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J - Emotional Wellbeing

Use of Guidelines in Canadian Rehabilitation Sites Currently available emotional wellbeing guidelines to address the detection and management of depression in SCI: 1. Depression following spinal cord injury. A clinical practice guideline for primary care physicians. Washington, DC: Paralyzed Veterans of America (PVA); 1998. 2. Depression: What You Should Know. PVA. Available at http://www.scicpg.org/cpg_cons.htm. 3. University of Washington, Department of Rehabilitation. Available at http://sci.washington.edu/info/pamphlets/depression_sci.asp. Even though guidelines are available for the treatment of depression, only one site reports use of a guideline, by the psychology/psychiatry service. The PVA guideline is not cited as a source by any of the E-Scan participating sites. One site report using the SCIRE Depression chapter, as a key reference. Use of Assesment Tools in Emotional Welbeing Data from the E-Scan reveal that very few assessment tools are routinely used, in the area of emotional wellbeing, either clinically or for research purposes. The most common assessment tools are described in Table 2.0. Table 2.0 Tools to Asses Emotional Welbeing in Canadian Rehabilitation Centres Canadian Experts Likely to Influence Practice in the Next Five Years 1. Patricia Bain, MSW RSW; and Sylvia Hycock, BHK BScOT Reg. (Ont); Toronto: Involved with the Community Reintegration Outpatient (CROP) service, which focuses on topics such as transition and adjustment, stress and pain management, at University Health Network – Toronto Rehab’s Spinal Cord Rehabilitation Program. 2. Cheryl Bradbury, PhD (Clinical Psychology), Toronto: Expertise in the concurrent management of individuals, with traumatic brain injuries, and identifying the individual’s need for emotional adjustment and wellbeing, following SCI. 3. Chris Davis, PhD (Psychology), Ottawa: Understanding the cognitive and emotional adaptations, following life-changing events such as SCI. Research on substance abuse issues, including patterns of use, and creating criteria to measure problematic substance use. 4. Sander Hitzig, PhD (Psychology), Toronto: Identifying factors and evaluating clinical programs that influence emotional wellbeing in people aging with SCI. This includes detailing the psychological benefits of therapeutic recreation programs (e.g., Toronto Rehab’s Spinal Cord Rehabilitation Program Cottage Program), and therapeutic education services (e.g., Toronto Rehab’s Community Reintegration Outpatient Service). Evidence collected from these evaluations will serve to address knowledge gaps, in these domains, while highlighting the importance of Emotional Welbeing Construct ICF Component Assesment Tool Reported Use of Tools in 12 Canadian Sites Depression (Screening) Body Functions Beck Depression Inventory (BDI) 3/12 (25%) Centre for Epidemiological Studies Depression Scale (CESD) 1/12 (8%) Geriatric Depression Scale 2/12 (17%) Patient Health Questionnaire-9 (PHQ-9) 1/12 (8%) Depression/Anxiety (Screening) Body Functions Depression and Anxiety Stress Scales (DASS) 1/12 (8%) Anxiety (Screening) Body Functions State Trait Anxiety Inventory (STAI) 2/12 (17%) Depression (Diagnosis) Body Functions Structured Clinical Interview for DSM Disorders (SCID) 1/12 (8%) Mini-International Neuropsychiatric Interview (M.I.N.I.) 1/12 (8%) Post-Traumatic Stress Disorder Personal Factors (Personal history and biography) Post-Traumatic Stress Disorder (PTSD) Inventory 7/12 (58%) Coping Personal Factors (Patterns of experience and behavior) Coping Inventory for Stressful Situations 1/12 (8%) Substance Use - Alcohol Personal Factors (Patterns of experience and behavior) Michigan Alcohol Screening Test (MAST) 1/12 (8%) CAGE Questionnaire 1/12 (8%) these programs, which could be implemented at different rehabilitation sites across the country. 5. Luc Noreau, PhD (Community Health), Québec City: Lead on the SCI Community Survey. This national survey identifies the needs of individuals with SCI in Canada, in areas such as SCI-specialized healthcare, emotional counselling and peer support, at both a provincial and national levels; and can inform future clinical and policy initiatives. 6. Steven Orenczuk, PsyD, London: Expertise in adjustment to disability, as well as cognitive and vocational assessments. 7. Michael Sullivan, PhD (Psychology), Montréal: Holds a Canada Research Chair in Behavioural Health. Research involves understanding how thoughts or thought patterns can interfere with recovery, following an illness or disability. Findings provide insight into the psychological variables contributing to recovery and development of new treatments. 102 CAPTURING CAPACITY IN CANADIAN SCI REHABILITATION


J - Emotional Wellbeing
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