Quality of life after spinal cord injury: a comparison across six countries

Abstract

Study design: An international cross-sectional study. Objective: To examine the quality of life (QoL) of people with spinal cord injury (SCI) across six countries worldwide, controlling for socio-demographic and lesion-related sample characteristics and using a cross-culturally valid assessment. Methods: Data from 243 persons with SCI from Australia, Brazil, Canada, Israel, South Africa and the United States were analyzed. QoL was measured using five satisfaction items from the World Health Organization Quality of Life Assessment. Cross-culturally valid, Rasch-transformed scores were used for comparison. Results: Analysis of variance showed a significant difference in QoL between countries (F ¼ 3.938; df ¼ 5; P ¼ 0.002). Shorter time since injury, no paid employment and living in Brazil were significant predictors of lower QoL, explaining 13% of variance in linear regression. Using multilevel regression with country as higher-order variable, time since injury and paid employment remained significant predictors and explained 18% of variance in QoL. The intraclass correlation coefficient (0.05) indicates that 5% of the variability can be accounted for by country. Conclusion: This study showed QoL differences between countries that could not be explained by differences in demographic and lesion-related characteristics. Results point to the relevance of reintegration of people with SCI into the workforce. Further international comparative research using larger samples is recommended.

Participation and Life Satisfaction in Aged People with Spinal Cord Injury: Does Age at Onset Make a Difference?

“…The median life satisfaction score found in our study was similar to the mean of 19.0 found in an international SCI study 27 and was even somewhat above the median of 18 found in participants aged 18 to 64 years in the Dutch ILIAS study [unpublished observation]. As in other studies, our study shows that it is possible to retain good life satisfaction even at older ages and many years after SCI.…”

Pressure ulcers in people with spinal cord injury in developing nations

“…Finally, people with SCI are often relegated to remote and rural homes far from mainstream society, making data collection quite difficult. [9][10][11] As demonstrated in Table 1, prevalence and incidence data about SCI-related PUs is highly variable, which may or may not reflect reality. Eleven articles reported PU prevalence during initial inpatient hospitalization and/or prior to rehabilitation admission 3,12-21 and four articles report PU prevalence or incidence during SCI rehabilitation programs.…”

Review of Cross-Cultural Issues Related to Quality of Life After Spinal Cord Injury

“…The WHOQOL-BREF measure of overall Another international study of QOL using 4 generic life satisfaction measures (Satisfaction With Life Scale, LiSAT-9, PWB, and the WHOQOL-5) and including participants from Australia, Brazil, Canada, Israel, South Africa, and the United States found that country explained 5% of the variance in a multivariate context, with persons from Brazil having the lowest levels of QOL and those living in the United States having the highest. 52 The study also noted that in non-SCI populations, differences in QOL across countries are dependent upon the measures used. Another study that used the same sample and 4 QOL measures found indications of cross-country bias in all of 4 measures.…”

“…The WHOQOL-BREF and the WHOQOL-5 have been developed for cross-cultural comparisons, and their psychometric properties have been examined in several countries. [51][52][53] A study by Geyh et al 52 reviewed the psychometric properties of the WHOQOL-5 in relation to 5 other measures of QOL to examine the cross-cultural validity of these scales across countries, using Rasch analysis. Results showed that the WHOQOL-5 has superior properties to the other measures, with the exception of the Personal Well-being Index (PWI), 51 which also scored highly in terms of cross-cultural validity.…”