A Mixed Methods Approach as a Channel to Interpret Outcomes Research and Lived Experience Enquiry of Upper Extremity Elective Surgery for Tetraplegia

Cervical spinal cord injury (SCI) causing tetraplegia is extremely disabling. In such circumstances, restoration of upper extremity (UE) function is considered the highest priority. The advent of early nerve transfer (NT) procedures, in addition to more traditional tendon transfers (TT), warranted i...

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Bibliographic Details
Published in:Journal of personalized medicine 2023-02, Vol.13 (3), p.394
Main Authors: Sinnott Jerram, K Anne, Dunn, Jennifer, Smaill, Richard, Middleton, James
Format: Article
Language:English
Subjects:
Analysis
Clinical outcomes
Cognitive ability
Content analysis
Data analysis
Decision making
Interviews
Medical research
Medicine, Experimental
Methods
Mixed methods research
Precision medicine
Quadriplegia
Spinal cord
Spinal cord injuries
Surgery
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Summary:Cervical spinal cord injury (SCI) causing tetraplegia is extremely disabling. In such circumstances, restoration of upper extremity (UE) function is considered the highest priority. The advent of early nerve transfer (NT) procedures, in addition to more traditional tendon transfers (TT), warranted in-depth consideration given the time-limited nature of NT procedures. Potential surgery candidates may not yet have come to terms with the permanence of their disability. A mixed methods convergent design was utilized for concurrent analysis of the Aotearoa/New Zealand upper limb registry data from the clinical assessments of all individuals considering UE surgery, regardless of their final decision. The International Classification of Functioning, Disability and Health (ICF) taxonomy guided data interpretation during the three-phased study series. It was the integration of the findings using the Stewart Model of care drawn from palliative health that enabled the interpretation of higher order messages. It is clear the clinical assessment and selection processes in use require reconsideration given the complexities individuals face following onset of SCI. We draw attention to the higher order cognitive demands placed on individuals, the requirement for SCI peer involvement in decision making and the need for acknowledgment of interdependence as a relational construct when living with tetraplegia.
ISSN:2075-4426
2075-4426
DOI:10.3390/jpm13030394