Research has consistently found that favourable exchange with one’s proximal social environment has positive effects on both mental health and wellbeing. Adults with physical disabilities may have fewer opportunities of favourable exchange, and therefore the effects on mental health and wellbeing may be less advantageous. The aim of this study is to systematically review quantitative studies exploring associations of social relationships with mental health and wellbeing in persons with physical disabilities. The databases PubMed, PsycINFO and Scopus were searched for relevant studies published between 1995 and 2016. Data was extracted on study and participants’ characteristics, independent and dependent variables, used measures and effects sizes of associations between social relationships and mental health or wellbeing. A narrative review was performed to synthesize findings along the constructs social support, social networks, negative social interactions, family functioning and relationship quality. Of the 63 included studies, 47 were cross-sectional and 16 longitudinal. Most studies included a measure of social support (n = 58), while other concepts were less often studied (social networks n = 6; negative social interaction n = 3; family functioning n = 2; relationship quality n = 1). Over half of studies included depression as outcome (n = 33), followed by wellbeing (n = 14), composite mental health measures (n = 10), anxiety (n = 8), psychological distress (n = 7), posttraumatic stress disorder (n = 3), and hopelessness (n = 1). Although trends for associations of social support with mental health and wellbeing were consistent, around a quarter of studies failed to report significant associations. Social networks were related to depression, but not to other mental health or wellbeing measures. Family functioning, negative social interactions and relationship quality showed consistent associations with mental health and wellbeing, however, only few studies were available. This review indicates that social relationships play an important role in mental health and wellbeing in persons with disabilities, although findings are less consistent than in general populations and strength of associations vary between constructs. Integrating persons with disabilities into social networks seems not sufficient and rehabilitation professionals together with affected persons and their peers should ensure that high quality relationships and tailored support are available.

Study design: Cross-sectional validation study. Objectives: To develop and validate a self-report version of the Spinal Cord Independence Measure (SCIM III). Setting: Two SCI rehabilitation facilities in Switzerland. Methods: SCIM III comprises 19 questions on daily tasks with a total score between 0 and 100 and subscales for ‘self-care’, ‘respiration & sphincter management’ and ‘mobility’. A self-report version (SCIM-SR) was developed by expert discussions and pretests in individuals with spinal cord injury (SCI) using a German translation. A convenience sample of 99 inpatients with SCI was recruited. SCIM-SR data were analyzed together with SCIM III data obtained from attending health professionals. Results: High correlations between SCIM III and SCIM-SR were observed. Pearson’s r for the total score was 0.87 (95% confidence interval (CI) 0.82–0.91), for the subscales self-care 0.87 (0.81–0.91); respiration & sphincter management 0.81 (0.73–0.87); and mobility 0.87 (0.82–0.91). Intraclass correlations were: total score 0.90 (95% CI 0.85–0.93); self-care 0.86 (0.79–0.90); respiration & sphincter management 0.80 (0.71–0.86); and mobility 0.83 (0.76–0.89). Bland–Altman plots showed that patients rated their functioning higher than professionals, in particular for mobility. The mean difference between SCIM-SR and SCIM III for the total score was 5.14 (point estimate 95% CI 2.95–7.34), self-care 0.89 (0.19–1.59), respiration & sphincter management 1.05 (0.18–2.28 ) and mobility 3.49 (2.44–4.54). Particularly patients readmitted because of pressure sores rated their independence higher than attending professionals. Conclusion: Our results support the criterion validity of SCIM-SR. The self-report version may facilitate long-term evaluations of independence in persons with SCI in their home situation.

The overall goal of the Swiss Spinal Cord Injury Cohort Study (SwiSCI) is to gain a better understanding of how to support functioning, health maintenance, and quality-of-life of persons with spinal cord injury (SCI) along the continuum of care, in the community, and along their life span. The purpose of this study was to present the SwiSCI study design. SwiSCI is composed of three complementary pathways and will include Swiss persons 16 yrs or older who have diagnoses of traumatic or nontraumatic SCI. Pathway 1 is a retrospective study of medical files of patients admitted to one of the collaborating SCI centers between 2005 and 2009. Pathway 2 is a nationwide survey of persons with chronic SCI. Pathway 3 is an inception cohort study including persons with newly acquired SCI. SwiSCI is conducted in collaboration with the Swiss Paraplegic Association and the major specialized rehabilitation centers in Switzerland. Measurement instruments that are to be used in Pathway 2 and 3 cover body structures and functions, activities, participation, life satisfaction, and personal and environmental factors. SwiSCI is a prospective cohort study that will contribute to a comprehensive understanding of the lived experience of persons with SCI.

Background: Health conditions in people with spinal cord injury are major determinants for disabilit...

Engagement in productive activities is an important determinant of mental health and quality of life (QoL). Persons with physical disabilities are often confronted with constraints to engage in productive activities and it remains largely unknown whether persons who nevertheless manage to be productive experience beneficial effects for mental health and QoL. This is the first study to analyse different productive activities (paid work, volunteering, education, housework) and its gender-specific associations with mental health and QoL in the disability setting, testing two contrasting hypotheses of Role Theory, the role strain and the role enhancement hypotheses. We used data from a representative sample of 1157 men and women of employable age who sustained a severe physical disability (spinal cord injury). Load of engagement in paid work, volunteering, education, and housework was classified into three groups (none; moderate; high). To assess the total productivity load, a score over the four items was calculated. Diversity of engagement was assessed with variables on the number and combination of activities. Tobit regressions were applied to evaluate associations of load and diversity of engagement in productive activities with mental health (Mental Health Inventory, SF-36) and QoL (WHOQoL-BREF items). We found that the total productivity load and the load of paid work were positively related to mental health and QoL in men. Individuals with moderate engagement in volunteering reported better mental health (both genders) and QoL (in women) than those with higher or no engagement. Our results support the role enhancement hypothesis, as mental health (in men) and QoL (both genders) increased with the number of performed activities. In men who had paid work, mental health and QoL increased consistently with each additional unpaid activity. In contrast, engagement in paid work played a minor role for mental health and QoL in women. This study in the disability setting provided clear support for the role enhancement hypothesis. Future research on the mechanisms behind the observed associations is warranted to develop interventions and policies that strengthen resources important for engagement in productive activities as well as for mental health and QoL in persons with physical disabilities.

The Learning Health System for Spinal Cord Injury (LHS-SCI) is an initiative embedded in the World Health Organization's (WHO's) Global Disability Plan and requires the statistical collection of data on the lived experience of persons with SCI to consequently formulate recommendations and policies. The International Spinal Cord Injury (InSCI) community survey has been developed as an initial step to gain information about the lived experience of persons with SCI within and across diverse nations. InSCI is a multinational community survey based on the International Classification of Functioning, Disability and Health Core Sets for SCI and involves 28 countries from all six WHO regions. The study will be implemented in 2017. Overall aims, guiding principles on sampling strategies, data collection modes, and reminder management are described. InSCI will be the first survey to be conducted simultaneously in many countries and in all six WHO world regions that identifies the factors associated with functioning, health, and well-being of persons living with SCI. Expected results of the survey will be used for the basis of conducting stakeholder dialogs for policy reforms designed to improve the functioning, health maintenance, and well-being of persons with SCI.