Effects of peer mentoring on self-efficacy and hospital readmission following inpatient rehabilitation of individuals with spinal cord injury: a randomized controlled trial

Publication date: Available online 23 March 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Julie Gassaway, Michael L. Jones, W. Mark Sweatman, Minna Hong, Peter Anziano, Karen DeVault
ObjectiveInvestigate the effect of intensive peer mentoring on patient reported outcomes of self-efficacy and unplanned hospital readmissions for persons with spinal cord injury/disease (SCI/D) within the first 6 months after discharge from inpatient rehabilitationDesignRandomized controlled trial;SettingNon-profit inpatient rehabilitation hospital specializing in care of persons with SCI/D and brain injuryParticipants158 patients admitted to the SCI rehabilitation program whose discharge location was a community setting. Participants (51% paraplegia and 49% tetraplegia) were 73% Caucasian and 77% male with a mean age of 38.InterventionsParticipants in the experimental group received initial consult/introduction with a peer support program liaison and were assigned a peer mentor, who met with the participant weekly throughout the inpatient stay and made weekly contact by phone, email or in person for 90 days post-discharge. Participants also were encouraged to participate in regularly scheduled peer support activities. Control group participants were introduced to peer support and provided services only upon request.Main Outcome Measure(s)General Self-efficacy Scale (adapted to SCI/D), project-developed community integration self-efficacy scale, and patient-reported unplanned rehospitalizations.ResultsGrowth rate for self-efficacy in the first 6 months post-discharge was significantly higher for experimental group participants compared to control group participants. Experimental group participants also had significantly fewer unplanned hospital days.ConclusionThis study provides evidence that individuals receiving intensive peer mentoring during and following rehabilitation for SCI/D demonstrate greater gains in self-efficacy over time and have fewer days of unplanned rehospitalization in the first 180 days post-discharge. More research is needed to examine the long-term effects of this intervention on healthcare utilization and the relationship between improved health and patient-reported quality of life outcomes.



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