Mental health, quality of life, self-efficacy, and social support of individuals living with spinal cord injury in Switzerland compared to that of the general population

Spinal Cord. 2021 Apr;59(4):398-409. doi: 10.1038/s41393-020-00582-5. Epub 2020 Nov 24.


Study design: Comparative study of survey self-report data.

Objectives: To compare individuals living with spinal cord injury (SCI) in Switzerland to the general population in terms of mental health, quality of life, self-efficacy, and social support.

Setting: Community, Switzerland.

Methods: Data from the 2017 community survey of the Swiss Spinal Cord Injury Cohort Study were compared to data from two matched (1:3 nearest neighbor propensity score) general population surveys collected in the same year. Measures of mental health (mental health index, psychological distress item, vitality scale, and energy item), quality of life (WHOQOL-BREF item), self-efficacy (General Self-Efficacy Scale item), and social support (items of relationship satisfaction, living alone, and marital status) were compared across datasets using regression adjusted for non-response correction weights. The analyses were then replicated in subgroups defined by sociodemographic, lesion-related, and secondary health issues factors.

Results: Individuals with SCI had significantly higher psychological distress and poorer mental health, vitality, energy, and quality of life than the general population, with medium to large effect sizes (Cohen's d: 0.35-1.08). They also had lower self-efficacy and relationship satisfaction, lived more frequently alone, and were more frequently single. Individuals with less severe secondary health issues reported mental health and quality of life more similar to the general population than those reporting more severe issues.

Conclusions: This study highlights a significant long-term impact of SCI on well-being and psychosocial resources, underlining the need for ongoing biopsychosocial care beyond inpatient rehabilitation.

MeSH terms

  • Cohort Studies
  • Cross-Sectional Studies
  • Humans
  • Mental Health
  • Quality of Life*
  • Self Efficacy
  • Social Support
  • Spinal Cord Injuries* / epidemiology
  • Surveys and Questionnaires
  • Switzerland / epidemiology