Background: Understanding the factors that can predict greater quality of life (QoL) is important for adults with spinal cord injury (SCI), given that they report lower levels of QoL than the general population. Objectives: To build a conceptual model linking SCI-related needs, secondary complications, and QoL in adults with SCI. Prior to testing the conceptual model, we aimed to develop and evaluate the factor structure for both SCI-related needs and secondary complications. Methods: Individuals with a traumatic SCI (N = 1,137) responded to an online survey measuring 13 SCI-related needs, 13 secondary complications, and the Life Satisfaction Questionnaire to assess QoL. The SCI-related needs and secondary complications were conceptualized into factors, tested with a confirmatory factor analysis, and subsequently evaluated in a structural equation model to predict QoL. Results: The confirmatory factor analysis supported a 2-factor model for SCI related needs, χ2(61, N = 1,137) = 250.40, P <.001, comparative fit index (CFI) = .93, root mean square error of approximation (RMSEA) = .05, standardized root mean square residual (SRMR) = .04, and for 11 of the 13 secondary complications, χ2(44, N = 1,137) = 305.67, P < .001, CFI = .91, RMSEA= .060, SRMR = .033. The final 2 secondary complications were kept as observed constructs. In the structural model, both vital and personal development unmet SCI-related needs (β = -.22 and -.20, P < .05, respectively) and the neuro-physiological systems factor (β = -.45, P < .05) were negatively related with QoL. Conclusions: Identifying unmet SCI-related needs of individuals with SCI and preventing or managing secondary complications are essential to their QoL.
DeVivo MJ. Trends in spinal cord injury rehabilitation outcomes from model systems in the United States: 1973–2006. Spinal Cord. 2007;45(11):713–721.
,
Trends in spinal cord injury rehabilitation outcomes from model systems in the United States: 1973–2006
, Spinal Cord.
, vol. 45
(pg. 713
-721
) Post MWM, van Leeuwen CMC. Psychosocial issues in spinal cord injury: A review. Spinal Cord. 2012;50:382–389.
,
Psychosocial issues in spinal cord injury: A review
, Spinal Cord.
, vol. 50
(pg. 382
-389
) Dijkers MPJM. Quality of life of individuals with spinal cord injury: A review of conceptualization, measurement, and research findings. J Rehabil Res Dev. 2005;42:87–110.
,
Quality of life of individuals with spinal cord injury: A review of conceptualization, measurement, and research findings
, J Rehabil Res Dev.
, vol. 42
(pg. 87
-110
) Post WM, Witte LPD, Asbeck FWAV, Dijk AJV, Schrijvers AJP. Predictors of health status and life satisfaction in spinal cord injury. Arch Phys Med Rehabil. 1998;79:395–401.
,
Predictors of health status and life satisfaction in spinal cord injury
, Arch Phys Med Rehabil.
, vol. 79
(pg. 395
-401
) van Leeuwen CM, Kraaijeveld S, Lindeman E, Post MWM. Associations between psychological factors and quality of life ratings in persons with spinal cord injury: A systematic review. Spinal Cord. 2012;50:174–187
,
Associations between psychological factors and quality of life ratings in persons with spinal cord injury: A systematic review
, Spinal Cord.
, vol. 50
(pg. 174
-187
) van Koppenhagen CF, Post MW, van der Woude LH, et al. Recovery of life satisfaction in persons with spinal cord injury during inpatient rehabilitation. Am J Phys Med Rehabil. 2009;88:887–895.
,
Recovery of life satisfaction in persons with spinal cord injury during inpatient rehabilitation
, Am J Phys Med Rehabil.
, vol. 88
(pg. 887
-895
) Martin Ginis KA, Jetha A, Mack DE, Hetz S. Physical activity and subjective well-being among people with spinal cord injury: A meta-analysis. Spinal Cord. 2010;48:65–72.
,
Physical activity and subjective well-being among people with spinal cord injury: A meta-analysis
, Spinal Cord.
, vol. 48
(pg. 65
-72
) Tomasone JR, Wesch N, Martin Ginis KA, Noreau L. Spinal cord injury, physical activity, and quality of life: A systematic review. Kinesiol Rev. 2013;2(2):113–129.
,
Spinal cord injury, physical activity, and quality of life: A systematic review
, Kinesiol Rev.
, vol. 2
(pg. 113
-129
) Noreau L, Noonan VK, Cobb J, Leblond J, Dumont FS. Spinal Cord Injury Community Survey: A national and comprehensive study to portray the life of Canadians with a spinal cord injury. Top Spinal Cord Inj Rehabil. 2014;20(4):249–264.
,
Spinal Cord Injury Community Survey: A national and comprehensive study to portray the life of Canadians with a spinal cord injury
, Top Spinal Cord Inj Rehabil.
, vol. 20
(pg. 249
-264
) Noreau L, Noonan VK, Cobb J, Leblond J, Dumont FS. Spinal Cord Injury Community Survey: Understanding the needs of Canadians with an SCI. Top Spinal Cord Inj Rehabil. 2014;20(4):265–276.
,
Spinal Cord Injury Community Survey: Understanding the needs of Canadians with an SCI
, Top Spinal Cord Inj Rehabil.
, vol. 20
(pg. 265
-276
) Heinemann AW, Sokol K, Garvin L, Bode RK. Measuring unmet needs and services among persons with traumatic brain injury. Arch Phys Med Rehabil. 2002;83(8):1052–1059.
,
Measuring unmet needs and services among persons with traumatic brain injury
, Arch Phys Med Rehabil.
, vol. 83
(pg. 1052
-1059
) Hansen DG, Larsen PV, Holm LV, Rottmann N, Bergholdt SH, Søndergaard J. Association between unmet needs and quality of life of cancer patients: A population-based study. Acta Oncol 2013;52(2):391–399.
,
Association between unmet needs and quality of life of cancer patients: A population-based study
, Acta Oncol
, vol. 52
(pg. 391
-399
) Whalley Hammell KR. Spinal cord injur y rehabilitation research: Patient priorities, current deficiencies and potential directions. Disabil Rehabil. 2010;32(14):1209–1218.
,
Spinal cord injur y rehabilitation research: Patient priorities, current deficiencies and potential directions
, Disabil Rehabil.
, vol. 32
(pg. 1209
-1218
) Barker RN, Kendall MD, Amsters DI, Pershouse KJ, Haines TP, Kuipers P. The relationship between quality of life and disability across the lifespan for people with spinal cord injury. Spinal Cord. 2009;47(2):149–155.
,
The relationship between quality of life and disability across the lifespan for people with spinal cord injury
, Spinal Cord.
, vol. 47
(pg. 149
-155
) Whalley Hammell K. Exploring quality of life following high spinal cord injury: A review and critique. Spinal Cord. 2004;42(9):491–502.
,
Exploring quality of life following high spinal cord injury: A review and critique
, Spinal Cord.
, vol. 42
(pg. 491
-502
) Noreau L, Cobb J, Bélanger LM, Dvorak MF, Leblond J, Noonan VK. Development and assessment of a community follow-up questionnaire for the Rick Hansen Spinal Cord Injury Registry. Arch Phys Med Rehabil. 2013;94(9):1753–1765.
,
Development and assessment of a community follow-up questionnaire for the Rick Hansen Spinal Cord Injury Registry
, Arch Phys Med Rehabil.
, vol. 94
(pg. 1753
-1765
) Fugl-Meyer AR, Melin R, Fugl-Meyer KS. Life satisfaction in 18- to 64-year-old Swedes: In relation to gender, age, partner and immigrant status. J Rehabil Med. 2002;34:239–246.
,
Life satisfaction in 18- to 64-year-old Swedes: In relation to gender, age, partner and immigrant status
, J Rehabil Med.
, vol. 34
(pg. 239
-246
) Kline RB. Principles and Practice of Structural Equation Modeling. Vol. 2. New York: Guilford Press; 2005.
,
Principles and Practice of Structural Equation Modeling.
, vol. 2
Hess MJ, Hough S. Impact of spinal cord injury on sexuality: Broad-based clinical practice intervention and practical application. J Spinal Cord Med. 2012;35(4):211–218.
,
Impact of spinal cord injury on sexuality: Broad-based clinical practice intervention and practical application
, J Spinal Cord Med.
, vol. 35
(pg. 211
-218
) Simpson LA, Eng JJ, Hsieh JTC, Wolfe DL, the Spinal Cord Injury Rehabilitation Evidence Research Team. The health and life priorities of individuals with spinal cord injury: A systematic review. J Neurotrauma. 2012;29(8):1548–1555.
,
the Spinal Cord Injury Rehabilitation Evidence Research Team. The health and life priorities of individuals with spinal cord injury: A systematic review
, J Neurotrauma.
, vol. 29
(pg. 1548
-1555
) Wijesuriya N, Tran Y, Middleton J, Craig A. Impact of fatigue on the health-related quality of life in persons with spinal cord injury. Arch Phys Med Rehabil. 2012;93(2):319–324.
,
Impact of fatigue on the health-related quality of life in persons with spinal cord injury
, Arch Phys Med Rehabil.
, vol. 93
(pg. 319
-324
) Richardson EJ, Richards JS. Factor structure of the PHQ-9 screen for depression across time since injury among persons with spinal cord injury. Rehabil Psychol. 2008;53(2):243–249.
,
Factor structure of the PHQ-9 screen for depression across time since injury among persons with spinal cord injury
, Rehabil Psychol.
, vol. 53
(pg. 243
-249
) van Leeuwen CM, Post MWM, Westers P, et al. Relationships between activities, participation, personal factors, mental health, and life satisfaction in persons with spinal cord injury. Arch Phys Med Rehabil. 2012;93:82–89.
,
Relationships between activities, participation, personal factors, mental health, and life satisfaction in persons with spinal cord injury
, Arch Phys Med Rehabil.
, vol. 93
(pg. 82
-89
)
This content is only available as a PDF.
