Environmental barriers, functioning and quality of life in 2008 Wenchuan earthquake victims with spinal cord injury eight years after the disaster: A cross-sectional study
Meilin Xu, Hao Li, Zhengen Zhao, Youping Yang, Zengchun Sun, Haijun Han, Xu Zhang, Jan D. Reinhardt
Institute for Disaster Management and Reconstruction, Sichuan University, China
Objective: To examine environmental barriers, func-tioning, and quality of life in Wenchuan earthquake survivors with spinal cord injury.
Design: Cross-sectional study.
Subjects: Thirty-two adult Wenchuan earthquake survivors with spinal cord injury.
Methods: Data were collected on environmental factors with the Nottwil Environmental Factors Inventory Short Form (NEFI-SF), physical and mental functioning with the 36-item Short-Form Health Survey (SF-36), and quality of life with the World Health Organization Quality of Life-BREF (WHOQOL-BREF). Descriptive analysis of environmental barriers and comparisons of SF-36 and WHOQOL-BREF domain scores with normative data were performed. Variations in outcomes across demographic and lesion characteristics were examined using Mann-Whitney U test. Associations of NEFI-SF with SF-36 and WHOQOL-BREF domain scores were explored using Spearman’s correlation.
Results: Wenchuan earthquake survivors with spinal cord injury were affected by a large number of environmental barriers. Their functioning and quality of life were considerably reduced in comparison with respective reference populations. Neither environmental barriers nor functioning or quality of life varied systematically by demographic and lesion characteristics. Increased numbers of perceived environmental barriers were strongly associated with decreased scores across SF-36 and WHOQOL-BREF sub-domains.
Conclusion: Wenchuan earthquake survivors with SCI faced a considerable number of environmental barriers and showed decreased functioning and quality of life. Environmental barriers were strongly related to functioning and quality of life.
Environmental barriers are important determinants of disability and reduced quality of life. This study measured perceived environmental barriers, physical and mental functioning, and quality of life in survivors of the 2008 major earthquake in Wenchuan, China, who had sustained spinal cord injuries in the disaster. The participants perceived a large number of barriers that made their life harder, and their functioning and quality of life was lower than that of the general population. The more environmental barriers the earthquake survivors perceived, the lower was their physical and mental functioning and quality of life. Targeted community-based interventions should be used to address environmental barriers in this population.
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