title: Associations between psychological factors and quality of life ratings in persons with spinal cord injury: a systematic review.
abstract: METHODS
  Systematic review.
  
  
  OBJECTIVE
  To review the literature on relationships between psychological factors and quality of life (QOL) of persons with spinal cord injury (SCI).
  
  
  METHODS
  NA.
  
  
  METHODS
  A systematic literature search was conducted in several online databases (PubMed, Embase and PsychInfo). Articles were included if they provided quantitative information on associations between QOL-related dependent variables and psychological factors as independent variables in an SCI population. The search was limited to empirical studies published in English. The methodological quality of the included articles was assessed.
  
  
  RESULTS
  A total of 48 studies were included. Total locus of control, sense of coherence, self-worth, hope, purpose in life and positive affect were consistently associated with greater QOL. Negative affect and posttraumatic cognitions were consistently associated with lower QOL. Inconsistent evidence was found for subscales of locus of control, the role of attribution of blame, spirituality, personality, appraisals, passive coping and emotion-focused coping. No evidence was found for an association between active problem-focused coping styles and QOL.
  
  
  CONCLUSIONS
  Many psychological factors were strongly and consistently related to QOL, but for some others no or inconsistent evidence was found. Further research should (1) use larger study groups, preferably in longitudinal designs, (2) improve terminological precision and avoid conceptual overlap between determinants and outcomes, (3) increase uniformity of questionnaires and (4) reexamine concepts that have been abandoned prematurely, such as personality and social comparison.
authors: Rudolf Magnus Institute of Neuroscience and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and Rehabilitiation Center De Hoogstraat, Utrecht, The Netherlands.
authors: C M C
authors: CM
authors: van Leeuwen
authors: S
authors: S
authors: Kraaijeveld
authors: E
authors: E
authors: Lindeman
authors: M W M
authors: MW
authors: Post
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D010551:Personality; D011788:Quality of Life / Q000523:psychology*; D060685:Sense of Coherence / Q000502:physiology; D013119:Spinal Cord Injuries / Q000523:psychology*; D029181:Spirituality; D011795:Surveys and Questionnaires; D055815:Young Adult