Chang F-H, Wang Y-H, Jang Y, Wang C-W. Factors associated with quality of life among people with spinal cord injury: application of the International Classification of Functioning, Disability and Health Model. Objective: To identify the factors that influence an individual's quality of life (QOL) after spinal cord injury (SCI) based on the International Classification of Functioning, Disability and Health (ICF) framework. Design: Cross-sectional exploratory study. Setting: Taiwan community. Participants: Community-dwelling adults (N=341) who had suffered an SCI at least 1 year previously and were between the ages of 18 and 60 years. Interventions: Not applicable. Main Outcome Measure(s): A combination of self-report questionnaire and interview. The dependent variable, QOL, was measured by the abbreviated version of the World Health Organization Quality of Life, while the independent variables - participation, activity, impairment, and contextual factors - were measured using the Frenchay Activity Index, Barthel Index, and a demographic form. Results: Multivariate analysis results indicated that participation, activity, and marital status are significant factors in the QOL outcome. Results also indicated that among the various factors that affect each domain of QOL (physical health, psychological health, social relationships, and environment), participation was the strongest determinant. Conclusions: The ICF provided an excellent framework with which to explore the factors influencing QOL after SCI. The results demonstrated that marital status, participation, and activity exert the strongest influence on QOL, while impairment and other variables do not directly influence QOL.
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