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Nursing Home Residence: Quality of Life Among Individuals with Spinal Cord Injury

Putzke, John D. PhD; Richards, J. Scott PhD

American Journal of Physical Medicine & Rehabilitation: June 2001 - Volume 80 - Issue 6 - p 404-409
Research Articles: Spinal Cord Injury

Putzke JD, Richards JS: Nursing home residence: quality of life among individuals with spinal cord injury. Am J Phys Med Rehabil 2001;80:404–409.

Objective To examine the quality of life among individuals with spinal cord injury currently living in a nursing home vs. community residence.

Design A case-control design matched nursing home and community residents on numerous demographic and medical characteristics. Two groups of 37 individuals (nursing home vs. community residents) were matched case-for-case on age (i.e., within 10 yr), education, gender, race, marital status, and impairment level. Etiology of spinal cord injury, American Spinal Injury Association Impairment Index at the time of rehabilitation discharge, and injury duration, although not specifically matched, were not significantly different between groups (P > 0.05). Outcome measures included the Satisifaction With Life Scale, and the Craig Handicap Assessment and Reporting Technique (CHART).

Results Results indicated that overall self-reported quality of life was significantly lower among nursing home residents compared with matched community-dwelling residents (mean = 18 and 14, respectively). Similarly, self-reported handicap was significantly higher among the nursing home residents compared with community residents (mean = 337 and 181, respectively), particularly in the areas of physical independence, mobility, occupational functioning, and economic self-sufficiency (P < 0.05). In contrast, the score on the CHART social integration subscale was similar across groups (P > 0.05).

Conclusion Despite matching numerous variables, the nursing home residents demonstrated significantly lower quality of life across multiple domains as compared with their community-dwelling counterparts. Additional research is needed to examine the specific mechanisms associated with these differences.

From the Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, Alabama.

Supported, in part, by the University of Alabama at Birmingham Model Spinal Cord Injury System of Care grant H133N50009 from the National Institute on Disability and Rehabilitation Research, Office of Special Education and Rehabilitation Services, Department of Education, Washington, DC.

Data used in this study were derived from the National Spinal Cord Injury Statistical Center and were contributed by the 18 currently Funded Model Spinal Cord Injury Systems of Care.

FIM is a trademark of the Uniform Data System for Medical Rehabilitation, a division of UB Foundation Activities, Inc.

All correspondence and requests for reprints should be addressed to J. Scott Richards, PhD, Spain Rehabilitation Center, 1717 6th Avenue South, Room 529, Birmingham, AL 35233-7330.

© 2001 Lippincott Williams & Wilkins, Inc.