Life satisfaction, appraisals and functional outcomes in spinal cord-injured people living in the community

Study design: Multi-centre, single cohort. Objectives: To assess the relationship between cognitive appraisals in a spinal cord-injured population living in the community, and examine how these factors affect social participation, life satisfaction and functional outcomes. Setting: The National Spinal Injuries Centre, Stoke Mandeville, UK; Princess Royal Spinal Injuries Centre, Sheffield UK; Midlands Centre for Spinal Injuries, Oswestry, UK. Method: Participants (n81) sustaining injury aged 18 or above were recruited from one of three spinal cord injuries units 3-18 months after discharge. Postal packs containing questionnaires, consent forms and information were distributed and a 2-week reminder sent. Results: Participation was found to be strongly related to life satisfaction, negative appraisals of disability were found to explain 12.9% of the variance in total participation scores. The variance in scores on Life Satisfaction Questionnaires was explained by appraisals, participation and secondary complications to a total of 69.6%. Functional Independence Scores were explained by negative perceptions of disability, growth and resilience and total secondary complication scores, explaining 49.4% of the variance in this measure. Conclusion: Participation, functional independence and life satisfaction were significantly related to appraisal styles in this population. Negative perceptions of disability, fearful despondency and overwhelming disbelief were themes that impacted on the likelihood of participation and independence and involved in expressed levels of life satisfaction. Our results suggest the need to tackle cognitive styles of SCI patients before discharge to improve the rehabilitation process.