Impact of spinal cord injury on self-perceived pre- and postmorbid cognitive, emotional and physical functioning

Abstract

Study Design: Cross-sectional study with repeated measurements. Objectives: To examine the patient's perspective of the impact of spinal cord injury (SCI) on physical, cognitive, emotional function, and quality of life (QOL). Setting: Australia. Methods: A sample of 63 patients with SCI, 32 of whom had recent injuries, and 31 with established injuries were administered the Ruff Neurobehavioral Inventory to examine patients' subjective evaluation of pre- and post-injury functioning. Current happiness levels were also evaluated using the Subjective Happiness Scale. A follow up assessment was performed 6 months later to examine changes over time. Results: A significant difference was found between perception of pre- and postmorbid function on composite Cognitive (t = 5.99, df = 62, P<0.001), Physical (t = 11.56, df = 62, P<0.001), and QOL (t = 7.16, df = 62, P<0.001) scales and on several of the Emotional subscales including anxiety, paranoia and suspicion, and substance abuse (P<0.001). A series of hierarchical regression analyses indicate that post-SCI pain was a significant predictor of: cognitive (R 2 = 0.20, P<0.001); emotional (R 2 = 0.13, P<0.004); and of QOL (R 2 = 0.22, P<0.001) functioning. With the exception of a decrease in happiness (P<0.01), there were no significant changes in any measures over the 6 month time period. Conclusions: There are significant changes in patients' perceptions of physical and cognitive functioning, and of QOL before and after SCI and some aspects of emotional functioning. Pain has a significant adverse effect on functioning. Happiness decreased slightly in the 6 months between surveys. © 2007 International Spinal Cord Society All rights reserved.