Life Satisfaction After Spinal Cord Injury and Psychological Factors: A Prospective Longitudinal Cohort Study.

OBJECTIVES

To examine (1) the course of life satisfaction in individuals with spinal cord injury (SCI) from admission to inpatient rehabilitation to 4 years after discharge and (2) the associations between psychological factors and this course of life satisfaction.

DESIGN

Prospective longitudinal cohort study.

SETTING

Rehabilitation center and community.

PARTICIPANTS

This study includes 266 individuals with recent-onset SCI.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Life satisfaction was assessed using the 2-item Life Satisfaction Scale (range, 2-13) at 9 time points. Patient characteristics, psychological resources (general self-efficacy, disability management self-efficacy, resilience, neuroticism, and meaning in life), coping, and cognitive appraisals were assessed at admission. Multilevel regression analyses were performed.

RESULTS

The mean age of the participants was 55.8 years (SD, 15.2); 47% had paraplegia, 50% had traumatic SCI, and 77% had incomplete SCI. Median duration of inpatient rehabilitation was 11 weeks. Life satisfaction gradually increased from 5.3 (SD, 2.3) at admission to 7.2 (SD, 2.1) 4 years after discharge, with significant increases in the first 4 weeks (Δ=0.8; SD=0.6), and between 1 and 4 years after discharge (Δ=.4; SD=.7). In the final regression model, younger age, Dutch nationality, higher education level, higher disability management self-efficacy, and lower threatening appraisals were independent predictors of a more positive course of life satisfaction.

CONCLUSION

Life satisfaction in individuals with SCI increased significantly over time. Results from this study suggest that long-term life satisfaction could be positively influenced by modifying low self-efficacy and high threatening appraisals during inpatient rehabilitation.