Improving current understanding of cognitive impairment in spinal cord injury: the patient perspective

CONTEXT: Emerging research suggests that individuals with a spinal cord injury (SCI) may be at a higher risk of developing cognitive impairment. Early detection of cognitive impairment is essential to improving quality of life and tailored rehabilitation. However, the true incidence of cognitive impairment in this group is unclear, largely due to the difficulty in administering cognitive assessment tools which often have elements that are dependent on hand function e.g. drawing and writing.

DESIGN: We conducted three semi-structured focus groups with a total of 9 participants with the aim of gaining a better understanding of patient perspectives on subjective cognitive difficulties following their SCI.

SETTING: Online focus groups.

PARTICIPANTS: 9 participants who have sustained a spinal cord injury.

INTERVENTIONS: Focus groups were transcribed verbatim and analyzed using reflexive thematic analysis. OUTCOME MEASURES: Transcript were coded to identify patterns which were analyzed using reflexive thematic analysis to produce five overarching themes.

RESULTS: People with SCI reported various levels of cognitive difficulties following their injury, and shared strategies that they have implemented to cope with these challenges. All participants expressed a lack of information or assessments on cognitive impairments, highlighting that the focus of their care has predominantly been about the physical aspects of their SCI. Additionally, they observed a difference in the approach to SCI management across different centers within the UK.

CONCLUSION: Patients with a SCI report cognitive issues following their injury but there is a lack of information or testing by healthcare professionals. Patients advocated for a more consistent and standardized approach, particularly since cognitive impairment can increase care needs and reduce engagement with rehabilitation.