Ranking the criteria for assessing quality of life after disability: Evidence for priority shifting among long-term spinal cord injury survivors

Objective. To identify the criteria spinal cord injury (SCI) survivors use in assessing their quality of life and to examine the concept of priority s hifting following SCI. Design. Comparison of results obtained from a population-based sample of SC I men to comparable general non-disabled population norms. Subjects, 195 SCI men, injured 23-49 years earlier, who participated in a p opulation-based study of outcomes following long-term SCI. Setting. Two British regional SCI treatment centres: the National Spinal In juries Centre at Stoke Mandeville Hospital in Aylesbury, and the Regional S pinal Injuries Centre at the District General Hospital in Southport. Main outcome measurement. Flanagan's Quality of Life and Individual Needs Q uestionnaire, which ranks 15 life priorities in terms of importance and how well personal needs are met in each area. Results, SCI men differed from non-disabled people in how they ranked the d eterminants of their quality of life. Unlike non-disabled people, for the S CI men neither health nor work were highly correlated to their perceived qu ality of life. Though age did not seem to ex plain observed differences, se verity of the disability and individuals' own abilities and accomplishments did play a role in their rankings. Conclusions, These findings suggest that SCI men do change the criteria the y use in assessing their quality of life and may in fact devalue less attai nable goals while increasing the importance of areas in which they might be successful.