Adjustment after spinal cord injury: A 9-year longitudinal study

Objective: To generate longitudinal data on the stability of life adjustment over a 9-year period among a sample of participants with spinal cord injury (SCI). Design: A field study was conducted by surveying the adjust ment of a sample of participants with SCI in 1985 and again in 1994. Setting: Outpatient files of a large, university hospital in the Midwest. Participants: All 235 participants had traumatic onset SCI, were a minimum of 18 years of age at the time of first testing, and were no less than 2 years postinjury. The average age was 46.7 yrs at the time of the 1994 study, with an average of 23.4 yrs having passed since injury. Main Outcome Measures: The Life Situation Questionnaire (LSQ) was the outcome measure used. It was developed in 1973 to measure mostly objective information on adjustment and quality of life after SCI. It contains 7 scales and 40 individual items that were of interest in the current study. Results: Declines were identified over the 9-year period in several aspects of subjective well-being, even though there were no declines in overall activity level and some limited increases in participation in employment related activities. Conclusions: The results of this study were in contrast to previous longitudinal follow ups that identified positive changes over time in both subjective and objective aspects of quality of life. These changes suggest that participants had a less optimistic outlook in 1994 than they did in 1985. (C) 1997 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.