Quality of Life and Adaptation in People With Spinal Cord Injury: Response Shift Effects From 1 to 5 Years Postinjury.
Arch Phys Med Rehabil
; 99(8): 1599-1608.e1, 2018 08.
Article
en En
| MEDLINE
| ID: mdl-29481771
OBJECTIVE: To investigate response shift effects in spinal cord injury (SCI) over 5 years postinjury. DESIGN: Prospective cohort study observed at 1, 2, and 5 years post-SCI. SETTING: Specialized SCI centers. PARTICIPANTS: Sample included 1125, 760, and 219 participants at 1, 2, and 5 years post-SCI (N = 2104). The study sample was 79% men; 39% were motor/sensory complete (mean age, 44.6±18.3y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Patient-reported outcomes included the Medical Outcomes Study 36-Item Short-Form Health Survey version 2 and the Life Satisfaction-11 Questionnaire. Participant latent variable scores were adjusted for (1) potential attrition bias and (2) propensity scores reflecting risk of worse outcomes. The Oort structural equation modeling approach for detecting and accounting for response shift effects was used to test the hypothesis that people with SCI would undergo response shifts over follow-up. RESULTS: The study data comprised the time after FIM scores, an objective measure of motor and cognitive function, had improved and stabilized. Three latent variables (Physical, Mental, and Symptoms) were modeled over time. The response shift model indicated uniform recalibration and reconceptualization response shift effects over time. When adjusted for these response shift effects, Physical showed small true change improvements at 2- and 5-year follow-up, despite FIM stability. CONCLUSIONS: We detected recalibration and reconceptualization response shift effects in 1- to 5-year follow-up of people with SCI. Despite stable motor and cognitive function, people with SCI are adapting to their condition. This adaptation reflects a progressive disconnection between symptoms and physical or mental health, and a real improvement in the Physical latent variable.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Calidad de Vida
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Traumatismos de la Médula Espinal
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Adaptación Psicológica
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Medición de Resultados Informados por el Paciente
Tipo de estudio:
Observational_studies
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Prognostic_studies
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Qualitative_research
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Risk_factors_studies
Aspecto:
Patient_preference
Límite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Arch Phys Med Rehabil
Año:
2018
Tipo del documento:
Article
Pais de publicación:
Estados Unidos