From the Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain; Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain; and Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain.
Am J Phys Med Rehabil. 2021 Sep 1;100(9):840-850. doi: 10.1097/PHM.0000000000001773.
The aims of the study were (1) to identify relationships between functional and psychological aspects with community integration and quality of life assessments in people with chronic traumatic spinal cord injury and (2) to analyze clinical and demographic predictors of quality of life dimensions.
This is an observational cohort study, and correlation coefficients were calculated between the Functional Independence Measure, the Hospital Anxiety and Depression Scale, the Community Integration Questionnaire, and the World Health Organization Quality of Life-BREF dimensions (physical [D1], psychological [D2], social [D3], and environmental [D4]). Quality of life predictors were identified using multiple linear regression analyses.
Nine hundred seventy-five people with traumatic spinal cord injury assessed since 2007-2020 were included. The Community Integration Questionnaire home integration correlated strongly with the Functional Independence Measure self-care (r = 0.74) and transfers (r = 0.62) for participants with tetraplegia. The specific Hospital Anxiety and Depression Scale items (known as the anhedonia subscale) correlated strongly with D1 (r = -0.65), D2 (r = -0.69), D3 (r = -0.53), and D4 (r = -0.51) for participants with paraplegia and D1 (r = -0.53), D2 (r = -0.61), D3 (r = -0.47), and D4 (r = -0.53) for participants with tetraplegia. The Hospital Anxiety and Depression Scale-depression was the most relevant predictor of D1 (β = -0.61) and D2 (β = -0.76).
The Functional Independence Measure transfers and self-care were strongly associated with the Community Integration Questionnaire home integration (in participants with tetraplegia). Anhedonia was strongly related to all four World Health Organization Quality of Life-BREF Scale dimensions, being the Hospital Anxiety and Depression Scale-depression the most relevant predictor of D1 and D2.
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Upon completion of this article, the reader should be able to (1) Determine the associations between functional and psychological measures with community integration domains and quality of life from a multidimensional perspective (physical, psychological, social, and environmental) in persons with chronic traumatic paraplegia or tetraplegia living in the community; (2) Identify long-term clinical and demographic predictors of specific quality of life dimensions (e.g., physical and psychological) in persons with paraplegia or tetraplegia living in the community; and (3) Illustrate the strength of the identified associations and the impact of the quality of life predictors to suggest possible specific aspects to be addressed by professionals in clinical practice.
Advanced.
The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
本研究的目的是（1）确定功能和心理方面与慢性创伤性脊髓损伤患者的社区融合和生活质量评估之间的关系，（2）分析生活质量维度的临床和人口统计学预测因素。
这是一项观察性队列研究，计算了功能独立性测量、医院焦虑和抑郁量表、社区融合问卷和世界卫生组织生活质量简表（身体 [D1]、心理 [D2]、社会 [D3] 和环境 [D4]）之间的相关系数。使用多元线性回归分析确定生活质量预测因素。
纳入了 2007-2020 年以来评估的 975 例创伤性脊髓损伤患者。社区融合问卷家庭融合与四肢瘫痪患者的功能独立性测量自我护理（r = 0.74）和转移（r = 0.62）密切相关。特定的医院焦虑和抑郁量表项目（称为快感缺失亚量表）与四肢瘫痪患者的 D1（r = -0.65）、D2（r = -0.69）、D3（r = -0.53）和 D4（r = -0.51）密切相关，与 D1（r = -0.53）、D2（r = -0.61）、D3（r = -0.47）和 D4（r = -0.53）密切相关。四肢瘫痪患者。医院焦虑和抑郁量表抑郁是 D1（β = -0.61）和 D2（β = -0.76）的最相关预测因素。
四肢瘫痪患者的功能独立性测量转移和自我护理与社区融合问卷家庭融合密切相关（r = 0.74）和转移（r = 0.62）。快感缺失与世界卫生组织生活质量简表的所有四个维度都密切相关，医院焦虑和抑郁量表抑郁是 D1 和 D2 的最相关预测因素（r = -0.61）。
要求 CME 学分：在 http://www.physiatry.org/JournalCME 上完成自我评估活动和评估。
CME 目标：完成本文后，读者应能够（1）确定慢性创伤性截瘫或四肢瘫痪患者的功能和心理测量与社区融合领域和生活质量之间的关联（从身体、心理、社会和环境的多维角度）生活在社区中的人；（2）确定长期临床和人口统计学预测因素对生活在社区中的截瘫或四肢瘫痪患者特定生活质量维度的影响（例如，身体和心理）；（3）说明确定关联的强度和生活质量预测因素的影响，以建议临床实践中的专业人员可能需要解决的具体方面。
高级。
学术物理治疗师协会经继续教育认证委员会认证，可为医生提供继续医学教育。学术物理治疗师协会将此次基于期刊的 CME 活动指定为最多 1.0 个 AMA PRA 类别 1 学分（™）。医生只能要求与其参与活动相称的学分。
