Factors determining health awareness in persons after spinal injury with neurological complications. Pilot study.

Background: Dedicated health education is a core intervention in comprehensive rehabilitation programmes. Health awareness of those disabled as a result of a spinal injury with neurological complications (SINC) has rarely been the subject of scientific analyses despite its importance for designing dedicated educational programs.

Purpose: To evaluate factors determining the health awareness of persons after SINC.

Material And Methods: 133 SINC patients (32 women) between 0.5 and 31 years after injury. An ad hoc questionnaire designed by the authors consisting of 150 detailed questions about the diagnosis, prophylaxis and management of typical health consequences of SINC.

Results: The mean test score (TS) was 56.6 points. TS correlated inversely with age in a statistically significant manner (correlation coefficient (CC) = -0.31). TS increased with the time elapsed since injury, with distinct increments at 1 year and 10 years after the event. Significantly higher TSs were noted in persons with university (64.6) and secondary education (65.7) compared with the rest of the group (37.9). Those unable to walk but able to use the wheelchair for independent locomotion had a higher TS (59.7) compared to wheelchair-bound persons unable to drive the wheelchair (47.5) and to persons with preserved walking ability (46.2). Significantly higher scores were achieved by inhabitants of towns above 100,000 population, those employed, members of an association for disabled persons, and respondents capable of independent self-care. There was an inverse correlation between TS and Beck's depression score (CC=-0.36). TS did not depend on gender. Interaction with other persons with SINC is perceived as the most important source of health related knowledge.

Conclusions: Predictors of better health awareness in SINC persons include a young age, at least secondary education, more than 10 years since injury, participation in community rehabilitation organised by an association of persons with disability, being employed, being unable to walk, effective self-care, and absence of depression.