Christofi Alice A S N, Tate Denise G, Witter Carla, Alonso Angelica Castilho, Greve Julia Maria D'Andrea
Institute of Orthopedics and Traumatology, Faculty of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil.
Department of Physical Medicine and Rehabilitation, The University of Michigan Medical School, Ann Arbor, MI, USA.
Spinal Cord. 2023 Apr;61(4):253-259. doi: 10.1038/s41393-023-00881-7. Epub 2023 Feb 16.
A cross-sectional, descriptive study.
To investigate the demographic, clinical behavioral, and rehabilitation predictors of the quality of life (QoL) of people with spinal cord injury/disease (SCI/D) in a middle-income country.
Ninety-five participants living in the community were evaluated with the following instruments: World Health Organization Quality of Life - Bref; International SCI Core DataSet; Clinical Interview; Spinal Cord Secondary Conditions Scale and Patient Health Questionnaire; Numerical Pain Intensity Scale; Short-Form 12 Health Survey - Item 8 (how much pain hinders activities); Patient Health Questionnaire 2, Numerical Fatigue Scale. Data were analyzed via Spearman correlation, univariate analysis, and multiple regression to explain the effects associated with quality-of-life predictors.
The main factors that decreased quality of life were fatigue (by 11.5%), depression (by 5.5-12.8%), pain (by 1.3 in total life quality, in the physical domain by 8.6-9.6%), sores (15.6% in the physical domain only). The practice of sports increased the total quality of life by 14.4%, in the physical domain by 11.9%, in the psychological domain by 17.2%, and in the social domain by 23.7%.
Fatigue, risk of depression, pain, and the presence of sores are predictors of poor quality of life, and sports are a predictor of a better quality of life, for people with spinal cord injury. Multidisciplinary rehabilitation, in addition to policies, to increase accessibility and social inclusion, and incentives or subsidies for the practice of sports could improve QoL following SCI/D.
一项横断面描述性研究。
调查一个中等收入国家脊髓损伤/疾病(SCI/D)患者生活质量(QoL)的人口统计学、临床行为学及康复预测因素。
使用以下工具对95名居住在社区的参与者进行评估:世界卫生组织生活质量简表;国际脊髓损伤核心数据集;临床访谈;脊髓继发病症量表和患者健康问卷;数字疼痛强度量表;简短健康调查问卷-第8项(疼痛对活动的阻碍程度);患者健康问卷2、数字疲劳量表。通过Spearman相关性分析、单因素分析和多元回归分析数据,以解释与生活质量预测因素相关的影响。
降低生活质量的主要因素包括疲劳(降低11.5%)、抑郁(降低5.5%-12.8%)、疼痛(总体生活质量降低1.3,身体领域降低8.6%-9.6%)、溃疡(仅在身体领域为15.6%)。体育锻炼使总体生活质量提高了14.4%,身体领域提高了11.9%,心理领域提高了17.2%,社会领域提高了23.7%。
对于脊髓损伤患者,疲劳、抑郁风险、疼痛和溃疡的存在是生活质量差的预测因素,而体育锻炼是生活质量较好的预测因素。除政策外,多学科康复以增加可及性和社会融合,以及对体育锻炼的激励或补贴,可以改善脊髓损伤/疾病后的生活质量。