Article

OBJECTIVE: To examine the association of race and cultural factors with
quality-of-life factors (participation, life satisfaction, perceived health
status) in people with spinal cord injury (SCI). DESIGN: Cross-sectional
multisite study using structured questionnaires. SETTING: Six National SCI Model
Systems centers. PARTICIPANTS: People with SCI (N=275; age >/=16y; SCI with
discernable neurologic impairments; used power or manual wheelchair for >1y as
primary means of mobility; nonambulatory except for exercise purposes).
INTERVENTIONS: None. MAIN OUTCOME MEASURES: Participation (Craig Handicap
Assessment and Reporting Technique Short Form); satisfaction (Satisfaction With
Life Scale); and perceived health status (2 items from 36-Item Short Form Health
Survey). RESULTS: African American (n=96) with SCI reported more experiences of
discrimination in health care, greater perceived racism, more health care system
distrust, and lower health literacy than whites (n=156; P range, <.001-<.05).
Participants who reported experiencing more discrimination in health care
reported better occupational functioning (odds ratio [OR], 1.5; 95% confidence
interval [CI], 1.07-2.09; P<.05). Those who perceived more racism in health care
settings reported better occupational functioning (OR, 1.65; 95% CI, 1.12-2.43;
P<.05) and greater perceived health (beta=.36; 95% CI, .05-.68; P<.05). Those who
reported more distrust in the health care system reported better current health
compared with 1 year ago (beta=.38; 95% CI, .06-.69; P<.05). Those who reported
better communication with their health care provider reported higher levels of
mobility (OR, 1.5; 95% CI, 1.05-2.13; P<.05) and better general health (beta=.27;
95% CI, .01-.53; P<.05). CONCLUSIONS: In this cross-sectional study of people
with SCI, higher levels of perceived discrimination and racism and better
communication with health care providers were associated with an increase in
participation and functioning and improvements in perceptions of well-being.
These associations are different from those reported in other study populations
and warrant confirmation in future prospective studies.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS