title: Health-related quality of life among individuals with long-standing spinal cord injury: a comparative study of veterans and non-veterans.
abstract: BACKGROUND
  Spinal cord-injured (SCI) patients experience poor health-related quality of life (HRQOL) and they usually report lower HRQOL than the general population or population subgroups in Iran and elsewhere. The aim of this study was to compare HRQOL between veterans and non-veterans with SCI in Iran.
  
  
  METHODS
  This was a cross-sectional study. HRQOL was measured using the 36-item Short Form Health Survey (SF-36). Thirty-nine male veterans and 63 non-veteran males with SCI were included in the study. Regression analyses were applied to determine the variables affecting physical and mental health-related quality of life among the patients.
  
  
  RESULTS
  The male veterans had a lower HRQOL than the non-veterans with SCI. The differences were significant for all measures except for physical and social functioning. The greatest difference was observed for bodily pain (P = 0.001). The regression analysis results indicated that a longer time since injury was associated (P = 0.01) with better physical health-related quality of life (PCS), while being a veteran (P < 0.001) and having a spinal lesion in the cervical region (P = 0.001) were associated with poorer PCS. Older age (P < 0.001) and higher education (P = 0.01) were associated with better mental health-related quality of life (MCS), while being a veteran and having a spinal lesion in the cervical region (P = 0.02) were associated with poorer MCS.
  
  
  CONCLUSIONS
  The study findings showed that veterans with SCI experienced lower HRQOL than their non-veteran counterparts. A qualitative study is recommended to evaluate why HRQOL was lower in veterans than in non-veterans with SCI although veterans had higher incomes as a result of their pensions and increased access to equipment, and medications. To improve quality of life in both veterans and non-veterans with spinal cord injuries, policy changes or implementation of new interventions may be essential so that veterans could receive additional support (e.g. counseling, recreation therapy, vocational therapy, etc.) and non-veterans could meet their basic needs.
authors.affiliation: Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Soheil
authors.initials: S
authors.lastname: Saadat
authors.forename: Masoud
authors.initials: M
authors.lastname: Javadi
authors.forename: Baharak Sabet
authors.initials: BS
authors.lastname: Divshali
authors.forename: Amir Hussein
authors.initials: AH
authors.lastname: Tavakoli
authors.forename: Seyed Mohammad
authors.initials: SM
authors.lastname: Ghodsi
authors.forename: Ali
authors.initials: A
authors.lastname: Montazeri
authors.forename: Vafa
authors.initials: V
authors.lastname: Rahimi-Movaghar
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D003430:Cross-Sectional Studies; D004522:Educational Status; D004651:Employment; D006305:Health Status Indicators; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D036301:Qualitative Research; D011788:Quality of Life; D013119:Spinal Cord Injuries / Q000150:complications*; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult