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The association of race, cultural factors, and health-related quality of life in persons with spinal cord injury

Myaskovsky, L and Burkitt, KH and Lichy, AM and Ljungberg, IH and Fyffe, DC and Ozawa, H and Switzer, GE and Fine, MJ and Boninger, ML (2011) The association of race, cultural factors, and health-related quality of life in persons with spinal cord injury. Archives of Physical Medicine and Rehabilitation, 92 (3). 441 - 448. ISSN 0003-9993

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Abstract

Objective To examine the association of race and cultural factors with quality-of-life factors (participation, life satisfaction, perceived health status) in people with spinal cord injury (SCI). Design Cross-sectional multisite study using structured questionnaires. Setting Six National SCI Model Systems centers. Participants People with SCI (N=275; age <16y; SCI with discernable neurologic impairments; used power or manual wheelchair for >1y as primary means of mobility; nonambulatory except for exercise purposes). Interventions None. Main Outcome Measures Participation (Craig Handicap Assessment and Reporting Technique Short Form); satisfaction (Satisfaction With Life Scale); and perceived health status (2 items from 36-Item Short Form Health Survey). Results African American (n=96) with SCI reported more experiences of discrimination in health care, greater perceived racism, more health care system distrust, and lower health literacy than whites (n=156; P range, <.001<.05). Participants who reported experiencing more discrimination in health care reported better occupational functioning (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.072.09; P<.05). Those who perceived more racism in health care settings reported better occupational functioning (OR, 1.65; 95% CI, 1.122.43; P<.05) and greater perceived health (β=.36; 95% CI, .05.68; P<.05). Those who reported more distrust in the health care system reported better current health compared with 1 year ago (β=.38; 95% CI, .06.69; P<.05). Those who reported better communication with their health care provider reported higher levels of mobility (OR, 1.5; 95% CI, 1.052.13; P<.05) and better general health (β=.27; 95% CI, .01.53; P<.05). Conclusions In this cross-sectional study of people with SCI, higher levels of perceived discrimination and racism and better communication with health care providers were associated with an increase in participation and functioning and improvements in perceptions of well-being. These associations are different from those reported in other study populations and warrant confirmation in future prospective studies. © 2011 American Congress of Rehabilitation Medicine.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Myaskovsky, Lmyaskov@pitt.eduMYASKOV
Burkitt, KH
Lichy, AM
Ljungberg, IH
Fyffe, DC
Ozawa, H
Switzer, GE
Fine, MJmjf1@pitt.eduMJF1
Boninger, MLboninger@pitt.eduBONINGER
Centers: Other Centers, Institutes, Offices, or Units > Human Engineering Research Laboratories
Date: 1 March 2011
Date Type: Publication
Journal or Publication Title: Archives of Physical Medicine and Rehabilitation
Volume: 92
Number: 3
Page Range: 441 - 448
DOI or Unique Handle: 10.1016/j.apmr.2010.10.007
Schools and Programs: School of Health and Rehabilitation Sciences > Rehabilitation Science and Technology
Refereed: Yes
ISSN: 0003-9993
MeSH Headings: Continental Population Groups--psychology; Cross-Sectional Studies; Culture; Female; Health Status Disparities; Humans; Male; Middle Aged; Prejudice; Professional-Patient Relations; Quality of Life--psychology; Socioeconomic Factors; Spinal Cord Injuries--psychology
PubMed ID: 21353826
Date Deposited: 04 Oct 2012 13:55
Last Modified: 01 Mar 2019 15:57
URI: http://d-scholarship.pitt.edu/id/eprint/14732

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