Archives of Physical Medicine and Rehabilitation
Quality of life issues in individuals with spinal cord injury
Section snippets
A review of QOL in SCI studies
Early efforts at assessing QOL in rehabilitation commonly involved health status or was qualified by the term health-related. To some, this was a subversion of construct of QOL, bringing it into conformity with the biomedical model.3 In general, objective indicators of QOL in rehabilitation have included health status, impairment, disability, societal participation, independent living, and employment. Fuhrer3 suggests that critics of using health status as a reflection of QOL encourage an
Discussion
There has been a large increase in the number of studies assessing QOL among persons with SCI. These studies have used a variety of methodologic approaches and assessment tools to examine the role of different factors in predicting QOL in SCI populations. The mixture of studies from the United States, Canada, and Western Europe provide an interesting perspective in that overt or substantial variations among groups of persons with SCI were not observed based on country of residence. This implies
Conclusions
Current measures of QOL have numerous limitations with respect to their use among persons with SCI. Not having been developed for persons with locomotor disabilities, the importance and relevance of the measures' content is frequently questionable; they often lack consistency and sensitivity to capture changes in internal standards and personal values among persons with SCI. As stated, the concept of response shift poses a challenge to the validity of these measures. This is suggested by
Acknowledgements
We thank the other SCI Model Systems and the National Spinal Cord Injury Statistical Center at the University of Alabama, Birmingham, AL, for making the SF-12 data available to us for these analyses.
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