Advertisement

Influence of Sociodemographic Factors, Health Conditions, and Activity on Participation in People With Spinal Cord Injury in South Korea

Published:August 23, 2022DOI:https://doi.org/10.1016/j.apmr.2022.08.004

      Abstract

      Objective

      To verify the causal relationship between sociodemographic factors, health conditions, and activities that influence the participation of people with spinal cord injury (SCI) using International Spinal Cord Injury (InSCI) Survey data and to investigate the moderation effects of environmental restrictions and health care system concerns.

      Design

      Cross-sectional community survey and structural equation model.

      Setting

      SCI databases of the Korea National Rehabilitation Center and Korea Spinal Cord Injury Association.

      Participants

      Community-dwelling adults (N=890) with SCI.

      Interventions

      Not applicable.

      Main Outcome Measures

      The InSCI questionnaire domains included sociodemographic factors, health conditions, activity, participation, environmental restrictions, and health system concerns. Sociodemographic factors included age, education, and income. Health conditions included bowel dysfunction, respiratory problems, and pain, among others. Activity included “daily routine” and “using hands,” among others. Participation included “interacting with people” and “intimate relationships,” among others. Environmental restrictions included “public places” and “negative attitudes,” among others. Health care system concerns included “nursing care” and “experience of being treated,” among others.

      Results

      The hypothesis that health conditions would have a significant effect on activity was supported because 51% of the total variance in activity factors was explained by health condition factors. The hypothesis that activity would have a significant effect on participation was also supported because 63.4% of total variance in participation factors was explained by activity factors. The moderation effect tests supported the hypotheses that health conditions, activity, and participation would differ depending on the extent of environmental restrictions as well as the extent of health system concerns.

      Conclusions

      When formulating policies and recommendations to promote the participation of people with SCI living in the South Korean community, the influence of environmental restrictions and health systems as well as the causal influence of health conditions and activity should be considered.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Jette AM
        • Haley SM
        • Kooyoomjian JT.
        Are the ICF activity and participation dimensions distinct?.
        J Rehabil Med. 2003; 35: 145-149
        • Krause JS
        • Crewe NM.
        Chronologic age, time since injury, and time of measurement: effect on adjustment after spinal cord injury.
        Arch Phys Med Rehabil. 1991; 72: 91-100
        • Lee JH
        • Kang B-R.
        Comparison of daily activities and quality of life according to general characteristics of spinal cord injury.
        Korea Soc Cogn Ther Exerc. 2021; 13: 1-8
        • Shin E-K
        • Lee HN
        • Lee I-S.
        Examination of the mediating effect of self-efficacy and perceived social support on the spinal cord injuries’ social participation.
        Korean J Health Psychol. 2008; 13: 625-643
        • Chang FH
        • Liu CH
        • Hung HP.
        An in-depth understanding of the impact of the environment on participation among people with spinal cord injury.
        Disabil Rehabil. 2018; 40: 2192-2199
        • Shin H.
        Etiology and epidemiology of spinal cord injury in Korea.
        J Korean Med Assoc. 2020; 63: 589-595
        • Kennedy P
        • Lude P
        • Elfström ML
        • Smithson EF.
        Psychological contributions to functional independence: a longitudinal investigation of spinal cord injury rehabilitation.
        Arch Phys Med Rehabil. 2011; 92: 597-602
      1. Bickenbach J, Officer A, Shakespeare T, von Groote P, World Health Organization. International perspectives on spinal cord injury: summary (No. WHO/NMH/VIP/13.03). Geneva: World Health Organization; 2013.

        • Ullrich PM
        • Spungen AM
        • Atkinson D
        • et al.
        Activity and participation after spinal cord injury: state-of-the-art report.
        J Rehabil Res Dev. 2012; 49: 155-174
        • Mole H.
        A US model for inclusion of disabled students in higher education settings: the social model of disability and Universal Design.
        Widening participation and lifelong learning. 2013; 14: 62-86
        • Mole H.
        A US model for inclusion of disabled students in higher education settings: the social model of disability and Universal Design.
        Widening Partic Lifelong Learn. 2013; 14: 62-86
        • Van Loo MA
        • Post MWM
        • Bloemen JHA
        • Van Asbeck FWA.
        Care needs of persons with long-term spinal cord injury living at home in the Netherlands.
        Spinal Cord. 2010; 48: 423-428
        • Pacheco Barzallo D
        • Gross-Hemmi M
        • Bickenbach J
        • et al.
        Quality of life and the health system: a 22-country comparison of the situation of people with spinal cord injury.
        Arch Phys Med Rehabil. 2020; 101: 2167-2176
        • Jette AM
        • Tao W
        • Haley SM.
        Blending activity and participation sub-domains of the ICF.
        Disabil Rehabil. 2007; 29: 1742-1750
        • Badley EM.
        Enhancing the conceptual clarity of the activity and participation components of the International Classification of Functioning, Disability, and Health.
        Soc Sci Med. 2008; 66: 2335-2345
        • Barclay L
        • McDonald R
        • Lentin P.
        Social and community participation following spinal cord injury: a critical review.
        Int J Rehabil Res. 2015; 38: 1-19
        • Carpenter C
        • Forwell SJ
        • Jongbloed LE
        • Backman CL.
        Community participation after spinal cord injury.
        Arch Phys Med Rehabil. 2007; 88: 427-433
        • De Groot S
        • Post MWM
        • Bongers-Janssen HMH
        • Bloemen-Vrencken JH
        • Van der Woude LHV.
        Is manual wheelchair satisfaction related to active lifestyle and participation in people with a spinal cord injury?.
        Spinal Cord. 2011; 49: 560-565
        • Fekete C
        • Brach M
        • Ehrmann C
        • Post MWM
        • InSCI Stucki G
        Cohort profile of the international spinal cord injury community survey implemented in 22 countries.
        Arch Phys Med Rehabil. 2020; 101: 2103-2111
        • Gross-Hemmi MH
        • Post MWM
        • Ehrmann C
        • et al.
        Study protocol of the International Spinal Cord Injury (InSCI) community survey.
        Am J Phys Med Rehabil. 2017; 96: S23-S34
        • Fekete C
        • Post MWM
        • Bickenbach J
        • et al.
        A structured approach to capture the lived experience of spinal cord injury: data model and questionnaire of the International Spinal Cord Injury community survey.
        Am J Phys Med Rehabil. 2017; 96: S5-16
        • Kalpakjian CZ
        • Scelza WM
        • Forchheimer MB
        • Toussaint LL.
        Preliminary reliability and validity of a spinal cord injury secondary conditions scale.
        J Spinal Cord Med. 2007; 30: 131-139
        • Jette AM
        • Slavin MD
        • Ni P
        • et al.
        Development and initial evaluation of the SCI-FI/AT.
        J Spinal Cord Med. 2015; 38: 409-418
        • Fekete C
        • Eriks-Hoogland I
        • Baumberger M
        • et al.
        Development and validation of a self-report version of the Spinal Cord Independence Measure (SCIM III).
        Spinal Cord. 2013; 51: 40-47
      2. World Health Organization. Model Disability Survey: survey manual. Geneva: World Health Organization; 2017.

        • Ballert CS
        • Post MW
        • Brinkhof MW
        • Reinhardt JD
        SwiSCI Study Group. Psychometric properties of the Nottwil Environmental Factors Inventory Short Form.
        Arch Phys Med Rehabil. 2015; 96: 233-240
        • Bentler PM
        • Bonett DG.
        Significance tests and goodness of fit in the analysis of covariance structures.
        Psychol Bull. 1980; 88: 588-606
        • Piatt JA
        • Nagata S
        • Zahl M
        • Li J
        • Rosenbluth JP.
        Problematic secondary health conditions among adults with spinal cord injury and its impact on social participation and daily life.
        J Spinal Cord Med. 2016; 39: 693-698
        • Rivers CS
        • Fallah N
        • Noonan VK
        • et al.
        Health conditions: effect on function, health-related quality of life, and life satisfaction after traumatic spinal cord injury. A prospective observational registry cohort study.
        Arch Phys Med Rehabil. 2018; 99: 443-451
        • Lundström U
        • Wahman K
        • Seiger Å
        • Gray DB
        • Isaksson G
        • Lilja M.
        Participation in activities and secondary health complications among persons aging with traumatic spinal cord injury.
        Spinal Cord. 2017; 55: 367-372
        • Van Leeuwen CM
        • Post MW
        • Westers P
        • et al.
        Relationships between activities, participation, personal factors, mental health, and life satisfaction in persons with spinal cord injury.
        Arch Phys Med Rehabil. 2012; 93: 82-89
        • Cobb JE
        • Leblond J
        • Dumont FS
        • Noreau L.
        Perceived influence of intrinsic/extrinsic factors on participation in life activities after spinal cord injury.
        Disabil Health J. 2018; 11: 583-590
        • Braaf S
        • Lennox A
        • Nunn A
        • Gabbe B.
        Social activity and relationship changes experienced by people with bowel and bladder dysfunction following spinal cord injury.
        Spinal Cord. 2017; 55: 679-686
        • Dijkers MPJM
        • Yavuzer G
        • Ergin S
        • Weitzenkamp D
        • Whiteneck GG.
        A tale of two countries: environmental impacts on social participation after spinal cord injury.
        Spinal Cord. 2002; 40: 351-362
        • Tsai IH
        • Graves DE
        • Chan W
        • Darkoh C
        • Lee MS
        • Pompeii LA.
        Environmental barriers and social participation in individuals with spinal cord injury.
        Rehabil Psychol. 2017; 62: 36-44
        • Hwang EJ
        • Groves MD
        • Sanchez JN
        • Hudson CE
        • Jao RG
        • Kroll ME.
        Barriers to leisure-time physical activities in individuals with spinal cord injury.
        Occup Ther Health Care. 2016; 30: 215-230
        • Pilusa S
        • Myezwa H
        • Potterton J.
        Environmental factors influencing the prevention of secondary health conditions among people with spinal cord injury, South Africa.
        PLoS One. 2021; 16e0252280
        • Dorjbal D
        • Prodinger B
        • Zanini C
        • Avirmed B
        • Stucki G
        • Rubinelli S.
        Living with spinal cord injury in Mongolia: a qualitative study on perceived environmental barriers.
        J Spinal Cord Med. 2020; 43: 518-531
        • Pelletier CA
        • Latimer-Cheung AE
        • Warburton DE
        • Hicks AL.
        Direct referral and physical activity counselling upon discharge from spinal cord injury rehabilitation.
        Spinal Cord. 2014; 52: 392-395
        • Jaglal SB
        • Munce SEP
        • Guilcher SJ
        • et al.
        Health system factors associated with rehospitalizations after traumatic spinal cord injury: a population-based study.
        Spinal Cord. 2009; 47: 604-609
        • Skelton F
        • Hoffman JM
        • Reyes M
        • Burns SP.
        Examining health-care utilization in the first year following spinal cord injury.
        J Spinal Cord Med. 2015; 38: 690-695
        • Eastwood EA
        • Hagglund KJ
        • Ragnarsson KT
        • Gordon WA
        • Marino RJ.
        Medical rehabilitation length of stay and outcomes for persons with traumatic spinal cord injury—1990-1997.
        Arch Phys Med Rehabil. 1999; 80: 1457-1463