Self-rated health among persons with spinal cord injury: What is the role of physical ability?

Abstract

Objectives: Self-rated health (SRH) is a powerful concept that has greatly advanced our understanding of health and health outcomes. The SRH measure has become increasingly common in health research. Yet, puzzles remain about what shapes SRH ratings. The absence of knowledge is particularly acute in the context of disability. The aim of this study was to examine the relationship between SRH and self-rated physical ability in a sample of individuals with spinal cord injury (SCI). Methods: Data from 140 eligible participants drawn from a study of life in the community after SCI were analyzed. The study, cross-sectional in design, was conducted in a large urban city in the mid-western United States. Basic statistics such as ANOVA and chi-square tests were performed as appropriate, and a multiple linear regression analysis modeled the relationship between SRH and physical ability adjusting for potential confounding variables. Results: Self-rated physical ability was significantly associated with SRH after controlling for relevant covariates (P < 0.001). An analysis of the interaction between physical ability and level of injury revealed that the relationship was significant for persons with paraplegia but not for persons with tetraplegia. Conclusions: This study provides evidence that self-rated physical ability is an important factor associated with SRH for persons with SCI, but that the strength of the relationship depends on level of injury (paraplegia vs. tetraplegia). The challenge for future research is to replicate the study using a more comprehensive measure of physical ability and to ask how beliefs in one's ability to do those activities that are most meaningful and desired shape SRH. Only in this way will our understanding of the physical ability-SRH relationship be clarified.

The World Health Organisation Disability Assessment Scale (WHODAS II): Links between self-rated health and objectively defined and clinical parameters in the population of spinal cord injury

“…This coincides with a study conducted by Machacova, et al, about the health and physical functioning of people with spinal cord injury [9]. Erosa, et al, by contrast found that people with spinal cord injury for whom severe functional disorders have been defined do not always evaluate their overall health status as being bad.…”

“…Functional self-evaluation differs from expected functional limitations and physical abilities, as was noted in Machacova, et al [9]. Functional abilities must be seen in the context of functional self-evaluation, which can be affected and influenced by a variety of individual barriers and opportunities that are faced by respondents on an everyday basis.…”

“…Erosa, et al, by contrast found that people with spinal cord injury for whom severe functional disorders have been defined do not always evaluate their overall health status as being bad. Better participation in society is experienced by those respondents who have a better evaluation of their physical functioning (getting around, self-care, and life activities), and that corresponds to studies about the evaluation of quality of life and physical functioning [9][10][11].…”

Disability Mediates the Impact of Common Conditions on Perceived Health

“…Nevertheless, many studies have previously shown an association between particular dimensions of disability and perceived health, in samples of patients with particular diseases. For instance, social functioning is an important determinant of perceived health among heart failure patients [40] while physical ability has an important role on perceived health among spinal cord injury patients [41]. And for individuals with major depressive episode, cognition and embarrassment seem to be more relevant disability dimensions [30].…”

Predicting quality of life 5 years after medical discharge for traumatic spinal cord injury

“…Responses were reverse scored for easier interpretation in this study. The use of a single item to assess self‐rated health has revealed clinically and theoretically consistent results among respondents with SCI (Krahn, Suzuki, & Horner‐Johnson, ; Machacova, Lysack, & Neufeld, ).…”