Life satisfaction in people with spinal cord injury during the first five years after discharge from inpatient rehabilitation

Abstract

Purpose: To describe the course of life satisfaction in persons with spinal cord injury (SCI) during the first 5 years after discharge from inpatient rehabilitation and to examine its determinants. Methods: Multi-centre prospective cohort study with four measurements, the first at discharge from inpatient rehabilitation, the last 5 years after discharge. Data of 162 persons with SCI were analyzed. Life satisfaction was measured as the sum score of ‘current life satisfaction’ and ‘current life satisfaction compared to life satisfaction before SCI’. Lesion characteristics, functional independence, secondary impairments, pain, social support and self-efficacy were analyzed as possible determinants of life satisfaction. Random coefficient analysis was used for the analyses. Results: No significant changes in life satisfaction were found between discharge and 2 years later, however there were significant increases from two to 5 years post discharge. High functional independence, low pain, high everyday social support and high self-efficacy were significant determinants of a positive course of life satisfaction after discharge. Conclusions: Increases in life satisfaction were found in persons with SCI in the long run. High functional status, low pain, good social skills and high self-efficacy were related to high life satisfaction.

Implications for Rehabilitation

• A spinal cord injury (SCI) is a major life event leading to serious physical disability and secondary medical problems, which has important consequences for the life satisfaction of the persons involved.

• No changes in mean life satisfaction ratings were found between discharge and two years later, but slight increases in life satisfaction were reported from two to five years post-discharge in persons with SCI.

• High functional independence, low pain, high everyday social support, and high self-efficacy were significant determinants of a positive course of life satisfaction after discharge.

• A combined model of physical (functional independence and pain) and psychosocial factors (social support and self-efficacy) explained 66% of the variance in life satisfaction.

Keywords::

• pain
• quality of life
• self-efficacy
• social support
• spinal cord injury

Acknowledgements

The authors would like to thank the participating Dutch rehabilitation centers, and the research assistants in these centers who collected all data: Rehabilitation Centre De Hoogstraat (Utrecht), Reade (Amsterdam), Rehabilitation Centre Het Roessingh (Enschede), Adelante (Hoensbroek), Rehabilitation Centre Sint Maartenskliniek (Nijmegen), Centre for Rehabilitation - Location Beatrixoord (Haren), Rehabilitation Centre Heliomare (Wijk aan Zee), and Rehabilitation Centre Rijndam (Rotterdam).

Declaration of interest: The authors report no conflicts of interest.