Table 3 Total, direct and indirect effects of ICF disability and health framework measures on overall QoL ratings under the main path model.
Effects on QoL (expressed as SDs of change) | Direct effect estimate (95% CI) | p value | Total effect estimate (95% CI) | p value | Indirect effect estimate (95% CI) | p value |
|---|---|---|---|---|---|---|
Current work participation: | ||||||
Current paid work | 0.07 (−0.02, 0.16) | 0.12 | 0.07 (−0.02, 0.16) | 0.12 | n/a | n/a |
Energy and feelings: | ||||||
SF-36 Mental health domain score (per SD) | 0.18 (0.12, 0.24) | <0.001 | 0.18 (0.12, 0.24) | <0.001 | −0.001 (−0.004, 0.002) | 0.4 |
SF-36 vitality domain score (per SD) | 0.14 (0.08, 0.2) | <0.001 | 0.14 (0.08, 0.2) | <0.001 | −0.001 (−0.004, 0.001) | 0.4 |
Personal psychological factors: | ||||||
Self-efficacy sum score (per SD) | 0.09 (0.04, 0.15) | <0.001 | 0.15 (0.09, 0.2) | <0.001 | 0.05 (0.03, 0.07) | <0.001 |
Perceived injustice sum score (per SD) | −0.05 (−0.1, −0.003) | 0.04 | −0.10 (−0.15, −0.05) | <0.001 | −0.05 (−0.07, −0.03) | <0.001 |
Activities and participation: | ||||||
Activity/participation problem burden score (per SD) | −0.12 (−0.18, −0.05) | <0.001 | −0.26 (−0.32, −0.09) | <0.001 | −0.14 (−0.17, −0.11) | <0.001 |
Environmental factors: | ||||||
NEFI-S (per SD) | −0.04 (−0.09, 0.02) | 0.14 | −0.11 (−0.17, −0.06) | <0.001 | −0.08 (−0.11, −0.04) | <0.001 |
Social integration sum score (per SD) | 0.19 (0.13, 0.24) | <0.001 | 0.36 (0.31, 0.41) | <0.001 | 0.18 (0.14, 0.21) | <0.001 |
Physical health: | ||||||
Secondary health conditions burden score (per SD) | 0.007 (−0.05, 0.07) | 0.8 | −0.28 (−0.34, −0.22) | <0.001 | −0.28 (−0.33, −0.24) | <0.001 |
Maximum pain intensity (per SD) | −0.06 (−0.1, −0.01) | 0.006 | −0.16 (−0.21, −0.11) | <0.001 | −0.10 (−0.13, −0.07) | <0.001 |
Independence level: | ||||||
m-SCIM-SR (per SD) | −0.02 (−0.09, 0.05) | 0.5 | 0.08 (0.01, 0.16) | 0.03 | 0.10 (0.05, 0.15) | <0.001 |
Use of electric or assisted wheelchair | −0.05 (−0.19, 0.08) | 0.4 | 0.04 (−0.13, 0.2) | 0.6 | 0.09 (−0.02, 0.2) | 0.09 |
Use of self-propelled manual wheelchair | 0.04 (−0.08, 0.16) | 0.5 | 0.17 (0.03, 0.31) | 0.02 | 0.13 (0.03, 0.22) | 0.004 |
Injury severity: | ||||||
Complete lesion | −0.17 (−0.26, −0.07) | <0.001 | −0.12 (−0.23, −0.01) | 0.02 | 0.05 (−0.04, 0.14) | 0.2 |
Tetraplegia | −0.04 (−0.13, 0.05) | 0.4 | −0.09 (−0.19, 0.005) | 0.06 | −0.05 (−0.13, 0.02) | 0.16 |
Assistance: | ||||||
Any day-to-day assistance | −0.02 (−0.12, 0.08) | 0.6 | −0.26 (−0.38, −0.14) | <0.001 | −0.24 (−0.32, −0.16) | <0.001 |
Socioeconomic status: | ||||||
Subjective social position ladder (per SD) | 0.03 (−0.01, 0.08) | 0.14 | 0.29 (0.24, 0.34) | <0.001 | 0.26 (0.22, 0.3) | <0.001 |
Covariables: | ||||||
Traumatic SCI | 0.05 (−0.06, 0.16) | 0.3 | 0.07 (−0.06, 0.19) | 0.3 | 0.02 (−0.07, 0.1) | 0.7 |
Time since injury in years (10 years) | 0.03 (0.01, 0.06) | 0.02 | 0.08 (0.04, 0.11) | <0.001 | 0.04 (0.02, 0.07) | <0.001 |
Age in years (10 years) | −0.06 (−0.09, −0.03) | <0.001 | −0.03 (−0.06, 0.01) | 0.1 | 0.03 (0.01, 0.06) | 0.01 |
Male | −0.12 (−0.2, −0.03) | 0.006 | −0.03 (−0.14, 0.06) | 0.5 | 0.08 (0.01, 0.15) | 0.01 |
Never married | −0.13 (−0.24, −0.01) | 0.02 | −0.14 (−0.28, −0.005) | 0.04 | −0.01 (−0.1, 0.08) | 0.8 |
Separated, divorced or widowed | −0.04 (−0.16, 0.09) | 0.5 | −0.12 (−0.27, 0.03) | 0.1 | −0.08 (−0.18, 0.06) | 0.07 |
Living alone at home | −0.11 (−0.22, 0.01) | 0.051 | −0.06 (−0.2, 0.08) | 0.4 | 0.05 (−0.04, 0.13) | 0.2 |
Living in an institutional setting | 0.11 (−0.11, 0.32) | 0.3 | 0.21 (−0.06, 0.48) | 0.13 | 0.1 (−0.06, 0.27) | 0.2 |
