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Twenty-Five-Year Cross-sequential Analysis of Self-reported Problems: Findings From 5 Cohorts From the Spinal Cord Injury Longitudinal Aging Study

  • Chao Li
    Affiliations
    College of Health Professions, Medical University of South Carolina, Charleston, South Carolina
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  • Jillian M.R. Clark
    Affiliations
    College of Health Professions, Medical University of South Carolina, Charleston, South Carolina

    Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, California

    Department of Psychiatry, University of California, San Diego, La Jolla, California
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  • James S. Krause
    Correspondence
    Corresponding author James S. Krause, PhD, College of Health Professions, Medical University of South Carolina, 151-B Rutledge Ave, MSC 962, Charleston, SC 29425.
    Affiliations
    College of Health Professions, Medical University of South Carolina, Charleston, South Carolina
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Published:December 26, 2020DOI:https://doi.org/10.1016/j.apmr.2020.11.016

      Abstract

      Objective

      To evaluate how self-reported problems change over time among people with spinal cord injury (SCI).

      Design

      Cross-sequential analysis.

      Setting

      Medical university in the Southeastern United States.

      Participants

      Participants included 1997 individuals with traumatic SCI of at least 1-year duration who were identified from participation in the SCI Longitudinal Aging Study from 1993-2018.

      Interventions

      None.

      Main Outcome Measures

      The outcomes analyzed were 6 problem factors defined as health, social isolation, emotional distress, environmental barriers, money, and lack of opportunities. A series of cross-sequential models, using PROC MIXED procedure, were developed to evaluate the initial and change of the 6 problem factors over the 6 times of measurements in 25 years.

      Results

      Years post injury was negatively associated with initial status of problems of social isolation, emotional distress, environmental barriers, and lack of opportunities because participants with more years post injury at baseline reported lower scores on each factor. Longitudinally, with increased years post injury, higher scores were observed on the health problem factor. However, problems of social isolation, emotional distress, environmental barriers, money, and lack of opportunities decreased over time with increasing years post injury.

      Conclusions

      Participants had more health problems with increasing years after SCI, but fewer problems of social isolation, emotional distress, environmental barriers, money, and lack of opportunities.

      Keywords

      List of abbreviations:

      SCI (spinal cord injury)
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