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The impact of social support at home on health-related quality of life among veterans with spinal cord injury participating in a supported employment program

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Abstract

Purpose

To investigate the impact of social support at home on health-related quality of life (HRQOL) as measured by the VR-6D utility index for spinal cord injury (SCI) veterans participating in a program of supported employment (SE).

Methods

We calculated a preference-based utility index called the VR-6D from the responses from a 36-item instrument called the VR-36. We estimated a growth curve model to examine the change in the VR-6D utility index over time adjusting for social support status, demographics, and chronic comorbidities.

Results

Study participants experienced an increase in HRQOL over time. The initial level and the rate of increase in HRQOL varied by groups based on their support status. The rate of increase in HRQOL diminished over time. Participants reporting no support at home experienced lower initial HRQOL but reached the same level of those who reported having support at home by the ninth month of follow-up. Quality-adjusted life-years, as measured by the area under the curves, were approximately the same for both groups after 2 years.

Conclusions

Differences in the rate of change in HRQOL by support status have important implications for evaluations of SE programs. Participants in this program of SE experienced improvement in HRQOL beyond 12 months and extending to 2 years. Follow-up times for evaluations should extend beyond 12 months to assess complete improvements in HRQOL. Future comparison groups in comparative effectiveness evaluations of SE need to be balanced carefully on support status in addition to other factors.

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Acknowledgments

All participants in this study gave their informed consent prior to their inclusion in the study. This study has been approved by the appropriate ethics committees and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. This material is based on work supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, and the Rehabilitation Research and Development Service. The contents of this paper do not represent the views of the Department of Veterans Affairs or the United States Government. We also acknowledge the contributions of study coordinators, program managers, data managers, dissemination managers, and veterans who participated in this study.

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Authors and Affiliations

  1. Health Services Research and Development/Rehabilitation Research and Development, Center of Innovation on Disability and Rehabilitation Research, Veterans Integrated Systems Network 8, James A. Haley Hospital, 8900 Grand Oak Circle (151R), Tampa, FL, 33637-1022, USA

    Bryce S. Sutton, Lisa Ottomanelli, Eni Njoh & Scott D. Barnett

  2. Department of Rehabilitation and Mental Health Counseling, University of South Florida, Tampa, FL, USA

    Lisa Ottomanelli

  3. Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VA, USA

    Lance L. Goetz

  4. Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA

    Lance L. Goetz

Authors
  1. Bryce S. Sutton
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  2. Lisa Ottomanelli
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  3. Eni Njoh
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  4. Scott D. Barnett
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  5. Lance L. Goetz
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Corresponding author

Correspondence to Bryce S. Sutton.

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Sutton, B.S., Ottomanelli, L., Njoh, E. et al. The impact of social support at home on health-related quality of life among veterans with spinal cord injury participating in a supported employment program. Qual Life Res 24, 1741–1747 (2015). https://doi.org/10.1007/s11136-014-0912-4

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  • DOI: https://doi.org/10.1007/s11136-014-0912-4

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