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The effect of health literacy on quality of life in individuals with chronic spinal cord injury

Spinal Cord volume 64, pages 46–52 (2026)Cite this article

Subjects

Abstract

Study desıgn

Cross-sectional survey.

Objectıves

This study aimed to investigate health literacy (HL) in individuals with spinal cord injury (SCI), focusing on its relationship with quality of life (QoL) and related factors.

Settıng

Rehabilitation Service, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey.

Methods

Between May 2025 and October 2025, 61 SCI participants aged 18–70 were enrolled in the Başakşehir Çam and Sakura City Hospital. HL and QoL surveys were administered to the participants. This cross-sectional study collected demographic and survey data from participant records. This study used the Ferrans & Powers Quality of Life Index Spinal Cord Injury Version (QLI) to measure QoL. The Turkey Health Literacy Scale (TSOY-32) was utilized to evaluate HL levels. QLI assesses QoL through four core subdomains: Health and Functioning, Family, Social/ Economic, and Psychological/Spiritual.

Results

Among the 61 individuals with SCI, 80.3% were male. Falls were the leading cause of injury, accounting for 44.3% of the cases, and 55.7% of the participants had complete SCI. It was determined that 26.2% of individuals had insufficient HL, 27.9% had problematic/limited HL, 32.8% had adequate HL, and 13.1% had excellent HL levels. A significant positive relationship was found between HL and QoL. Individuals with excellent HL had significantly higher scores on the social and economic subdomains of the QLI compared to those in the insufficient and problematic/limited categories. The multivariable regression model was statistically significant (F (12,48) = 2.649, p = 0.008), explaining 16.5% of the variance in overall QoL (adjusted R² = 0.165).

Conclusions

HL levels are positively associated with QoL. For these reasons, conducting studies aimed at enhancing HL in individuals with SCI, particularly through communication and education strategies, would be beneficial.

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Fig. 1: Cause of SCI.
Fig. 2: Distribution of neurological levels and ASIA impairment scale.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We are grateful to the participants who provided the survey data.

Funding

No financial assistance was received in support of the study.

Author information

Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Sultan 2. Abdülhamid Han Training and Research Hospital, Istanbul, Türkiye

    Mustafa Hüseyin Temel

  2. Department of Physical Medicine and Rehabilitation, Başakşehir Çam ve Sakura City Hospital, Istanbul, Türkiye

    Ebru Kübra Taşpolat, Fatih Bağcıer & Evrim Coşkun Çelik

Authors
  1. Mustafa Hüseyin Temel
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  2. Ebru Kübra Taşpolat
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  3. Fatih Bağcıer
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  4. Evrim Coşkun Çelik
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Contributions

The authors confirm their contributions to this work as follows: study conception and design – Fatih Bağcier; data collection – Ebru Kübra Taşpolat; analysis and interpretation – Mustafa Hüseyin Temel; manuscript drafting – Evrim Coşkun Çelik. All authors critically reviewed the results and approved the final version of the manuscript.

Corresponding author

Correspondence to Ebru Kübra Taşpolat.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethical approval

Ethical approval for this study was obtained from the Institutional Review Board at Başakşehir Çam and Sakura City Hospital (Approval number: KAEK/28.05.2025.204). Written informed consent was obtained from all subjects or their legal guardians.

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Temel, M.H., Taşpolat, E.K., Bağcıer, F. et al. The effect of health literacy on quality of life in individuals with chronic spinal cord injury. Spinal Cord 64, 46–52 (2026). https://doi.org/10.1038/s41393-025-01146-1

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