Impact of work and environmental factors on quality of life in community-dwelling spinal cord injury individuals in South Korea using latent profile analysis

Authors

  • Bum-Suk Lee Department of Rehabilitation Medicine, International St. Mary’s Hospital, Incheon, Korea
  • Boram Lee Division of Health Services Development for Persons with Disabilities, National Rehabilitation Center, Seoul, Korea
  • Jincheol Lim School of Liberal Studies, Sejong University, Seoul
  • Onyoo Kim Department of Spinal Cord Injury Rehabilitation Medicine, National Rehabilitation Center, Seoul, Korea

DOI:

https://doi.org/10.2340/jrm.v57.41903

Keywords:

disabled persons, Quality of life, Rehabilitation,, Spinal cord injuries

Abstract

Objective: To classify Koreans with spinal cord injury into groups with similar levels of life satisfaction and analyse the differences in life satisfaction between the groups, and identify the factors influencing their quality of life.

Design: A cross-sectional study was conducted.

Subjects: The International Spinal Cord Injury Survey of 711 persons with traumatic or non-traumatic spinal cord injury was used.

Methods: The latent profiles were classified according to the sub-items of quality of life, and variables influencing the latent profiles were identified. The Mplus 8.0 program was used for the main analysis. Logistic regression analysis was performed to examine how the predictors were associated with latent profile membership.

Results: The factors associated with a higher likelihood of belonging to the high quality of life group included marital status; having less bowel dysfunction and muscle spasms or spasticity; receiving vocational rehabilitation services and currently engaging in paid work; and negative social attitude and problematic financial status.

Conclusion: Enhancing the quality of life of individuals with spinal cord injury necessitates providing medical care for bowel dysfunction or spasticity, providing vocational rehabilitation services, enabling successful return to work, improving negative perceptions regarding people with disabilities, and implementing policies to guarantee them an income.

Downloads

Download data is not yet available.

References

World Health Organization. WHOQOL user manual: Programme on mental health. WHO; 1998. https://www.who.int/tools/whoqol

Nandoe Tewarie RD, Hurtado A, Bartels RH, Grotenhuis JA, Oudega M. A clinical perspective of spinal cord injury. NeuroRehabilitation 2010; 27: 129–139. DOI: https://doi.org/10.3233/NRE-2010-0589

Jensen MP, Truitt AR, Schomer KG, Yorkston KM, Baylor C, Molton IR. Frequency and age effects of secondary health conditions in individuals with spinal cord injury: a scoping review. Spinal Cord 2013; 51: 882–892. DOI: https://doi.org/10.1038/sc.2013.112

Halvorsen A, Pape K, Post MWM, Biering-Sørensen F, Mikalsen S, Hansen AN, et al. Participation and quality of life in persons living with spinal cord injury in Norway. J Rehabil Med 2021; 53: jrm00217. DOI: https://doi.org/10.2340/16501977-2858

World Health Organization. International perspectives on spinal cord injury; 2013 [cited 2020 Jan 7]. Available from: https://www.who.int/publications/i/item/international-perspectives-on-spinal-cord-injury

Ullrich PM, Spungen AM, Atkinson D, Bombardier CH, Chen Y, Erosa NA, et al. Activity and participation after spinal cord injury: state-of-the-art report. J Rehabil Res Dev 2012; 49: 155–174. DOI: https://doi.org/10.1682/JRRD.2010.06.0108

Strøm V, Månum G, Arora M, Joseph C, Kyriakides A, Le Fort M, et al. Physical health conditions in persons with spinal cord injury across 21 countries worldwide. J Rehabil Med 2022; 54: jrm00302. DOI: https://doi.org/10.2340/jrm.v54.2040

Nagoshi N, Kaneko S, Fujiyoshi K, Takemitsu M, Yagi M, Iizuka S, et al. Characteristics of neuropathic pain and its relationship with quality of life in 72 patients with spinal cord injury. Spinal Cord 2016; 54: 656–661. DOI: https://doi.org/10.1038/sc.2015.210

Burke D, Lennon O, Fullen BM. Quality of life after spinal cord injury: the impact of pain. Eur J Pain 2018; 22: 1662–1672. DOI: https://doi.org/10.1002/ejp.1248

Andresen SR, Biering-Sørensen F, Hagen EM, Nielsen JF, Bach FW, Finnerup NB. Pain, spasticity and quality of life in individuals with traumatic spinal cord injury in Denmark. Spinal Cord 2016; 54: 973–979. DOI: https://doi.org/10.1038/sc.2016.46

Theisen KM, Mann R, Roth JD, Pariser JJ, Stoffel JT, Lenherr SM, et al. Frequency of patient-reported UTIs is associated with poor quality of life after spinal cord injury: a prospective observational study. Spinal Cord 2020; 58: 1274–1281. DOI: https://doi.org/10.1038/s41393-020-0481-z

Putzke JD, Richards JS, Hicken BL, DeVivo MJ. Predictors of life satisfaction: a spinal cord injury cohort study. Arch Phys Med Rehabil 2002; 83: 555–561. DOI: https://doi.org/10.1053/apmr.2002.31173

Tate DG, Kalpakjian CZ, Forchheimer MB. Quality of life issues in individuals with spinal cord injury. Arch Phys Med Rehabil 2002; 83: S18–S25. DOI: https://doi.org/10.1053/apmr.2002.36835

Post MW, Reinhardt JD, Avellanet M, Escorpizo R, Engkasan JP, Schwegler U, et al. Employment among people with spinal cord injury in 22 countries across the world: results from the international spinal cord injury community survey. Arch Phys Med Rehabil 2020; 101: 2157–2166. DOI: https://doi.org/10.1016/j.apmr.2020.05.027

Reinhardt JD, Middleton J, Bökel A, Kovindha A, Kyriakides A, Hajjioui A, et al. Environmental barriers experienced by people with spinal cord injury across 22 countries: results from a cross-sectional survey. Arch Phys Med Rehabil 2020; 101: 2144–2156. DOI: https://doi.org/10.1016/j.apmr.2020.04.027

Gross-Hemmi MH, Post MW, Ehrmann C, Fekete C, Hasnan N, Middleton JW, et al. Study protocol of the International Spinal Cord Injury (InSCI) community survey. Am J Phys Med Rehabil 2017; 96: S23–S34. DOI: https://doi.org/10.1097/PHM.0000000000000647

Barzallo DP, Gross-Hemmi M, Bickenbach J, Juocevičius A, Popa D, Wahyuni LK, et al. Quality of life and the health system: a 22-country comparison of the situation of people with spinal cord injury. Arch Phys Med Rehabil 2020; 101: 2167–2176. DOI: https://doi.org/10.1016/j.apmr.2020.04.030

Han ZA, Lee BS, Kim W, Lee SJ, Im HJ, Kim C, et al. People with spinal cord injury in Korea. Am J Phys Med Rehabil 2017; 96: S83–S85. DOI: https://doi.org/10.1097/PHM.0000000000000593

Barzallo DP, Gross-Hemmi MH. The cross-cultural societal response to SCI: health and related systems. Am J Phys Med Rehabil 2017; 96: S41–S54. DOI: https://doi.org/10.1097/PHM.0000000000000664

Shin JC, Goo HR, Yu SJ, Kim DH, Yoon SY. Depression and quality of life in patients within the first 6 months after the spinal cord injury. Ann Rehabil Med 2012; 36: 119–125. DOI: https://doi.org/10.5535/arm.2012.36.1.119

Lee JS, Kim SW, Jee SH, Kim JC, Choi JB, Cho SY, et al. Factors affecting quality of life among spinal cord injury patients in Korea. Int Neurourol J 2016; 20: 316–320. DOI: https://doi.org/10.5213/inj.1630540.270

Lanza ST, Cooper BR. Latent class analysis for developmental research. Child Dev Perspect 2016; 10: 59–64. DOI: https://doi.org/10.1111/cdep.12163

WHOQOL Group. Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med 1998; 28: 551–558. DOI: https://doi.org/10.1017/S0033291798006667

Asparouhov T, Muthen B. Auxiliary variables in mixture modeling: three-step approaches using Mplus. Struct Equ Modeling 2014; 21: 329–341. DOI: https://doi.org/10.1080/10705511.2014.915181

Nylund KL, Asparouhov T, Muthen BO. Deciding on the number of classes in latent class analysis and growth mixture modeling: a Monte Carlo simulation study. Struct Equ Modeling 2007; 14: 535–569. DOI: https://doi.org/10.1080/10705510701575396

Muthén B. Latent variable analysis: growth mixture modeling and related techniques for longitudinal data. In: Kaplan D, editor. The SAGE handbook of quantitative methodology for the social sciences. Thousand Oaks, CA: Sage; 2004, 345–368. DOI: https://doi.org/10.4135/9781412986311.n19

Curran PJ, West SG, Finch JF. The robustness of test statistics to nonnormality and specification error in confirmatory factor analysis. Psychol Methods 1996; 1: 16–29. DOI: https://doi.org/10.1037//1082-989X.1.1.16

Adriaansen JJ, Ruijs LE, van Koppenhagen CF, van Asbeck FW, Snoek GJ, van Kuppevelt D, et al. Secondary health conditions and quality of life in persons living with spinal cord injury for at least ten years. J Rehabil Med 2016; 48: 853–860. DOI: https://doi.org/10.2340/16501977-2166

Rivers CS, Fallah N, Noonan VK, Whitehurst DG, Schwartz CE, Finkelstein JA, et al. Health conditions: effect on function, health-related quality of life, and life satisfaction after traumatic spinal cord injury. An observational registry cohort study. Arch Phys Med Rehabil 2018; 99: 443–451. DOI: https://doi.org/10.1016/j.apmr.2017.06.012

Bloemen-Vrencken JH, Post MW, Hendriks JM, De Reus EC, De Witte LP. Health problems of persons with spinal cord injury living in the Netherlands. Disabil Rehabil 2005; 27: 1381–1390. DOI: https://doi.org/10.1080/09638280500164685

Kim SH, Kim O, Bae YH, Choi DI, Heo JE, Song WK, et al. Caregiver burden according to ageing and type of care activity in caregivers of individuals with spinal cord injury. Spinal Cord Ser Cases 2023; 9: 16. DOI: https://doi.org/10.1038/s41394-023-00570-w

Kent ML, Dorstyn DS. Psychological variables associated with employment following spinal cord injury: a meta-analysis. Spinal Cord 2014; 52: 722–728. DOI: https://doi.org/10.1038/sc.2014.92

Ottomanelli L, Barnett S, Goetz L, Toscano R. Vocational rehabilitation in spinal cord injury: what vocational service activities are associated with employment program outcome? Top Spinal Cord Inj Rehabil 2015; 21: 31–39. https://doi.org//10.1310/sci2101-31 DOI: https://doi.org/10.1310/sci2101-31

Krause JS, Terza JV, Dismuke CE. Factors associated with labor force participation after spinal cord injury. J Vocat Rehabil 2010; 33: 89–99. DOI: https://doi.org/10.3233/JVR-2010-0518

Reinhardt JD, Mansmann U, Fellinghauer BA, Strobl R, Grill E, von Elm E, et al. Functioning and disability in people living with spinal cord injury in high- and low-resourced countries: a comparative analysis of 14 countries. Int J Public Health 2011; 56: 341–352. DOI: https://doi.org/10.1007/s00038-010-0222-8

Filipcic T, Sember V, Pajek M, Jerman J. Quality of life and physical activity of persons with spinal cord injury. Int J Environ Res Public Health 2021; 18: 9148. DOI: https://doi.org/10.3390/ijerph18179148

Lee BS, Kim O, Ham D. Epidemiological changes in traumatic spinal cord injuries for the last 30 years (1990–2019) in South Korea. Spinal Cord 2022; 60: 612–617. DOI: https://doi.org/10.1038/s41393-021-00694-6

Geyh S, Peter C, Müller R, Bickenbach JE, Kostanjsek N, Üstün BT, et al. The personal factors of the International Classification of Functioning, Disability and Health in the literature: a systematic review and content analysis. Disabil Rehabil 2011; 33: 1089–1102. DOI: https://doi.org/10.3109/09638288.2010.523104

Lanza ST, Rhoades BL. Latent class analysis: an alternative perspective on subgroup analysis in prevention and treatment. Prev Sci 2013; 14: 157–168. DOI: https://doi.org/10.1007/s11121-011-0201-1

Giang MT, Graham S. Using latent class analysis to identify aggressors and victims of peer harassment. Aggress Behav 2008; 34: 203–213. DOI: https://doi.org/10.1002/ab.20233

Published

2025-08-20

How to Cite

Lee, B.-S., Lee, B., Lim, J., & Kim, O. (2025). Impact of work and environmental factors on quality of life in community-dwelling spinal cord injury individuals in South Korea using latent profile analysis. Journal of Rehabilitation Medicine, 57, jrm41903. https://doi.org/10.2340/jrm.v57.41903

Issue

Section

Original Report

Categories