Review of Cross-Cultural Issues Related to Quality of Life After Spinal Cord Injury

Top Spinal Cord Inj Rehabil, 2014 · DOI: 10.1310/sci2003-181 · Published: July 1, 2014

Spinal Cord Injury Participation Research Methodology & Design

Simple Explanation

Quality of life (QOL) is understood differently by different people and researchers, making a universal definition difficult. The article explores how culture influences QOL after spinal cord injury (SCI). Factors like economic status, race, society, and culture influence QOL for SCI individuals. These factors are still unclear. The cultural environment and personal choices impact QOL. Only a few studies have examined how cultural and ethnic differences affect QOL among individuals with SCI in the US.

Study Duration

Not specified

Participants

US Sample: 75 persons with SCI; Brazilian Sample: 50 persons with chronic SCI

Evidence Level

Review

Key Findings

1
There were no significant differences in how the US and Brazilian samples rated their QOL, suggesting good preliminary concurrent validity for the translated version of the QOL Data Set.
2
The International SCI QOL Basic Data Set items were strongly associated with each other and with the WHOQOL-BREF’s measures of overall QOL and general health, suggesting good preliminary validity for the international items.
3
Country explained 5% of the variance in QOL, with Brazilians having the lowest levels and US residents having the highest.

Research Summary

This article describes how QOL is defined and conceptualized. Cross-culturally, the concept has been assessed in many ways, evolving from an economic indicator to what is currently primarily understood as a subjective construct including happiness and overall well-being along with social, functional, and health status. Differences between health and disability for persons with SCI are also acknowledged and must be taken in consideration when future QOL assessments are designed. Qualitative findings provide further evidence of the importance of subject assessments. Our quantitative findings suggest that there is good reciprocity between international assessments of QOL when tested in 2 countries, Brazil and the United States.

Practical Implications

Standardize QOL Assessments

Finding a common metric for QOL will allow comparisons to be made across countries and will enhance the promotion of policies that ensure equality and reduce disparities.

Use International Datasets

The International SCI QOL Basic Datasets represent a promising approach to the collection of QOL data by providing a common measure of QOL.

Future Research

Further studies with larger samples are necessary to ensure the reliability and validity of measures and items designed to assess QOL across nations.

Study Limitations

1
Lack of significant differences between QOL in the 2 samples suggests that the International SCI QOL Basic Data Sets can be used across nations, judgments are seemingly contextualized to what is deemed normal and expected by respondents in different cultures.
2
The 3 items comprising the QOL International Data Sets may be insufficient to fully capture the QOL construct.
3
The items have not been examined for their psychometric properties.

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