|dc.description.abstract||This dissertation presents the prediction of quality of life (QoL), composed of by life satisfaction and self-perceived health status, across 5 years post a spinal cord injury (SCI) hospital discharge. Predictor variables of functional independence, pain, and family satisfaction, as mediated by environmental accessibility are examined. Environmental accessibility is conceptualized as being composed of mobility and social integration. Data are a subset from a longitudinal study of adjustment following disability. Two models were examined in order to predict QoL, Model 1 (Life Satisfaction) and Model 2 (Self-Perceived Health Status).
Results from this study were obtained by testing models using path modeling. Evaluation indices suggest good to adequate model fit, CFI, RMSEA, and SRMR for Model 1 and Model 2. In Model 1, results indicated that mobility and social integration, components of environmental accessibility, mediated the relationship between functional independence and life satisfaction (beta = 0.243, p = 0.009 and beta = 0.120, p = 0.038, respectively). In Model 2, the component of mobility of environmental accessibility mediated the relationship between functional independence and self-perceived health status (beta = 0.288, p = 0.002).
Results indicate that access to the environment is an important predictor of life satisfaction and perceived health status five years after medical discharge for a traumatically-acquired SCI. These factors of environmental access ? mobility and social integration ? appear to be more important determinants of quality of life post-SCI than functional impairment or the presence of pain. Programs that enhance mobility and social integration following return to the community following SCI may be indicated. Furthermore, given that the construct of environmental accessibility is relatively new, studies that examine this construct are needed in order to better understand how it is best conceptualized.||en_US