Etiology, disablement, and quality of life: Interpersonal violence versus other causes of spinal cord injury

This analysis was part of a larger investigation of quality of life (QOL) that produced lengthy interviews with 40 persons with a spinal cord injury (SCI). Ten subjects with interpersonal violence- related (VR) injuries were matched with 10 subjects whose SCIs were not related to violence (NVR). Compared to the NVR group, the VR subjects talked more extensively about the injury experience and, with respect to their disability, were more likely to emphasize their disabilities rather than abilities. The two groups did not differ in descriptions of the experience of handicap. Factors moderating disability and handicap favored the NVR subjects. They had better financial resources, more accessible homes, more equipment, and more reliable attendants (if needed). VR subjects relied more heavily on family and friends for care and social support, worried more about the availability of future support, and were more dependent on the safety net of community agencies. The majority of VR subjects reported instances of physical intimidation, exploitation, or discrimination by others in the community; no NVR subjects reported such experiences. On a 1 -to-7 subjective QOL scale, the majority of VR subjects rated themselves at midpoint (4), whereas the NVR subjects' ratings were clustered at the high (6 or 7) and low (3) ends of the scale. Possible reasons for these discrepancies are explored. Preinjury differences combined with differences in postinjury experiences seem to account for the observed differences in the disablement experience and QOL of these two groups.