The relationship between and predictors of quality of life after spinal cord injury at 3 and 15 months after discharge

Abstract

Study Design-Longitudinal studyObjectives-To examine the relationship between and predictors of quality of life (QOL) at 3 months and 15 months post-rehabilitation discharge using the Disability Creation Process (DCP) model as an explanatory framework.Setting-Subjects attended an in-patient rehabilitation program and were discharged to a variety of settings.Methods-A consecutive sample of individuals with spinal cord injury (SCI) was enrolled in the study. Data were collected using the Quality of Life Index (QLI) and a variety of personal, participation and environmental instruments. On admission, 197 subjects were recruited, but drop outs and missing values led to the final inclusion of 93 cases in multiple regression models used to identify predictors of QOL at 3 and 15 months post-rehabilitation discharge.Results-Mean QLI group scores did not differ between 3 and 15 months (p = .85). Regression models accounted for 64% of variance in QLI total scores at 3 months and 70% of variance at 15 months. The main predictors of QOL at 3 months were health competence and mood state. The main predictors of QOL at 15 months were QOL level at 3 months, health competence, and family support. At both time points, personal factors explained most of the variance, while participation and environmental factors were less significant.

Psychological resources in spinal cord injury: a systematic literature review

“…25,26,29 HSE, but not GSE predicted quality of life in a multivariate longitudinal study. 30 However, HSE's association with quality of life [30][31][32] and perceived health was inconsistent 32,33 and may be explained by differences in the study populations.…”

“…90 Associations with other sociodemographic or lesion-related variables were statistically not significant. 85,86 Hope and optimism Hope and optimism conceptualized as positive orientation toward the future 91 were assessed in five cross-sectional and two longitudinal Psychological resources in SCI C Peter et al Psychological resources in SCI C Peter et al studies 30,92 (Table 5). Evidence appears fragmented and contradictory.…”

“…93 However, relations were not significant in multivariate, longitudinal analyses. 30,92,93 Affected persons perceived optimism as compromised by SCI. 51,52 Interconnections of hope with education and ethnicity, 68 time since mobilization 93 and in-or out-patient status were found.…”

“…In one longitudinal study, SE predicted quality of life post-injury, suggesting that strengthening SE might enhance life quality. 30 Evidence regarding associations of SE with other variables is to a large extent inconsistent or fragmented. Limiting the capacity to compare findings is the fact, that SE is not a homogeneous concept.…”

“…133 The review of the literature suggests that people with SCI who are hopeful and optimistic are also more satisfied and less depressed. 30,63,92,93 However, this relationship did not hold in longitudinal studies. 30,92,93 It could be hypothesized that hope and optimism support the affected people during rehabilitation while other resources might become more important after rehabilitation discharge.…”