Comparison of life satisfaction in persons with spinal cord injury living in 22 countries with different economic status

Published:December 16, 2021DOI:


      Objective: To analyze and compare life satisfaction (LS) in persons with spinal cord injury (SCI) living in 22 countries participating in the International SCI (InSCI) community survey. The study tested the hypothesis that there are differences in LS across InSCI countries according to the countries’ economic status specified as gross domestic product per capita purchased power parity (GDP-PPP).
      Design: Cross-sectional survey.
      Setting: Community setting (22 countries representing all 6 World Health Organization regions).
      Participants: Persons (N=12,108) with traumatic or non-traumatic SCI aged at least 18 years, living in the community and able to respond to one of the available language versions of the questionnaire.
      Interventions: Not applicable.
      Main outcomes: Life satisfaction measured by 5 items selected from the World Health Organization Quality of Life Assessment-BREF (WHOQOL-5): satisfaction with overall quality of life, health, daily activities, relationships, and living conditions. LS index was calculated as the mean of these 5 items.
      Results: The highest level of LS was reported by persons with SCI living in USA, Malaysia, and Switzerland (mean range: 3.76-3.80), and the lowest by persons with SCI living in South Korea, Japan and Morocco (mean range: 2.81-3.16). There was a significant cubic association between LS index and GDP-PPP. Regression Trees analysis revealed the main variables differentiating LS index were GDP-PPP and monthly income, followed by time since injury and education.
      Conclusions: Life satisfaction reported by persons with SCI related mainly to their country economic situation expressed by GDP-PPP and monthly income. The results of this study underscore the need for policy dialogues to avoid inequalities and improve the life experience in persons with SCI.

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