What determines low satisfaction with life in individuals with spinal cord injury?

Abstract

Objective: To examine variables associated with satisfaction with life (SWL) in individuals with a spinal cord injury (SCI).

Design: Cross-sectional, national survey to assess SWL, demographic and injury characteristics, health care utilization, chronic conditions (obesity, diabetes, heart problems, lung problems, hypertension, high cholesterol), symptoms (poor sleep, pain, depression), social support, grief/loss, and independence.

Setting/Participants: Community-dwelling Veterans with SCI.

Outcome Measures/Analyses: Bivariate analyses were conducted to assess differences in demographics, injury characteristics, chronic conditions, symptoms, social support, grief/loss, and independence in individuals who reported low SWL (≤20) vs. average/high SWL (21-35). Multivariate logistic regression assessed factors independently associated with low SWL.

Results: 896 Veterans with SCI (62%) responded. Average age was 62 years, the majority were male (94%), Caucasian (77%), and had paraplegia (61%). Odds of low SWL were 2.4 times greater for individuals experiencing pain (OR = 2.43, CI95: 1.47-4.02, P = 0.0005). Odds of low SWL were increased for individuals reporting greater grief/loss due to their SCI (OR = 1.14, CI95: 1.10-1.18, P < 0.0001). Lesser odds of low SWL were seen for individuals reporting greater emotional social support (OR = 0.97, CI95: 0.96-0.99, P < 0.0001) and independence (OR = 0.94, CI95: 0.90-0.97, P < 0.0001).

Conclusions: Pain and feelings of grief/loss due to injury were associated with low SWL. Self-perceived independence and good social support were associated with better SWL. Along with addressing pain and facilitating independence and social support, these findings suggest that interventions to improve SWL should focus on helping individuals deal with grief/loss due to injury.

Keywords:

• Satisfaction with life
• Grief/loss
• Spinal cord injuries
• Veterans
• Social support
• Independence
• Pain

Acknowledgments

The views expressed in this manuscript are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.

Disclaimer statements

Contributors None.

Declaration of interest The authors report no conflicts of interest.

Conflicts of interest None.

Ethics approval None.

Additional information

Funding

This work was supported by the Department of Veterans Affairs, Office of Research and Development Health Services Research and Development [RRP 13-248].