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Measuring Outcomes of Best Practices: The Diener Satisfaction with Life Scale and Spinal Cord Injury
Smith BM, LaVela SL, Burns SP, Evans CT, Rapacki LM, Miskevics SA, Weaver FM. Measuring Outcomes of Best Practices: The Diener Satisfaction with Life Scale and Spinal Cord Injury. Poster session presented at: VA QUERI National Meeting; 2008 Dec 12; Phoenix, AZ.
Documenting the association between patient outcomes and quality of life is one of the purposes of QUERI. The Diener Satisfaction with Life Scale (SWLS) measures subjective well-being which is an important component of quality of life. The objectives of this study are to examine the associations between chronic illness, respiratory symptoms, common complications of SCI/D, and SWLS scores for a sample of veterans with SCI/D.
This study is part of a larger SCI QUERI study to characterize variability in respiratory care in veterans with SCI/D. To examine SWLS, we used survey data from 1,023 patients. The survey included questions about respiratory conditions, respiratory symptoms, and other patient characteristics. In addition to descriptive statistics, linear regression models were used to examine the associations between patient characteristics and SWLS score.
The mean SWLS score was 19.0 (SD = 9.1). This score is below the average range for most populations, but consistent with previous estimates for persons with SCI/D. In the unadjusted analyses, presence of each respiratory symptom (shortness of breath, wheezing, cough, phlegm) was associated with lower life satisfaction (p < 0.01). When adjusted for smoking status, depression, number of chronic conditions, and other patient characteristics, only shortness of breath was significantly negatively associated with SWLS (p = 0.013). Self-report of depression, pressure ulcer, and being a current smoker were also significant predictors of lower satisfaction in the adjusted models (p < 0.05), while weight problems were marginally significant.
The findings suggest smoking and shortness of breath affect life satisfaction, highlighting the potential of smoking cessation programs to increase QoL. The impacts of depression and pressure ulcers on SWLS also suggest the continued importance of programs to address these issues, and ongoing QUERI work in these areas.
SCI QUERI implementation efforts are currently focused on conditions associated with SCI/D including respiratory complications, pressure ulcers, depression and obesity. The findings of this study suggest positively affecting these outcomes should improve quality of life for veterans with SCI/D. Additionally, this study provides baseline data that will be useful to future quality improvement and research efforts that utilize the new SCI Outcomes database which includes the SWLS.