Participation and quality of life among youth with spinal cord injury

Aim: Examine relationships between participation and quality of life (QOL) among youth with spinal cord injury (SCI). Method: Youth ages 6-18 years with SCI completed the Children's Assessment of Participation and Enjoyment, which measures participation frequency (diversity/intensity) and context (with whom/where), and the Pediatric Quality of Life Inventory, which measures emotional, social, school, and overall psychosocial QOL. Analyses were conducted separately for children (ages 6-12) and adolescents (ages 13-18) and included correlations and multiple regression. Results: 340 youth participated; the participants were 56% male with an average age of 13.33 years (SD = 3.75), 66% had paraplegia, and their average injury duration was 5.13 years (SD = 4.31). Among children, participating further from home was related to increased social, school, and overall QOL. Among adolescents, participating with a more diverse group was related to greater emotional QOL. In general, participation context was more closely related to QOL, but among physical (for all youth) and social (for children) activities, frequency of participation was related to QOL. Interpretation: Relationships between participation and QOL differ with child age. Among children, encouraging participation out of the home may be most beneficial to QOL. Among adolescents, fostering participation with a more varied group may be most beneficial to QOL.