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Factors Influencing Quality of Life of People with Noncongenital Spinal Cord Injury
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Korean J Adult Nurs : Korean Journal of Adult Nursing

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Original Article

Factors Influencing Quality of Life of People with Noncongenital Spinal Cord Injury

Hye Min Hwang1, Myungsun Yi2
Korean Journal of Adult Nursing 2014;26(4):444-454.
Published online: August 31, 2014

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Corresponding author: Hwang, Hye Min Department of Nursing, Bucheon University, 25 Shinheung-ro 56 beon-gil, Wonmi-gu, Bucheon 420-735, Korea. Tel: +82-32-610-0830, Fax: +82-32-610-0839, E-mail: julie06@bc.ac.kr
• Received: June 7, 2014   • Accepted: August 4, 2014

Copyright © 2014 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purposeof thestudy wasto examinethe relationshipsamongpainbelief, perceivedsocial support, coping strategies, and qualityoflife ofpeoplewith noncongenitalspinalcordinjury and toidentifyfactors influencing quality of life.
  • Methods
    A correlation alpredictive design wasused. The data were collected from 197 people with non congenital spinal cord injury with question naires in 2012 in Korea. The data were analyzed using descriptive statistics, t-tests, one-way ANOVA, Pearson's correlation coefficients, and stepwise multiple regression using SPSS/WIN 18.0.
  • Results
    Pain belief, perceived social support, and coping strategies were correlated significantly with the quality of life. As a result of stepwise multiple regression analysis, pain belief, perceived social support, coping strategies, damaged area, and time since injury were discovered to account for 59.1% varianceofthequalityoflife. Thevariablethatmostaffectedthequalityoflifewaspainbelief followedbyperceived social support and coping strategies.
  • Conclusion
    The results of the study clearly demonstrate the importance of pain control, social support, and coping skills in order to improve quality of life among people with non congenital spinal cord injury.
  • Key Words: Spinal cord injury; Quality of life; Pain; Social support; Coping skill
Table 1.
Demographic and Spinal Cord Injury-related Characteristics (N=197)
Characteristics Categories n (%) M±SD
Age (year) 20~29 23 (11.7) 41.9±10.9
30~39 68 (34.5)
40~49 52 (26.4)
50~59 42 (21.3)
60 ≥ 12 (6.1)
Gender Male 157 (79.7)
Female 40 (20.3)
Marital status Unmarried 87 (44.2)
Married 91 (46.2)
Divorced 19 (9.6)
Religion None 89 (45.2)
Yes 108 (54.8)
Educational level Middle school 12 (6.1)
High school 87 (44.2)
College 78 (39.6)
College ＞ 20 (10.2)
Occupation Yes 57 (28.9)
No 140 (71.7)
Economic status High 5 (2.5)
Middle 103 (52.3)
Low 89 (45.2)
Cause of injury Traffic accident 101 (51.3)
Fall Sports 54 (28.3) 26 (13.2)
Others 16 (8.1)
Injured area Cervical 95 (48.2)
Thoracic 90 (45.7)
Lumbar 12 (6.1)
Severity of injury (ASIA scale) Motor complete quadriplegia 62 (31.5)
Motor incomplete quadriplegia 32 (16.2)
Motor complete paraplegia 73 (37.1)
Motor incomplete paraplegia 30 (15.2)
Time since injury (year) 2 ＜ 36 (18.3) 8.3±5.5
2~ 5 ≥ ＜ 28 (14.2)
5~ 10 ≥ ＜ 61 (31.0)
10~ 20 ≥ ＜ 72 (36.6)
Table 2.
Descriptive Statistics of the Study Variables (N=197)
Variables M±SD Range
Pain belief 2.40±0.54 1.00~3.81
   PBPI: time 2.73±0.65 1.00~4.00
   PBPI: mystery 1.92±0.64 1.00~4.00
   PBPI: self blame 2.10±0.83 1.00~4.00
Perceived social support 57.95±25.30 2.34~100.00
   Tangible support 64.99±26.34 0~100
   Affection 55.22±30.12 0~100
   Positive interaction 54.95±28.60 0~100
   Emotional & informational support 56.63±24.67 0~100
Coping strategies 2.60±0.04 1.50~3.75
   SCL-CSQ: acceptance 2.62±0.69 1.00~4.00
   SCL-CSQ: fighting spirit 2.71±0.65 1.25~4.00
   SCL-CSQ: social reliance 2.42±0.62 1.00~4.00
Quality of life (QOL) 2.88±0.45 1.38~4.31
   Overall QOL & General health domain 2.75±0.88 1.00~5.00
   Physical health domain 2.75±0.74 1.14~4.43
   Psychological health domain 3.10±0.79 1.17~5.00
   Social domain 2.63±0.74 1.00~4.67
   Environmental domain 2.93±0.68 1.13~4.38

PBPI=pain belief & perception inventory; SCL-CSQ=spinal cord lesion-coping strategies questionnaire.

Table 3.
Quality of Life by General and Spinal Cord Injury-related Characteristics (N=197)
Characteristics Categories Quality of life
M±SD t or F p (Duncan†)
Age (year) 20~29 3.16±0.52 3.13 .010
30~39 2.93±0.66
40~49 2.81±0.57
50~59 2.66±0.64
60 ≥ 3.08±0.63
Gender Male 2.79±0.68 -0.92 .357
Female 2.89±0.62
Marital status Unmarrieda 2.96±0.59 3.44 .034
Marriedb 2.86±0.65 (a, b ＜c)
Divorcedc 2.55±0.63
Religion Yes 2.95±0.63 1.97 .049
No 2.77±0.63
Educational level Middle schoola 2.37±0.69 4.52 .012
High schoolb 2.85±0.59 (a b, ＜ c)
≥Collegec 2.94±0.65
Occupation Don't have 2.77±0.61 3.58 .001 ＜
Have 3.11±0.63
Economic status Higha 2.00±0.65 4.83 .009
Middleb 2.32±0.54 (a b, ＜ c)
Lowc 2.52±0.50
Cause of injury Traffic accident 2.92±0.66 0.35 .791
Fall 2.83±0.58
Sports 2.84±0.61
Others 2.79±0.66
Injured area Cervicala 2.72±0.62 5.64 .004
Thoracicb 3.01±0.65 a b, ＜ c)
Lumbarc 3.00±0.40
Severity of injury Motor complete quadriplegiaa 2.72±0.62 3.59 .015
Motor incomplete quadriplegiab 2.74±0.64 (a, b c, ＜ d)
Motor complete paraplegiac 2.95±0.65
Motor incomplete paraplegiad 3.11±0.52
Time since diagnosis (year) ＜2a 2.58±0.51 6.32 ＜.001
≥ 2~ ≥5b 2.67±0.60 (a, b, c ＜d)
≥5~ <10c 3.03±0.61
10~ 20 ≥ ＜ d 3.03±0.61

†The result of multiple comparison test.

Table 4.
Correlations between Quality of Life, Pain Belief, Perceived Social Support, and Coping Strategies (N=197)
Variables Pain belief Perceived social support Coping strategies Quality of life
r (p) r (p) r (p) r (p)
Pain belief 1      
Perceived social support -.23 (.001) 1    
Coping strategies -.08 (.252) .34 (.001) ＜ 1  
Quality of life -.52 (.001) ＜ .54 (.001) ＜ .44 (.001) ＜ 1
Table 5.
Factors Influencing Quality of Life (N=197)
Variables B SE β t p
(Constant) 2.14 .23     .001 ＜
Pain belief -0.46 .06 -.39 -8.33 .001 ＜
Perceived social support 0.20 .03 .32 6.19 .001 ＜
Coping strategies 0.36 .06 .29 5.94 .001 ＜
Injured area 0.23 .06 .18 3.89 .001 ＜
Time since injury 0.21 .06 .16 3.42 .001
Adj. R2=.59, F=55.50, p .001 ＜
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    Factors Influencing Quality of Life of People with Noncongenital Spinal Cord Injury
    Korean J Adult Nurs. 2014;26(4):444-454.   Published online August 31, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.4.444
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    Factors Influencing Quality of Life of People with Noncongenital Spinal Cord Injury
    Korean J Adult Nurs. 2014;26(4):444-454.   Published online August 31, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.4.444
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    Factors Influencing Quality of Life of People with Noncongenital Spinal Cord Injury
    Factors Influencing Quality of Life of People with Noncongenital Spinal Cord Injury

    Demographic and Spinal Cord Injury-related Characteristics (N=197)

    Characteristics Categories n (%) M±SD
    Age (year) 20~29 23 (11.7) 41.9±10.9
    30~39 68 (34.5)
    40~49 52 (26.4)
    50~59 42 (21.3)
    60 ≥ 12 (6.1)
    Gender Male 157 (79.7)
    Female 40 (20.3)
    Marital status Unmarried 87 (44.2)
    Married 91 (46.2)
    Divorced 19 (9.6)
    Religion None 89 (45.2)
    Yes 108 (54.8)
    Educational level Middle school 12 (6.1)
    High school 87 (44.2)
    College 78 (39.6)
    College ＞ 20 (10.2)
    Occupation Yes 57 (28.9)
    No 140 (71.7)
    Economic status High 5 (2.5)
    Middle 103 (52.3)
    Low 89 (45.2)
    Cause of injury Traffic accident 101 (51.3)
    Fall Sports 54 (28.3) 26 (13.2)
    Others 16 (8.1)
    Injured area Cervical 95 (48.2)
    Thoracic 90 (45.7)
    Lumbar 12 (6.1)
    Severity of injury (ASIA scale) Motor complete quadriplegia 62 (31.5)
    Motor incomplete quadriplegia 32 (16.2)
    Motor complete paraplegia 73 (37.1)
    Motor incomplete paraplegia 30 (15.2)
    Time since injury (year) 2 ＜ 36 (18.3) 8.3±5.5
    2~ 5 ≥ ＜ 28 (14.2)
    5~ 10 ≥ ＜ 61 (31.0)
    10~ 20 ≥ ＜ 72 (36.6)

    Descriptive Statistics of the Study Variables (N=197)

    Variables M±SD Range
    Pain belief 2.40±0.54 1.00~3.81
       PBPI: time 2.73±0.65 1.00~4.00
       PBPI: mystery 1.92±0.64 1.00~4.00
       PBPI: self blame 2.10±0.83 1.00~4.00
    Perceived social support 57.95±25.30 2.34~100.00
       Tangible support 64.99±26.34 0~100
       Affection 55.22±30.12 0~100
       Positive interaction 54.95±28.60 0~100
       Emotional & informational support 56.63±24.67 0~100
    Coping strategies 2.60±0.04 1.50~3.75
       SCL-CSQ: acceptance 2.62±0.69 1.00~4.00
       SCL-CSQ: fighting spirit 2.71±0.65 1.25~4.00
       SCL-CSQ: social reliance 2.42±0.62 1.00~4.00
    Quality of life (QOL) 2.88±0.45 1.38~4.31
       Overall QOL & General health domain 2.75±0.88 1.00~5.00
       Physical health domain 2.75±0.74 1.14~4.43
       Psychological health domain 3.10±0.79 1.17~5.00
       Social domain 2.63±0.74 1.00~4.67
       Environmental domain 2.93±0.68 1.13~4.38

    PBPI=pain belief & perception inventory; SCL-CSQ=spinal cord lesion-coping strategies questionnaire.

    Quality of Life by General and Spinal Cord Injury-related Characteristics (N=197)

    Characteristics Categories Quality of life
    M±SD t or F p (Duncan†)
    Age (year) 20~29 3.16±0.52 3.13 .010
    30~39 2.93±0.66
    40~49 2.81±0.57
    50~59 2.66±0.64
    60 ≥ 3.08±0.63
    Gender Male 2.79±0.68 -0.92 .357
    Female 2.89±0.62
    Marital status Unmarrieda 2.96±0.59 3.44 .034
    Marriedb 2.86±0.65 (a, b ＜c)
    Divorcedc 2.55±0.63
    Religion Yes 2.95±0.63 1.97 .049
    No 2.77±0.63
    Educational level Middle schoola 2.37±0.69 4.52 .012
    High schoolb 2.85±0.59 (a b, ＜ c)
    ≥Collegec 2.94±0.65
    Occupation Don't have 2.77±0.61 3.58 .001 ＜
    Have 3.11±0.63
    Economic status Higha 2.00±0.65 4.83 .009
    Middleb 2.32±0.54 (a b, ＜ c)
    Lowc 2.52±0.50
    Cause of injury Traffic accident 2.92±0.66 0.35 .791
    Fall 2.83±0.58
    Sports 2.84±0.61
    Others 2.79±0.66
    Injured area Cervicala 2.72±0.62 5.64 .004
    Thoracicb 3.01±0.65 a b, ＜ c)
    Lumbarc 3.00±0.40
    Severity of injury Motor complete quadriplegiaa 2.72±0.62 3.59 .015
    Motor incomplete quadriplegiab 2.74±0.64 (a, b c, ＜ d)
    Motor complete paraplegiac 2.95±0.65
    Motor incomplete paraplegiad 3.11±0.52
    Time since diagnosis (year) ＜2a 2.58±0.51 6.32 ＜.001
    ≥ 2~ ≥5b 2.67±0.60 (a, b, c ＜d)
    ≥5~ <10c 3.03±0.61
    10~ 20 ≥ ＜ d 3.03±0.61

    †The result of multiple comparison test.

    Correlations between Quality of Life, Pain Belief, Perceived Social Support, and Coping Strategies (N=197)

    Variables Pain belief Perceived social support Coping strategies Quality of life
    r (p) r (p) r (p) r (p)
    Pain belief 1      
    Perceived social support -.23 (.001) 1    
    Coping strategies -.08 (.252) .34 (.001) ＜ 1  
    Quality of life -.52 (.001) ＜ .54 (.001) ＜ .44 (.001) ＜ 1

    Factors Influencing Quality of Life (N=197)

    Variables B SE β t p
    (Constant) 2.14 .23     .001 ＜
    Pain belief -0.46 .06 -.39 -8.33 .001 ＜
    Perceived social support 0.20 .03 .32 6.19 .001 ＜
    Coping strategies 0.36 .06 .29 5.94 .001 ＜
    Injured area 0.23 .06 .18 3.89 .001 ＜
    Time since injury 0.21 .06 .16 3.42 .001
    Adj. R2=.59, F=55.50, p .001 ＜
    Table 1. Demographic and Spinal Cord Injury-related Characteristics (N=197)

    Table 2. Descriptive Statistics of the Study Variables (N=197)

    PBPI=pain belief & perception inventory; SCL-CSQ=spinal cord lesion-coping strategies questionnaire.

    Table 3. Quality of Life by General and Spinal Cord Injury-related Characteristics (N=197)

    The result of multiple comparison test.

    Table 4. Correlations between Quality of Life, Pain Belief, Perceived Social Support, and Coping Strategies (N=197)

    Table 5. Factors Influencing Quality of Life (N=197)

    Table 1.

    Table 2.

    Table 3.

    Table 4.

    Table 5.

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