title: Virtual socialization in adults with spina bifida.
abstract: OBJECTIVE
  To use spina bifida (SB) as a model of chronic physical disability to study the associations of virtual socialization, friendships, and quality of life (QOL) in adults.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Subjects were recruited from residential living facilities, outpatient clinics, and the University of Pittsburgh Medical Center (UPMC) research registry.
  
  
  METHODS
  Inclusion criteria were age between 18 and 80 years and clinical diagnoses of SB cystica (myelomeningocele) and hydrocephalus. The exclusion criterion was the diagnosis of SB occulta. Sixty-three eligible adults were enrolled, and all completed the study.
  
  
  METHODS
  The survey via questionnaire was performed in person or over the telephone.
  
  
  METHODS
  Data collected included the World Health Organization's Medical Outcomes Study 26-item Short Form, Economic Self-Sufficiency from the Craig Handicap Assessment and Reporting Technique Short Form, virtual socializing habits, and number of friends. Three linear regression models were performed, each with a unique dependent variable: number of friends, psychological QOL, or social QOL. The following independent variables were included in all models: age, gender, ethnicity, economic self-sufficiency, marital status, education level, lesion level, health status, user group, collection method, and time spent virtually socializing. In addition, each regression model included the dependent variables from the other 2 models in its independent variables.
  
  
  RESULTS
  Increased degree of virtual socialization (VS) was associated with a greater number of friends (P = .003, r = .684). Mean (standard deviation) numbers of friends by VS groups were the following: users, n = 4.9 ± 2.7; semi-users, n = 3.8 ± 2.7; and nonusers, n = 2.1 ± 2.3, which represent a 2.3 times greater number of friends between the users and nonusers. The effect of virtual socialization on QOL was also positive, however, not statistically significant.
  
  
  CONCLUSIONS
  People with chronic physical disabilities, such as SB, are at high risk for peer rejection and long-term social avoidance. Users of the most immersive forms of virtual socialization, have more real world friends than both semi-users and nonusers. Any form of VS, whether immersive or real time, may improve the opportunity for meaningful social encounters. Prospective intervention studies are needed to elucidate whether a causal positive relationship between virtual socialization and friendships exists. Further research is needed to clarify virtual socialization's impact on QOL; however, the upward trend in all 4 domains of QOL across user groups suggests similar potential benefits.
authors.affiliation: University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY, USA.
authors.forename: Wendy M
authors.initials: WM
authors.lastname: Chan
authors.forename: Brad E
authors.initials: BE
authors.lastname: Dicianno
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D033062:Friends; D006304:Health Status; D006801:Humans; D020407:Internet; D016014:Linear Models; D008297:Male; D011788:Quality of Life; D012944:Social Support; D016136:Spina Bifida Occulta / Q000523:psychology*; D011795:Surveys and Questionnaires