year of the project, months 6 to 10) and post-intervention measure (during the third year of the project, months 6 to 10); (tool for professionals). |
| Job Content Questionnaire (JCQ). | Job Content was assessed with the Spanish version of the Job Content Questionnaire. | Baseline (during the first year of the project, months 6 to 10) and post-intervention measure (during the third year of the project, months 6 to 10); (tool for professionals). |
| Derived |
| Lusilla-Palacios P, Castellano-Tejedor C. Spinal cord injury and substance use: a systematic review. Adicciones. 2015 Dec 15;27(4):294-310. English, Spanish. |
| 24311743 | Derived | Lusilla-Palacios P, Castellano-Tejedor C, Lucrecia-Ramirez-Garceran, Navarro-Sanchis JA, Rodriguez-Urrutia A, Parramon-Puig G, Valero-Ventura S, Cuxart-Fina A. Training professionals' communication and motivation skills to improve spinal cord injury patients' satisfaction and clinical outcomes: Study protocol of the ESPELMA trial. J Health Psychol. 2015 Oct;20(10):1357-68. doi: 10.1177/1359105313512351. Epub 2013 Dec 5. |
| ID | Term |
|---|---|
| D013119 | Spinal Cord Injuries |
| D010349 | Patient Compliance |
| D010549 | Personal Satisfaction |
| D017060 | Patient Satisfaction |
| D000077062 | Burnout, Psychological |
| ID | Term |
|---|---|
| D013118 | Spinal Cord Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D020196 | Trauma, Nervous System |
| D014947 | Wounds and Injuries |
| D010342 | Patient Acceptance of Health Care |
| D000074822 | Treatment Adherence and Compliance |
| D015438 | Health Behavior |
| D001519 | Behavior |
| D013315 | Stress, Psychological |
| D001526 | Behavioral Symptoms |
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| ID | Term |
|---|---|
| D017144 | Focus Groups |
| ID | Term |
|---|---|
| D003625 | Data Collection |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D017531 | Health Care Evaluation Mechanisms |
| D011787 | Quality of Health Care |
| D017530 | Health Care Quality, Access, and Evaluation |
| D011634 | Public Health |
| D004778 | Environment and Public Health |
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