Abstract
Study design
Cohort study with two measurement occasions.
Objectives
To investigate change in environmental barriers experienced by people living with spinal cord injury (SCI) over a 5-year period.
Setting
Community, Switzerland.
Methods
Data were from the Swiss spinal cord injury (SwiSCI) survey. Main outcome measure was the Nottwil Environmental Factors Inventory-Short Form. Random-effects Poisson regression featuring between-within estimation was used to examine predictors of the number of environmental barriers and of its change over time.
Results
One thousand five hundred and forty-nine persons participated in Survey 2012 and 1530 participated in Survey 2017; 761 participated in both surveys. In both surveys most participants reported at least three barriers. Leading issues were unfavorable climate, inaccessibility of buildings and public spaces, and lack of or insufficiently adapted means of transportation. Reporting of barriers related to climate, finances, and state services declined over time. Between subjects, having more health problems, lesser physical independence, poorer mental health, and a lower household income were related to a higher number of barriers experienced. Within subjects, improvements in income, physical independence, and mental health over time were related to a reduction in barriers.
Conclusions
Inaccessibility of buildings and places and problems with transportation remained major barriers over a 5-year period and should be priorities of Swiss disability policy. People with reduced mental and physical health, and those with lower income are vulnerable groups deserving specific attention. Policies targeting income and life-long rehabilitation targeting health promotion and maintenance may be suitable means to reduce the experience of environmental barriers.
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Data availability
Owing to our commitment to SwiSCI study participants and their privacy, datasets generated during the current study are not made publicly available but can be provided by the SwiSCI Study Center based on reasonable request (contact@swisci.ch).
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Acknowledgements
We thank the SwiSCI Steering Committee with its members Xavier Jordan, Fabienne Reynard (Clinique Romande de Réadaptation, Sion); Michael Baumberger, Hans Peter Gmünder (Swiss Paraplegic Center, Nottwil); Armin Curt, Martin Schubert (University Clinic Balgrist, Zürich); Margret Hund-Georgiadis, Kerstin Hug (REHAB Basel, Basel); Laurent Prince (Swiss Paraplegic Association, Nottwil); Heidi Hanselmann (Swiss Paraplegic Foundation, Nottwil); Daniel Joggi (Representative of persons with SCI); Nadja Münzel (Parahelp, Nottwil); Mirjam Brach, Gerold Stucki (Swiss Paraplegic Research, Nottwil); Armin Gemperli (SwiSCI Coordination Group at Swiss Paraplegic Research, Nottwil).
Funding
SwiSCI is hosted and funded by Swiss Paraplegic Research.
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Contributions
JDR designed the study, wrote the first draft, and performed the data analysis. CSF provided Rasch-transformed SCIM-SR scores, and revised the manuscript critically for content. MWMP designed the study and revised the manuscript critically for content. All authors have read and approved the submitted version of the manuscript.
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The authors declare that they have no conflict of interest.
Ethical approval
Ethical approval for Survey 2012 was granted by Kantonale Ethikkommission Luzern (internal application 11042, approved 28.06.2011, Commission Cantonale Valaisanne d’Ethique Médicale Sion (internal application CCVEM042/11, approved 06.12.2011), and Ethikkommission Basel (internal application 306/11, approved 06.09.2011). Ethical approval for Survey 2017 was granted by the Ethikkommission Nordwest-und Zentralschweiz (EKNZ, Project-ID = 11042 PB_2016-02608, approved Dec 2016). We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research.
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Reinhardt, J.D., Fellinghauer, C.S. & Post, M.W.M. Change in environmental barriers experienced over a 5-year period by people living with spinal cord injury in Switzerland: a prospective cohort study. Spinal Cord 59, 441–451 (2021). https://doi.org/10.1038/s41393-020-00580-7
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DOI: https://doi.org/10.1038/s41393-020-00580-7
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