Ranking the criteria for assessing quality of life after disability: Evidence for priority shifting among long‐term spinal cord injury survivors

Abstract

Objective. To identify the criteria spinal cord injury (SCI) survivors use in assessing their quality of life and to examine the concept of priority shifting following SCI. Design. Comparison of results obtained from a population‐based sample of SCI men to comparable general non‐disabled population norms. Subjects. 195 SCI men, injured 23‐49 years earlier, who participated in a population‐based study of outcomes following long‐term SCI. Setting. Two British regional SCI treatment centres: the National Spinal Injuries Centre at Stoke Mandeville Hospital in Aylesbury, and the Regional Spinal Injuries Centre at the District General Hospital in Southport. Main outcome measurement. Flanagan's Quality of Life and Individual Needs Questionnaire, which ranks 15 life priorities in terms of importance and how wellpersonal needs are met in each area. Results. SCI men differed from non‐disabled people in how they ranked the determinants of their quality of life. Unlike non‐disabled people, for the SCI men neither health nor work were highly correlated to their perceived quality of life. Though age did not seem to explain observed differences, severity of the disability and individuals' own abilities and accomplishments did play a role in their rankings. Conclusions. These findings suggest that SCI men do change the criteria they use in assessing their quality of life and may in fact devalue less attainable goals while increasing the importance of areas in which they might be successful.