Components of Quality of Life for Persons with a Quadriplegic and Paraplegic Spinal Cord Injury

Abstract

This investigation determined the themes that represented quality of life for persons with a spinal cord injury. Fifteen people (6 females, 9 males; 7 persons with quadriplegia, 8 with paraplegia) participated in this study, which used naturalistic inquiry methodologies. Results showed that quality of life for this population, regardless of severity of impairment, consisted of nine themes: (a) physical function and independence, (b) accessibility, (c) emotional well-being, (d) stigma, (e) spontaneity, (f) relationships and social function, (g) occupation, (h) finances, and (i) physical well-being. The themes of life quality were similar for quadriplegics and paraplegics; however, physical function and independence and physical well-being affected the quality of life of persons with a quadriplegic injury to a greater extent. These findings may provide health professionals with information necessary to assist in the development of programs to enhance quality of life.

Quality of life after spinal cord injury: a meta-synthesis of qualitative findings

“…Impact of SCI on sense of self Bell and Hinjosa 78 Unknown Impact of assistive devices on daily life Indirect: importance of choice and control, independence, feelings of usefulness Kleiber et al 79 Recreation and leisure studies Impact of SCI on leisure Indirect: themes of loss, relationship disruption, dependence on others, environmental barriers Lee et al 80 Leisure 90 Rehabilitation Describe subjective QOL Importance of financial security, material assets, meaningful social roles, length of time since injury. Personal growth and positive value changes Duggan and Dijkers 91 Rehabilitation Meaning and assessment of QOL and its components Loss importance of biographical connections; envisioning a productive future, relationships, sense of purpose, ability to contribute Langeno et al 92 Nursing Experience of having a pressure sore Indirect: negative impact of pressure sores on QOL Chan 93 Psychology Impact of SCI on marital relationships None Dewar 94 Nursing 101 Kinesiology The concept and experience of QOL Physical function and independence, accessibility, emotional well-being, stigma, spontaneity, relationships and social function, occupation, financial stability and physical wellbeing Sullivan 102 Nursing The experience of acute care after SCI None Duggan et al 103 Rehabilitation Impact of nursing home environment on QOL None Pentland et al 104 Rehabilitation Impact of ageing on women with SCI Indirect: concerns about deteriorating body and needs for enhanced environmental supports Barclay 105 OT Factors influencing goal setting during rehabilitation None Houlihan et al 106 Health outcomes Effect of Internet access on health-related QOL Indirect: correlation of Internet use and QOL Bloemen-Vrencken and de Witte 107 …”

“…69 The natural environment was also important: 'It's almost like come spring, I get out of jail and I've been in jail for the last 7 months [due to cold temperatures and snow]'. 101 The economic context was important: 'Finances are a big problem'; 'Our cost of living is extremely high'; 69 'We almost lost everything because of this accident. Financially'.…”

“…73 Above all, SCI was hugely inconvenient, frustrating and thwarting spontaneity: 'after all these years, I still find it very frustrating to do some of the things that should be so simple yet they take so much energy'. 101 The synthesis identified the need to assume responsibility for planning, organizing and orchestrating one's days in light of significant impediments to spontaneity in daily living. 101 Of fundamental concern was the impact of the impaired body on the ability to engage in desired activities, for example: 'I used to cut the grass and do all that.…”

“…101 The synthesis identified the need to assume responsibility for planning, organizing and orchestrating one's days in light of significant impediments to spontaneity in daily living. 101 Of fundamental concern was the impact of the impaired body on the ability to engage in desired activities, for example: 'I used to cut the grass and do all that. And now my wife and my kids have to do ityI want toydo something to help them out'; 'It's hard to see people bathing [my baby] and changing heryI wanted to do it myself'.…”

“…91 Engagement in meaningful occupations was connected to a sense of selfworth: 'I set my own goalsywhen I achieve them it makes me feel good about myself'; 73 'I'm doing something good with my lifeyand I have more self-esteem which is important to me'. 12 Echoing and overlapping the previous theme, engagement in occupations following injury had evidently Able to make a difference 91 New opportunities 12,53,73 Basic needs must be met 53 See I'm the same 73 Inherent need to contribute 12 New 'I ams' 73 Cold/snow 101 Treat me the same 73 Need to give back 12 12,73,91 Work is important 53,69,91,101 Bureaucracy/red tape 12,69,91 More empathy now 53 Need to be productive 69,101 Discrimination 73,101 QOL is caring people 91 Not being bored 69,101 Disabling policies 12,69,91,101 Not taken for granted 73,101 Creativity 53 Medical insurance 69 Interacting with others 69,73 Doing what you want to do 12,53 Urban infrastructure 101 Learning from peers 73,91,101,110 Doing things benefits health 101 Access to equipment 69 Need to do things …”