A study funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR).
A spinal cord injury (SCI) is damage anywhere along the spine caused by trauma. People with SCI may experience physical, psychological, or social changes after their injury which may have an impact on their satisfaction with life and their overall quality of life. Physical changes can include increases in urinary tract infections (UTI), cardiovascular disease, and pain. Psychological changes can include changes in mood, emotional distress, and self-esteem. Social changes can include changes in relationship status and increased need for support. Prior research has shown that people with SCI have reduced life satisfaction compared to those without SCI, and these physical, psychological, and social changes are associated with life satisfaction after SCI.
A recent NIDILRR-funded study looked at the relationship between physical, psychological, and social factors and life satisfaction in a group of people with a history of traumatic SCI averaging more than 30 years. The researchers wanted to know whether better physical and mental health, and increased social support was related to increased home, work, and overall life satisfaction in this population.
Researchers from the project Aging and Spinal Cord Injury: A 45-Year Longitudinal Study looked at data from 546 participants in the SCI Longitudinal Aging Study who were enrolled in the study between 1973 and 2004. The participants were all over 18 years old, with a history of traumatic SCI, and all were at least two years post-injury. Participants in the study complete surveys by mail every four or five years. For this study, the researchers looked at survey responses collected in 2018-2019. The participants answered questions about their demographics (age, race/ethnicity, years of education, relationship status) and SCI characteristics (years since injury, ability to walk or not, spinal level of injury). Those who were under 66 years old answered questions about their employment status. They also answered questions about their physical health, including how severely they experienced pain and how much pain interfered with day to day activity, how often they were treated for UTI in the previous year, and any history of chronic conditions such as sleep apnea (or other sleep disorders), diabetes, heart attack/heart disease, stroke, lung disease, arthritis, or cancer. To assess their psychological health, participants answered questions about how often they experienced symptoms of depression in the previous two weeks or anxiety in the previous month. To assess their social health, the participants answered questions about whether they felt they could confide in someone, felt appreciated, and whether they had someone to help with tasks such as errands. Finally, the participants answered questions about their satisfaction with life opportunities and social life (global satisfaction); living arrangements/family relationships (home life satisfaction);, and employment/job opportunities for those under 66 years old (work satisfaction).
The 546 participants were mostly White males, with an average age of 58 years old. The majority had some education after high school and were about 31 years post-injury on average. More than half of the participants were not in a relationship at the time of data collection. About 40% of those under 66 were employed and were working an average of 33 hours per week at the time of data collection.
The researchers found the following results:
- Global life satisfaction was greater for individuals with less severe depressive symptoms and more social support, when all factors were considered together.
- Home life satisfaction was greater for individuals with less severe depressive symptoms, who were in a relationship, and had more social support, when all factors were considered together.
- Work satisfaction was greater for individuals who were non-Hispanic, White, were in a relationship, had more education, less severe depressive symptoms , and more social support, when all factors were considered together.
Upon reflecting on the results of the study, the authors noted that when considered individually, many of the individual physical, psychological, and social factors were related to the life satisfaction of people aging post-traumatic SCI. When the researchers looked at all factors together, being in a relationship and greater social support were identified as the most important facilitators of greater life satisfaction. They suggested that finding ways to improve romantic relationships and other social supports may be beneficial for people aging with traumatic SCI in achieving greater life satisfaction. The authors also noted that the depression symptoms could be a significant risk factor that may impact life satisfaction in this population. They suggested that ongoing assessment and treatment of the mental health symptoms of these individuals may be an important part of their care as they age.
The researchers noted that this study offers promising insight into how a holistic approach to caring for people aging with traumatic SCI may improve their life satisfaction for the long term. However, additional research to examine the relationships between health challenges and psychological and social factors should also be considered to further understand how these relationships may influence life satisfaction. Additional research may also be needed to examine how physical, psychological, and social factors impact a more diverse group of people with SCI.
To Learn More
The Model Systems Knowledge Translation Center (MSKTC) offers a wide array of information resources for people with SCI, including adjusting to life after injury, mental health, aging, managing health, and more.
The Research In Focus series has highlighted several studies on aging, SCI, and quality of life:
- What Do People with SCI Need to Know Before They Return to Work?
- SCI Advocates and SCI Practitioners Share Their Strategies for Successfully Navigating the Complex Healthcare System
- How is Spirituality Linked to Quality of Life in People with Spinal Cord Injury?
- Staying Healthy and Connecting with Neighbors May Help People with Mobility Disabilities Stay Involved in Their Communities
- Healthy Lifestyles May be Linked with Longer Life Expectancy for People with Spinal Cord InjuriesPeople Aging with Mobility Disabilities Share Common Challenges and Strategies for Success
To Learn More About this Study
Clark, J.M.R, and Krause, J.S (2022) Life satisfaction in individuals with long-term traumatic spinal cord injury: an investigation of associated biopsychosocial factors. Archives of Physical Medicine and Rehabilitation, 103(1), 98-105. This article is available from the NARIC collection under Accession Number J88385.