Krause James S, Saladin Lisa K, Adkins Rodney H
College of Health Professions, Medical University of South Carolina, Charleston, SC 29425, USA.
NeuroRehabilitation. 2009;24(1):47-56. doi: 10.3233/NRE-2009-0453.
To identify disparities and changes in subjective well-being, participation, and health over a 6-year period as a function of race-ethnicity and gender in persons with spinal cord injury (SCI).
Stratified sampling was used to maximize inclusion of women and racial-ethnic minorities. Three model SCI systems participated, representing the Southeastern, Western, and Mountain regions of the United States. 250 participants completed measures on two occasions. Similar portions of Caucasians (n = 62), African-Americans (n = 61), American-Indians (n = 56), and Hispanics (n = 71) participated. Women made up approximately 43.1% of the sample. Three sets of outcome measures assessed: (a) subjective well-being and depressive symptoms, (b) participation, and (c) health.
MANOVA indicated significant effects for race-ethnicity (between subjects effect) and time (within subjects effect) but not for gender or the interaction effects. A Bonferroni correction was used to compare outcomes as a function of race-ethnicity and time. Five outcomes were significantly related to race-ethnicity, whereas no items were significantly related to the time effect after the Bonferroni correction. Caucasians reported best subjective well-being scores in several domains followed by African-Americans. Caucasians also reported more hours out of bed than either African-Americans or Hispanics.
Over a 6-year period, race-ethnicity continued to be related to differences in subjective well-being and participation but not health. Disparities in outcomes did not systematically increase or diminish over time, suggesting that once developed, such disparities are unlikely to change in the absence of intervention.
确定脊髓损伤（SCI）患者在6年期间主观幸福感、参与度和健康状况的差异及变化，作为种族和性别的函数。
采用分层抽样以最大限度纳入女性和少数族裔。三个脊髓损伤模型系统参与研究，代表美国东南部、西部和山区。250名参与者分两次完成测量。白种人（n = 62）、非裔美国人（n = 61）、美洲印第安人（n = 56）和西班牙裔（n = 71）参与比例相近。女性约占样本的43.1%。评估了三组结果指标：（a）主观幸福感和抑郁症状，（b）参与度，（c）健康状况。
多变量方差分析表明种族（组间效应）和时间（组内效应）有显著影响，但性别或交互效应无显著影响。采用Bonferroni校正来比较作为种族和时间函数的结果。五项结果与种族显著相关，而经Bonferroni校正后，没有项目与时间效应显著相关。白种人在几个领域报告的主观幸福感得分最高，其次是非裔美国人。白种人报告的起床时间也比非裔美国人或西班牙裔更多。
在6年期间，种族仍然与主观幸福感和参与度的差异有关，但与健康无关。随着时间的推移，结果差异没有系统性地增加或减少，这表明一旦形成，在没有干预的情况下，这种差异不太可能改变。
