Access limitations and level of psychological distress during the COVID-19 pandemic in a geographically-limited sample of individuals with spinal cord injury

Abstract

Objectives

Assess changes in access and psychological status during the COVID-19 pandemic in people with spinal cord injury (SCI).

Study Design

Cohort telephone survey study.

Setting

South Florida SCI Model System (SF-SCIMS)

Participants

A convenience sample of 51 individuals with traumatic SCI who had previously completed SCIMS Form II follow-up interviews.

Interventions

Not applicable.

Main Outcome Measure(s)

Questionnaire administration included assessments of resilience, depressive symptoms, satisfaction with life, anxiety, pain, alcohol and substance use, COVID-19 diagnoses and symptoms, and impact of early COVID-19 community restrictions on various aspects of life.

Results

Of the individuals interviewed, 78% reported limited access to their regular activities, 40% to healthcare information and services, 38% to personal protective equipment (PPE), 37% to food/groceries, and 34% to medication refills. Sixteen percent of the participants had at least moderate levels of depression, and 10% had at least moderate levels of anxiety. Statistically significant increases in depressive symptoms (Patient Health Questionnaire 9; P = 0.004) and significant decreases in resilience (SCI-Quality of Life Resilience subscore; P = 0.010) were found when comparing scores on measures of psychological function at the time of the study to scores collected during the previous SCIMS Form II interview (within 2 years pre-COVID-19).

Conclusion(s)

Limitations to basic needs and face-to-face communication can exacerbate challenges in access for persons with disabilities. Our results show increased levels of psychological distress related to decreased access to goods and services in individuals with SCI due to the COVID-19 pandemic. The results of this study can help the SCI community to target strategies for enhanced access, outreach, shared information, and social support in preparation for future community health or weather emergencies.

Key words:

• Spinal Cord injury
• COVID-19
• Depression
• Anxiety
• Mental health

Acknowledgments

We would like to thank Eleuterio Baliwis, RN, BSN for assistance with participant recruitment and data collection.

Disclaimer statements

Data availability statement The data that support the findings of this study are available from two sources: (a) “Baseline” or pre-COVID-19 data are available from the National SCI Statistical Center, as part of the NIDILRR-supported SCI Model Systems [https://www.nscisc.uab.edu/Research/NSCISC_DatabasePublicUse]; (b) Data collected specifically for this study (during-COVID-19 data) are available from the corresponding author, ERF, upon reasonable request.

Statement of ethics This study was reviewed and approved by the Institutional Review Board of the University of Miami. Study number: 20100501. We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research.

Conflict of interests The authors attest that they have no financial or other conflicts of interest.

Additional information

Funding

The contents of this manuscript were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90SI5023). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this manuscript do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.