Sweet Shane N, Noreau Luc, Leblond Jean, Dumont Frédéric S
McGill University , Montreal , Canada.
Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) and Université Laval , Quebec City , Canada.
Top Spinal Cord Inj Rehabil. 2014 Fall;20(4):321-8. doi: 10.1310/sci2004-321.
Understanding the factors that can predict greater quality of life (QoL) is important for adults with spinal cord injury (SCI), given that they report lower levels of QoL than the general population.
To build a conceptual model linking SCI-related needs, secondary complications, and QoL in adults with SCI. Prior to testing the conceptual model, we aimed to develop and evaluate the factor structure for both SCI-related needs and secondary complications.
Individuals with a traumatic SCI (N = 1,137) responded to an online survey measuring 13 SCI-related needs, 13 secondary complications, and the Life Satisfaction Questionnaire to assess QoL. The SCI-related needs and secondary complications were conceptualized into factors, tested with a confirmatory factor analysis, and subsequently evaluated in a structural equation model to predict QoL.
The confirmatory factor analysis supported a 2-factor model for SCI related needs, χ(2)(61, N = 1,137) = 250.40, P <.001, comparative fit index (CFI) = .93, root mean square error of approximation (RMSEA) = .05, standardized root mean square residual (SRMR) = .04, and for 11 of the 13 secondary complications, χ(2)(44, N = 1,137) = 305.67, P < .001, CFI = .91, RMSEA = .060, SRMR = .033. The final 2 secondary complications were kept as observed constructs. In the structural model, both vital and personal development unmet SCI-related needs (β = -.22 and -.20, P < .05, respectively) and the neuro-physiological systems factor (β = -.45, P < .05) were negatively related with QoL.
Identifying unmet SCI-related needs of individuals with SCI and preventing or managing secondary complications are essential to their QoL.
鉴于脊髓损伤（SCI）成人患者的生活质量（QoL）水平低于一般人群，了解能够预测更高生活质量的因素对他们而言非常重要。
构建一个概念模型，将SCI成人患者的SCI相关需求、继发性并发症和生活质量联系起来。在测试该概念模型之前，我们旨在开发并评估SCI相关需求和继发性并发症的因素结构。
创伤性SCI患者（N = 1137）对一项在线调查做出回应，该调查测量了13项SCI相关需求、13项继发性并发症，并使用生活满意度问卷评估生活质量。将SCI相关需求和继发性并发症概念化为因素，通过验证性因素分析进行测试，随后在结构方程模型中进行评估以预测生活质量。
验证性因素分析支持SCI相关需求的二因素模型，χ(2)(61, N = 1137) = 250.40，P <.001，比较拟合指数（CFI）=.93，近似均方根误差（RMSEA）=.05，标准化均方根残差（SRMR）=.04；对于13项继发性并发症中的11项，χ(2)(44, N = 1137) = 305.67，P <.001，CFI =.91，RMSEA =.060，SRMR =.033。最后2项继发性并发症保留为可观察的结构。在结构模型中，重要需求和个人发展方面未满足的SCI相关需求（β分别为-.22和-.20，P <.05）以及神经生理系统因素（β = -.45，P <.05）均与生活质量呈负相关。
识别SCI患者未满足的SCI相关需求并预防或管理继发性并发症对其生活质量至关重要。
