title: Self-rated health in persons with spinal cord injury: relationship of secondary conditions, function and health status.
abstract: OBJECTIVE
  Self-rated health is used frequently as a measure of health in the general population, and increasingly with persons with disabilities. However, its meaning and its relationship with other measures of self-reported health (health status and secondary conditions) are not well understood for this group. The purpose of the present study was to use a conceptual model to examine the structure of self-rated health with persons with spinal cord injuries.
  
  
  METHODS
  A US sample of 270 adults with mobility impairment stemming from spinal cord injury (SCI) provided data on three measures of self-reported health that differ in degree of subjectivity: physical problems common to SCI, four domains of health status from the SF-36, and a single item on self-rated health. Data were compared with the norm sample of the SF-36. The conceptual model was tested using path analyses.
  
  
  RESULTS
  SF-36 scores were lower on three of four domains compared with the norm sample. The conceptual model analyses indicated that 35% of variance in self-rated health is accounted for through direct relationship with physical secondary conditions common to persons with SCI and as mediated through SF-36 domains of Role Physical and Vitality. The SF-36 domain of Physical Function was statistically unrelated to self-rated health.
  
  
  CONCLUSIONS
  The conceptual model of self-rated health was verified in a sample of persons with SCI. Importantly, the SF-36 domain of Physical Function does not relate to self-rated health for this group. Its inclusion in measures of self-reported for disability populations creates difficulty without apparent benefit.
authors.affiliation: Rehabilitation Research and Training Center, Child Development and Rehabilitation Center, Oregon Health & Science University, P.O. Box 574, Portland, OR 97201-0574, USA. gfk2@cdc.gov
authors.forename: Gloria L
authors.initials: GL
authors.lastname: Krahn
authors.forename: Rie
authors.initials: R
authors.lastname: Suzuki
authors.forename: Willi
authors.initials: W
authors.lastname: Horner-Johnson
mesh_terms: D000328:Adult; D015897:Comorbidity; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009922:Oregon; D011788:Quality of Life; D013119:Spinal Cord Injuries; D011795:Surveys and Questionnaires; D014481:United States