Quality of life after spinal cord injury in Thai individuals: A mixed-methods study

Background: Patients with spinal cord injury (SCI) face various health-related difficulties. Physical limitations and health-related complications in individuaLs with SCI can lead to activity restrictions and lowering their quality of life (QoL). It is important to assess the QoL in population with SCI to gain more valuable insights into aspects of health-related QoL (HRQoL) that could play a key role in improving care for persons with SCI. Objective: To quantitatively measure the QoL in persons with SCI in Thailand and expand the results through qualitative investigation to provide meaning, context and depth of "how" and "why" they rated, defined and addressed their QoL in that way. Methods: The philosophical assumption of this study was set based on the post-positivist views using mixed-methods sequential explanatory design. 'The quantitative data were collected and analyzed in 101 Thai individuals with SCI using standardized Thai version of the Short Form health Survey version 2 (SF-36v2), followed by the qualitative investigation of semi-structured interviews in 11 volunteers who participated in the SF-36v2 phase. Priority is given to quantitative data. The data integration occurred at the qualitative data collection through the data interpretation and discussion stage. Results: With regard to quantitative data, a recent study found a statistically significant difference (p < 0.05) in four domains for male and three domains for the female when comparing the SF-36 Thai normative data with SF-36v2 SCI data. Qualitative data revealed that the most salient themes of HRQoL in individuals with SCI were "supporting factors toward QoL" and "driving force post injury". The integration of the findings revealed that the qualitative data could individually explain and define QoL as well as support quantitative results. The connection of both findings indicated that the higher scores in psycho-social variables and lower scores in physical domains of SF-36v2 in Thai persons with SCI may be due to unique Thai family traditions and community values. Conclusion: The scores on SF-36v2 and the replies in the qualitative investigation of QoL themes of Thai individuals with SCI were similar to those of other research, but this study is unique in that it specifically represents the Thai socio-environmental-cultural aspects.