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Background/Objective: This longitudinal study investigated changes in life satisfaction, general health, activities, and adjustment over 3 decades among individuals with spinal cord injury (SCI).Participants: The cohort of participants was identified from outpatient records of a large Midwestern United States university hospital. In 1973, 256 individuals completed an initial survey. There were 5 subsequent follow-up surveys, with the most recent being in 2002. Seventy-eight participants completed materials on all 6 occasions.Methods: The Life Situation Questionnaire was used to identify changes over the 30-year period in 6 areas of life satisfaction, self-rated adjustment (current and predicted), employment status, activities, and medical treatments.Analyses: These analyses used data from 3 points in time, separated by approximately 15-year intervals. One-way analysis of variance with repeated measures was used to identify changes in outcomes between 1973, 1988, and 2002 for all continuous variables. Results:We found a mixed pattern of changes over the 30 years, with increases noted during the first 15-year period in sitting tolerance, educational and employment outcomes, satisfaction with employment, and adjustment. Although these changes tended to remain stable during the last 15 years, subtle declines were suggested in some areas, with clear declines noted in terms of diminished sitting tolerance, an increase in the number of physician visits, and decreased satisfaction with social life and sex life. Conclusions:The results suggest that many positive changes occur within the first 2 decades after SCI, followed by a period of stability in some life areas, but decline with aging in some participation and healthrelated aspects of life.

Individuals with spinal cord injury were studied in 1974 (N = 256), 1985 (N = 347) and 1989 (N = 286) using the Life Situation Questionnaire (LSQ). The latter surveys included nearly all of the surviving participants from the 1974 sample plus a new sample of individuals with more recent injuries. Items covered activities, frequency of medical treatment, ratings of satisfaction with various aspects of life, ratings of problem areas, and judgments regarding personal adjustment to SCI. Subjects were grouped according to marital status (single, married or other) and compared on these variables. The single group was somewhat younger than the other two and included a higher proportion of employed individuals. Few differences were found in terms of subjective adjustment variables, however, possibly because the married group included both individuals who were married before their injuries and those married afterwards. A second set of analyses reported in this paper focused on subjects who were single during the 1974 study. On data collected in 1974 as well as data from 1985, the group who married were measurably different in several respects from those who remained single. This suggests that individuals in post-injury marriages were a select group and that the experience of marriage further strengthened their satisfaction with life and with their own adjustment.

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