Article

OBJECTIVE: To test the hypotheses that: (i) pain is associated with depressive
symptoms and quality of life;
and (ii) participation restriction, satisfaction,
and frequency mediate these relationships. DESIGN: Population-based,
cross-sectional study. SUBJECTS / PATIENTS: Community-dwelling individuals with
spinal cord injury (n = 1,549). METHODS: Hypotheses were tested in individuals
with at least moderate chronic pain on the spinal cord injury - Secondary
Conditions Scale (n = 834), applying structural equation modelling to data for
spinal cord injury subgroups related to lesion severity (paraplegia, tetraplegia,
complete, incomplete) and time since injury (/= 10 years). Model
parameters included pain intensity (numerical rating scale), participation
frequency, restriction, satisfaction (Utrecht Scale of Evaluation of
Rehabilitation-Participation; USER-Participation), depressive symptoms (5-item
Mental Health Index of the Short Form Health Survey; MHI-5), and 5 selected
quality of life items (World Health Organization Quality of Life Scale;
WHOQoL-BREF). RESULTS: Structural equation models confirmed associations of pain
with depressive symptoms and quality of life, as well as the mediating role of
participation restriction and low satisfaction with participation. These findings
were apparent in individuals with tetraplegia or complete lesion and in those </=
10 years since paraplegia or incomplete injury.
CONCLUSION: Unrestricted or
satisfactory participation was found to be a crucial resource for individuals
living less than 10 years with a more severe spinal cord injury, since it
represents buffering potential for the negative effects of chronic pain on mental
health and quality of life.

Langue : ANGLAIS