The relationship between and predictors of quality of life after spinal cord injury at 3 and 15 months after discharge

Study design: Longitudinal study. Objectives: To examine the relationship between and predictors of quality of life (QOL) at 3 and 15 months post-rehabilitation discharge using the Disability Creation Process model as an explanatory framework. Setting: Vancouver, Canada. Methods: A consecutive sample of individuals with spinal cord injury (SCI) was enrolled in the study. Data were collected using the Quality of Life Index (QLI) and a variety of personal, participation and environmental instruments. On admission, 197 subjects were recruited, but dropouts and missing values led to the final inclusion of 93 cases in multiple regression models used to identify predictors of QOL at 3 and 15 months post-rehabilitation discharge. Results: Mean QLI group scores did not differ between 3 and 15 months (P = 0.85). Regression models accounted for 64% of variance in QLI total scores at 3 months and 70% of variance at 15 months. The main predictors of QOL at 3 months were health competence and mood state. The main predictors of QOL at 15 months were QOL level at 3 months, health competence and family support. At both time points, personal factors explained most of the variance, whereas participation and environmental factors were less significant. Conclusion: Given that health competence, mood state and some environmental factors may be amenable to modification, this study suggests interventions to mediate these variables might improve subjective QOL after SCI. Spinal Cord (2010) 48, 73-79; doi:10.1038/sc.2009.92; published online 28 July 2009