A comparison of perceptions of quality of life among adults with spinal cord injury in the United States versus the United Kingdom

Qual Life Res, 2017 · DOI: 10.1007/s11136-017-1646-x · Published: November 1, 2017

Spinal Cord Injury Participation Healthcare

Simple Explanation

This study compares the quality of life (QOL) perceptions of adults with spinal cord injury (SCI) in the United States (US) and the United Kingdom (UK). It explores how access to care, cultural differences, and other factors influence their QOL. Participants were recruited through advertisements and SCI forums. They were interviewed about their experiences with rehabilitation, medical care, functional adjustment, financial resources, and socio-political context. The study found that medical care is a central influence on QOL, with US participants reporting negative experiences due to fragmented care and insurance issues, while UK participants reported positive experiences due to universal healthcare.

Study Duration

April to June 2016

Participants

20 adults with SCI (10 US, 10 UK)

Evidence Level

Not specified

Key Findings

1
Medical care significantly impacts QOL for individuals with SCI, with US participants reporting negative experiences due to fragmented care and insurance-related barriers.
2
UK participants generally had more positive experiences with medical care due to the universal healthcare system, which provides free and continuous care, wheelchair provision, and home care services.
3
Both groups highlighted the importance of family support, social relationships, and attitudes towards disability in influencing their QOL, but also reported negative experiences such as abandonment and lack of understanding from others.

Research Summary

This study explored the quality of life (QOL) perspectives of adults with spinal cord injury (SCI) in the United States (US) and the United Kingdom (UK), focusing on factors such as medical care, functional adjustment, financial resources, and socio-political context. The study found that medical care has a significant influence on QOL. US participants reported negative experiences because of fragmented primary and specialist care, rehabilitation and wheelchair provision contingent on insurance, and an overwhelming bureaucratic burden. The UK participants experienced predominantly positive influence, because of the advantages and benefits of universal provision, including free and continuous care, free provision of goods (wheelchairs) and services (home care), and length of rehabilitation in relation to level of injury.

Practical Implications

Policy implications for healthcare

The study highlights the need for healthcare policies that ensure continuous and comprehensive care for individuals with SCI, regardless of their insurance status or financial resources.

Improve Patient-Physician Communication

There is a need for better communication and patient education regarding SCI and life after discharge from rehabilitation, especially in the US.

Address Physical and Mental Fatigue

Healthcare providers should recognize and address physical and mental fatigue as significant functional impairments in individuals with SCI.

Study Limitations

1
Sample representativeness is a key limitation, as the participants may not fully represent the broader SCI population in each country.
2
Self-selection bias may exist due to the recruitment methods, which relied on online advertisements and patient advocacy organizations.
3
The low remuneration offered may have discouraged participation.

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