title: Understanding Quality of Life in Adults with Spinal Cord Injury Via SCI-Related Needs and Secondary Complications.
abstract: BACKGROUND
  Understanding the factors that can predict greater quality of life (QoL) is important for adults with spinal cord injury (SCI), given that they report lower levels of QoL than the general population.
  
  
  OBJECTIVE
  To build a conceptual model linking SCI-related needs, secondary complications, and QoL in adults with SCI. Prior to testing the conceptual model, we aimed to develop and evaluate the factor structure for both SCI-related needs and secondary complications.
  
  
  METHODS
  Individuals with a traumatic SCI (N = 1,137) responded to an online survey measuring 13 SCI-related needs, 13 secondary complications, and the Life Satisfaction Questionnaire to assess QoL. The SCI-related needs and secondary complications were conceptualized into factors, tested with a confirmatory factor analysis, and subsequently evaluated in a structural equation model to predict QoL.
  
  
  RESULTS
  The confirmatory factor analysis supported a 2-factor model for SCI related needs, χ(2)(61, N = 1,137) = 250.40, P <.001, comparative fit index (CFI) = .93, root mean square error of approximation (RMSEA) = .05, standardized root mean square residual (SRMR) = .04, and for 11 of the 13 secondary complications, χ(2)(44, N = 1,137) = 305.67, P < .001, CFI = .91, RMSEA = .060, SRMR = .033. The final 2 secondary complications were kept as observed constructs. In the structural model, both vital and personal development unmet SCI-related needs (β = -.22 and -.20, P < .05, respectively) and the neuro-physiological systems factor (β = -.45, P < .05) were negatively related with QoL.
  
  
  CONCLUSIONS
  Identifying unmet SCI-related needs of individuals with SCI and preventing or managing secondary complications are essential to their QoL.
authors.affiliation: McGill University , Montreal , Canada.
authors.forename: Shane N
authors.initials: SN
authors.lastname: Sweet
authors.affiliation: Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) and Université Laval , Quebec City , Canada.
authors.forename: Luc
authors.initials: L
authors.lastname: Noreau
authors.affiliation: Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) and Université Laval , Quebec City , Canada.
authors.forename: Jean
authors.initials: J
authors.lastname: Leblond
authors.affiliation: Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) and Université Laval , Quebec City , Canada.
authors.forename: Frédéric S
authors.initials: FS
authors.lastname: Dumont
keywords: life satisfaction; needs; quality of life; secondary complications; spinal cord injury