Although occupational therapists frequently state that one of their primary goals is that of enhancing quality of life, this does not appear to be supported by either their outcome measures or their literature. Studies have shown that satisfaction with quality of life following a spinal cord injury is not predicted by either degree of impairment or disability. Handicap is negatively correlated with quality of life and this may require interventions that are focused towards the environment rather than the individual. Occupational therapists may need to adopt a more client-centred approach to practice, in which assessment, Intervention and outcome measures are sensitive to the subjective views of the individual, thus enabling therapists to understand more of what quality of life means to each client.
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References
1.
AbelaMBDijkersM (1994) Predicting life satisfaction among spinal cord injured patients one to three years post-injury (abstract). Journal of the American Paraplegia Society, 17(2), 118.
2.
Aristotle (4th century BC) Nichomachean Ethics, 1.10. Translated by ThomsonJ A. In: TrippR T, ed. Penguin international thesaurus of quotations.London: Penguin.
3.
ASIA (1992) Standards for neurological and functional classification of spinal cord injury.Chicago, Illinois: American Spinal Injury Association.
4.
BachCAMcDanielRW (1993) Quality of life in quadriplegic adults: A focus group study. Rehabilitation Nursing, 18(6), 364–67, 374.
5.
BachJRTiltonMC (1994) Life satisfaction and well-being measures in ventilator-assisted individuals with traumatic tetraplegia. Archives of Physical Medicine and Rehabilitation, 75, 626–32.
6.
BowlingA (1991) Measuring health: A review of quality of life rating scales.Milton Keynes: Open University Press.
7.
Canadian Association of Occupational Therapists (1991) Occupational therapy guidelines for client-centred practice.Toronto, Ontario: CAOT Publications ACE.
8.
ClaytonKSChubonRA (1994) Factors associated with the quality of life of long-term spinal cord injured persons. Archives of Physical Medicine and Rehabilitation, 75, 633–38.
9.
CreekGMooreMOliverMSalisburyVSilverJZarbG (1987) Personal and social implications of spinal cord injury: A retrospective study.London: Thames Polytechnic.
10.
CrepeauEB (1991) Achieving intersubjective understanding: Examples from an occupational therapy treatment session. American Journal of Occupational Therapy, 45(11), 1016–25.
11.
CushmanLAHassettJ (1992) Spinal cord injury: 10 and 15 years after. Paraplegia, 30(10), 690–96.
12.
DeckerSDSchulzR (1985) Correlates of life satisfaction and depression in middle-aged and elderly spinal cord injured persons. American Journal of Occupational Therapy, 39(11), 740–45.
13.
DeVivoMJRichardsJS (1992) Community reintegration and quality of life following spinal cord injury. Paraplegia, 30(2), 108–12.
14.
DriedgerD (1989) The last civil rights movement. Disabled Peoples' International.London: C Hurst and Company.
15.
EisenbergMGSaltzCC (1991) Quality of life among ageing spinal cord injured persons: Long-term rehabilitation outcomes. Paraplegia, 29(8), 514–20.
16.
EvansRLHendricksRDConnisRTHaselkornJKRiesKRMennetTE (1994) Quality of life after spinal cord injury: A literature critique and meta-analysis (1983–1992). Journal of the American Paraplegia Society, 17(2), 60–66.
17.
FlanaganJC (1982) Measurement of quality of life: Current state of the art. Archives of Physical Medicine and Rehabilitation, 63, 56–59.
18.
FuhrerMJRintalaDHHartKAClearmanRYoungME (1992) Relationship of life satisfaction to impairment, disability and handicap among persons with spinal cord injury living in the community. Archives of Physical Medicine and Rehabilitation, 73, 552–57.
19.
GlassCA (1993) The impact of home-based ventilator dependence on family life. Paraplegia, 31(2), 93–101.
20.
GrangerCVHamiltonBBKeithRAZieleznyMSherwinFS (1986) Advances in functional assessment for medical rehabilitation. Topics in Geriatric Rehabilitation, 1(3), 59–74.
21.
GrantMFerrellBSchmidtGMFonbuenaPNilandJCFormanSJ (1992) Measurement of quality of life in bone marrow transplantation survivors. Quality of Life Research, 1(6), 375–84.
22.
GreshamGLabiMDittmarSHicksJJoyceSStehlikM (1986) The Quadriplegia Index of Function (QIF): Sensitivity and reliability demonstrated in a study of 30 quadriplegic patients. Paraplegia, 24, 38–44.
23.
Health Services Directorate, Health Canada and the Canadian Association of Occupational Therapists (1993) Occupational therapy guidelines for client-centred mental health practice.Toronto, Ontario: Canadian Association of Occupational Therapists.
24.
HollandsworthJ (1988) Evaluating the impact of medical treatment on the quality of life: 5-year update. Social Science and Medicine, 26, 425–434.
25.
JongbloedLCrichtonA (1990) A new definition of disability: Implications for rehabilitation practice and social policy. Canadian Journal of Occupational Therapy, 57, 32–38.
26.
KielhofnerG (1993) Functional assessment: Toward a dialectical view of person-environment relations. American Journal of Occupational Therapy, 47(3), 248–51.
27.
KinneyWBCoyleCP (1992) Predicting life satisfaction among adults with physical disabilities. Archives of Physical Medicine and Rehabilitation, 73, 86369.
28.
KrauseJS (1991) Survival following spinal cord injury: A 15-year prospective study. Rehabilitation Psychology, 36(2), 89–98.
29.
KrauseJCreweN (1987) Prediction of long-term survival among persons with spinal cord injury: An 11-year prospective study. Rehabilitation Psychology, 32, 205–13.
30.
KrauseJSDawisRV (1992) Prediction of life satisfaction after spinal cord injury: A four-year longitudinal approach. Rehabilitation Psychology, 37(1), 49–60.
31.
KrauseJSKjörsvigJM (1992) Mortality after spinal cord injury: A four-year prospective study. Archives of Physical Medicine and Rehabilitation, 73, 558–63.
32.
LawMBaptisteSCarswell-OpzoomerAMcCollMAPolatajkoHPollockN (1991) Canadian occupational performance measure.Toronto, Ontario: CAOT Publications ACE.
33.
LubekDPFriesJF (1992) Changes in quality of life among persons with HIV infection. Quality of Life Research, 1(6), 359–66.
MahoneyFIBarthelDW (1965) Functional evaluation: The Barthel index. Maryland State Medical Journal, 14, 61–65.
36.
MattinglyC (1991) The narrative nature of clinical reasoning. American Journal of Occupational Therapy, 45(11), 998–1005.
37.
MenterR (1989) Introduction to high quadriplegia care. In: WhiteneckG G, eds. The management of high quadriplegia.New York, Demos.
38.
MenterRMaddoxS (1989) Ethics. In: WhiteneckG G, eds. The management of high quadriplegia.New York: Demos.
39.
MurphyRF (1990) The body silent.New York: W W Norton, 87–88.
40.
NajmanJMLevineS (1981) Evaluating the impact of medical care and technologies on the quality of life: A review and critique. Social Science and Medicine, 15, 107–15.
41.
NiemiMLLaaksonenRKotilaMWaltimoO (1988) Quality of life 4 years after stroke. Stroke, 19, 1101–1107.
42.
OliverMBarnesC (1993) Discrimination, disability and welfare: From needs to rights. In: SwainJFinkelsteinVFrenchSOliverM, eds. Disabling barriers — Enabling environments.London: Open University and Sage Publications.
43.
SchulzRDeckerS (1985) Long-term adjustment to physical disability — The role of social support, perceived control and self-blame. Journal of Personality and Social Psychology, 48(5), 1162–72.
44.
SiösteenALundqvistCBlomstrandCSullivanLSullivanM (1990) The quality of life of three functional spinal cord injury subgroups in a Swedish community. Paraplegia, 28, 476–88.
45.
StensmanR (1985) Severely mobility-disabled people assess the quality of their lives. Scandinavian Journal of Rehabilitation Medicine, 17, 87–99.
46.
StensmanR (1994) Adjustment to traumatic spinal cord injury. A longitudinal study of self-reported quality of life. Paraplegia, 32(6), 416–422.
47.
HammellWhalley KR (1994a) Establishing objectives in occupational therapy practice, part 1. British Journal of Occupational Therapy, 57(1), 9–14.
48.
HammellWhalley KR (1994b) Establishing objectives in occupational therapy practice, part 2. British Journal of Occupational Therapy, 57(2), 45–48.
49.
HammellWhalley K (1995a) Spinal cord injury rehabilitation.London: Chapman and Hall.
50.
HammellWhalley K (1995b) Application of learning theory in spinal cord injury rehabilitation. Scandinavian Journal of Occupational Therapy, in press.
51.
WHO (1980) International classification of impairments, disabilities and handicaps: A manual of classification relating to the consequences of disease.Geneva: World Health Organisation.
52.
Wood-DauphineeSKuchlerT (1992) Quality of life as a rehabilitation outcome: Are we missing the boat?Canadian Journal of Rehabilitation, 6(1), 3–12.
53.
YerxaEJBaumS (1986) Engagement in daily occupations and life satisfaction among people with spinal cord injuries. Occupational Therapy Journal of Research, 6(5), 271–83.
