The Role of Environmental Factors on Health Conditions, General Health and Quality of Life in Persons with Spinal Cord Injuries in South Africa

Lucian Bezuidenhout; Anthea Rhoda; David Moulaee Conradsson; Joyce Mothabeng; Conran Joseph

doi:10.3390/ijerph20095709

The Role of Environmental Factors on Health Conditions, General Health and Quality of Life in Persons with Spinal Cord Injuries in South Africa

Int J Environ Res Public Health. 2023 May 3;20(9):5709. doi: 10.3390/ijerph20095709.

Authors

Lucian Bezuidenhout^{1

2}, Anthea Rhoda¹, David Moulaee Conradsson^{2

3

4}, Joyce Mothabeng⁵, Conran Joseph³

Affiliations

¹ Faculty of Community and Health Sciences, University of Western Cape, Cape Town 7701, South Africa.
² Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, 17177 Stockholm, Sweden.
³ Department of Health and Rehabilitation Sciences, Division of Physiotherapy, Stellenbosch University, Cape Town 7602, South Africa.
⁴ Medical Unit Occupational Therapy & Physiotherapy, Theme Women's Health and Allied Health Professional, Karolinska University Hospital, 17176 Stockholm, Sweden.
⁵ Department of Physiotherapy, University of Pretoria, Pretoria 0028, South Africa.

Abstract

Objective: The objective was to describe the individual items of the environmental factors and to investigate the relationship between the environmental factors to health conditions, general health and quality of life in people with SCI in South Africa.

Methods: Two hundred persons with SCI participated in a cross-sectional survey design. This study formed part of the International Spinal Cord Injury (InSCI) Community Survey. Four major domains, environmental factors, health conditions, general health and quality of life of the survey questionnaire responses, were used for the analysis. Regression models were used to determine the association between the independent variable, which consisted of the specific environmental factors items, and the dependent variables comprising health conditions, general health and quality of life.

Results: The commonly reported environmental barriers were public access, lack of short- and long-distance transport and finances. Environmental factors such as public access (p < 0.001), short- (p < 0.001) and long-distance transport (p = 0.001), and friends' (p = 0.003) and colleagues' (p < 0.001) attitudes and communication (p = 0.042) were significantly associated with the presence of secondary health conditions. Finances (p = 0.026), family attitudes (p = 0.037) and communication (p = 0.039) had a significant association with worsened mental health. Services (p = 0.022) and communication (p = 0.042) were also significantly associated with decreased general health.

Conclusion: The results provide insight into modifiable environmental factors policymakers need to consider or adapt to improve the lives of people with SCI in South Africa with respect to health (secondary health conditions), as well as general and mental health.

Keywords: South Africa; environmental factors; general health; health conditions; quality of life; spinal cord injury.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cross-Sectional Studies
Humans
Mental Health
Quality of Life* / psychology
South Africa / epidemiology
Spinal Cord Injuries* / epidemiology
Spinal Cord Injuries* / psychology
Surveys and Questionnaires

Grants and funding

The work reported herein was made possible through the South African Medical Research Council (SAMRC) funding through its Division of Research Capacity Development under the RCDI. The content hereof is the sole responsibility of the authors and does not necessarily represent the official views of the SAMRC.