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Self-rated health in persons with spinal cord injury: relationship of secondary conditions, function and health status

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Abstract

Objective

Self-rated health is used frequently as a measure of health in the general population, and increasingly with persons with disabilities. However, its meaning and its relationship with other measures of self-reported health (health status and secondary conditions) are not well understood for this group. The purpose of the present study was to use a conceptual model to examine the structure of self-rated health with persons with spinal cord injuries.

Methods

A US sample of 270 adults with mobility impairment stemming from spinal cord injury (SCI) provided data on three measures of self-reported health that differ in degree of subjectivity: physical problems common to SCI, four domains of health status from the SF-36, and a single item on self-rated health. Data were compared with the norm sample of the SF-36. The conceptual model was tested using path analyses.

Results

SF-36 scores were lower on three of four domains compared with the norm sample. The conceptual model analyses indicated that 35% of variance in self-rated health is accounted for through direct relationship with physical secondary conditions common to persons with SCI and as mediated through SF-36 domains of Role Physical and Vitality. The SF-36 domain of Physical Function was statistically unrelated to self-rated health.

Conclusion

The conceptual model of self-rated health was verified in a sample of persons with SCI. Importantly, the SF-36 domain of Physical Function does not relate to self-rated health for this group. Its inclusion in measures of self-reported for disability populations creates difficulty without apparent benefit.

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Acknowledgments

We extend our thanks to durable medical equipment vendors who helped recruit this sample of persons with SCI; the respondents; and our colleagues Charles Drum, Glenn Fujiura and Elena Andresen who provided their responses to an earlier draft of these findings. We also thank Carolyn van der Gaag as editor of QOLR and the anonymous reviewers who made numerous and valuable suggestions for revisions. Thanks also to Susan Wingenfeld for literature searching and manuscript preparation. The contents of this paper were developed under a grant from the Department of Education, NIDRR grant number H133B040034. However, the contents do not necessarily represent the policy of the Department of Education, and the reader should not assume endorsement by the Federal Government.

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Authors and Affiliations

  1. Rehabilitation Research and Training Center, Child Development and Rehabilitation Center, Oregon Health & Science University, P.O. Box 574, Portland, OR, 97201-0574, USA

    Gloria L. Krahn, Rie Suzuki & Willi Horner-Johnson

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  1. Gloria L. Krahn
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  2. Rie Suzuki
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Correspondence to Gloria L. Krahn.

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Krahn, G.L., Suzuki, R. & Horner-Johnson, W. Self-rated health in persons with spinal cord injury: relationship of secondary conditions, function and health status. Qual Life Res 18, 575–584 (2009). https://doi.org/10.1007/s11136-009-9477-z

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