Mental well-being and quality of life related to participation in leisure-time activities among people with spinal cord injury: A secondary analysis of a cross-sectional survey

CONTEXT/OBJECTIVE: People with spinal cord injury (SCI) may experience reduced mental well-being and quality of life (QoL), as well as barriers to community and social participation. This study examined associations between social and non-social leisure-time participation and mental well-being, and between perceived participation restrictions and QoL, among people with SCI. DESIGN: Secondary analysis of a cross-sectional survey. SETTING: Western Denmark. PARTICIPANTS: People with SCI who had previously completed inpatient rehabilitation. Of 1,157 invitees, 479 completed the survey, of whom 474 were included in the analyses. INTERVENTIONS: Not applicable. OUTCOME MEASURES: Mental well-being, QoL, and perceived participation restrictions were assessed using the WHO-5, SCI-QoL Basic, and USER-P Restrictions, respectively. Multiple linear regression analyses examined associations after adjustment for potential confounders. RESULTS: Compared with very low social leisure-time participation, low to very high participation was associated with WHO-5 scores 12.3-15.3 points higher. For non-social participation, differences ranged from 1.3 to 5.5 points, with all 95% confidence intervals including zero. Fewer perceived participation restrictions were associated with higher QoL; participants in the highest USER-P Restrictions quartile scored 26.2 points higher than those in the lowest quartile. CONCLUSION: Greater social leisure-time participation was associated with better mental well-being, whereas non-social participation was not clearly associated with mental well-being. Fewer perceived participation restrictions were associated with higher QoL. Longitudinal studies are needed to clarify temporal direction.