Abstract
Objective: Spinal cord injury (SCI) is a catastrophic injury impairing body systems and functions with secondary conditions like infections, chronic pain and fatigue having major negative impacts on functionality and well-being. The objective of this research was to conduct a prospective study of the change in health related quality of life (HRQOL) from the hospitalization stage to six months following discharge in adults with SCI. Methods: Participants included 91 adults with SCI, admitted over two-years into three SCI Units in Sydney, Australia. Multiple measures were taken, including socio-demographic and injury-related variables. Health related quality of life (HR-QOL) was assessed using the Short-Form Health Survey (SF-36) on three occasions, the first soon after admission to rehabilitation, the second within 2 weeks of discharge and the third six-months after discharge. Results: After six months of living in the community, QOL of the SCI sample was significantly lower than Australian adult norms for all SF-36 domains except mental health. QOL domains such as physical functioning and vitality significantly improved from admission to discharge and 6 months after discharge. In contrast, SF-36 general health scores had deteriorated significantly 6 months after discharge. There was a non-significant trend for emotional functioning to also deteriorate 6 months after discharge. No improvement in the SF-36 pain interference scores were found over the time of the three assessments. Conclusion: SCI has a substantial negative impact on QOL for domains such as physical functioning, physical role, pain and health. While participants showed some improvement in HR-QOL at discharge and 6 months after discharge, it is a concern that adults with SCI living in the community continue to have significantly lower QOL. Considered advancements in
Highlights
Chronic spinal cord injury (SCI) is a catastrophic injury that occurs when the spinal cord is severely bruised, lacerated, or severed due to traumatic injury or disease [1,2]
The SCI sample was found to have significantly lower QOL scores (p
Repeated measures multivariate analysis of variance (MANOVA) indicated that significant within group changes occurred over time in the eight SF-36 domains: Wilk’s λ=.48; F (16,55)=3.6; p
Summary
Chronic spinal cord injury (SCI) is a catastrophic injury that occurs when the spinal cord is severely bruised, lacerated, or severed due to traumatic injury or disease [1,2]. Physical measures of SCI rehabilitation outcome assess aspects of the injury such as level or extent of impairment and activity limitation related to the disability. These measures alone are insufficient for explaining much of the variation in health outcomes after discharge following rehabilitation [11]. Health-related quality of life (HR-QOL) is viewed as an important and sensitive outcome measure when assessing the well-being of people with SCI, as they complement physical assessments [5]. The construct of QOL has been developed and become widely used in health related research in particular [12], assessing health from a multidimensional perspective, including physical, psychological, social, and vocational aspects [10,11,12]
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More From: International Journal of Physical Medicine & Rehabilitation
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