Determinants of quality of life among community‑dwelling persons with spinal cord injury: A path analysis

Abstract

Context: Recent advancement in technology and medical care has resulted in an increase not only in disability arising from spinal cord injury (SCI) but also its attendant challenges such as poor quality of life (QoL).
Aim: To test a theoretical model of predictors of QoL among persons with SCI.
Settings and Design: Study was conducted in the South Eastern Nigeria. A longitudinal study design was employed.
Materials and Methods: A total of 64 persons with SCI discharged from in‑hospital admission participated in this study. QoL, state self‑esteem (SSE), social support satisfaction (SSS), and functional potentials (FPs) were assessed using short form health survey‑12, SSE scale, social support questionnaire 6, and spinal cord independent measure III, respectively. Their motor function (MF) and sensory function (SF) were assessed using the motor and sensory subscales of American Spinal Cord Association impairment scale.
Statistical Analysis Used: Data obtained were analyzed using path analysis. The level of significance was set at α = 0.05.
Results: Most of the participants were male (92.3%) with incomplete type of SCI (65.4%). The selected variables (SSE, SSS, FP, MF, and SF) significantly predicted a large percentage (R2 = 0.861) of QoL. All the predictor variables except age had a direct significant effect on QoL (P < 0.05). The trimmed model revealed that SSS (β =3.04, P = 0.002) had the highest direct effect on QoL.
Conclusions: This study revealed that the combined assessment of SSE, SSS, FP, MF, and SF can be used to predict QoL significantly. Moreover, psychosocial factors are as important as clinical (biological) factors in predicting the outcomes of SCI, especially their QoL. Thus, the study buttresses the need to emphasize on the biopsychosocial model in the rehabilitation of persons with SCI.

Key words: Determinants, path analysis, quality of life, spinal cord injury