The Quality of Life of Children and Adolescents with Spinal Cord Injury in Physical, Emotional, Social and School functioning

Abstract

Background: Spinal Cord injury (SCI), whether traumatic or non-traumatic, is a devastating neurological condition (Rahman et al., 2017). SCI are a major public health problem in Bangladesh (Hoque et al., 1999). Having spinal cord injury may impact largely on normal development of children by considering various dimension like their physical health, psychosocial health, social functioning, emotional functioning and their school functioning level, Pediatric SCI (pedSCI) is further complicated by issues related to ongoing physical and emotional growth (Augutis et al., 2006). Spinal cord injury before the age 15 years is a relatively rare occurrence, but it can have important psychological and physiological consequences (Parent et al.,2011). SCI is common problem but SCI among pediatric population is slightly under considerable position in Bangladesh. Globally each year, around the world, 250,000 to 500,000 people experience a spinal cord injury (Spinal Research Institute, 2024). Worldwide most affected age group are males aged 18-32 years. The most affected age group in south Asian countries such as Bangladesh, India and Pakistan are between 20 and 30 years (Ema et al., 2022). Author sought to obtain a more accurate picture about the Quality of Life of children and adolescents with SCI in physical health, emotional functioning, social functioning and school functioning status living with SCI in Bangladesh. Many studies from high-income countries (HICs) have examined the physical, psychological, and social well-being of people following spinal cord injuries (SCI) (Hossain et al., 2019). However, there is very little information about the Quality of Life and functioning status of children and adolescents with SCI. On the other hand, there are no evidence found specifically based on physical, emotional, social and school functioning domains and the factors related to physical, Social, emotional & school functioning of children and adolescents with SCI in Bangladesh. Aim: This study aimed to know the quality of life of children and adolescents with spinal cord injury (SCI) in physical health, psychosocial health, emotional functioning, social functioning and school functioning. Methods and Materials: Quantitative methodology and an analytical Cross sectional study approach followed to conducted the study. The study conducted in the community settings of the participants. The community was selected according to the living areas of patient particularly those were discharge from Centre for the Rehabilitation of Paralysed (CRP) after their initial treatment and currently living in their own community. Purposive sampling technique was used in this study. The calculated sample size was about 384. Data from 48 participants of the study sample were entered for the analysis. Among all participants of the study sample 27 were male and 21 were female children & adolescents with SCI. Find out the Socio-demographic overview of children and adolescence with SCI. An overview of average score of functioning status among children & adolescents with SCI was observed. Independent samples test- t test and one way ANOVA test was conducted for the association of physical, social functioning, emotional, school functioning with socio-demographic factors of children and adolescents with SCI. Results: The socio-demographic profile of children and adolescents with SCI the notable findings are that, a high percentage of participants were male children with SCI and they were reside in rural areas. Among all the participants a significant proportion of the children with SCI (72.9%) were involved in an institution- based study program, while 27.1 % were not. History of school drop was also present among the participants, 43.8% of the children with SCI were reported having dropped out of school. And the children and adolescents face various social, emotional, physical challenges that impact on their school functioning. Children & adolescents with SCI facing moderate level physical functioning difficulties. The average emotional functioning shows 11.56 ± 3.92 that indicates emotional functioning status level is low among them. The Social functioning level is also lower as the average score was 11.02 ± 5.53. On the other hand, the average score of psychosocial health was 57.54 ± 16.140 represents psychosocial functioning status is higher level among the children and adolescents with SCI in Bangladesh. On the other hand, there was no significant association between male & female gender, age group with physical & social functioning of children and adolescents with SCI. Social functioning shows a statistically significant association with the living area (p = .040) among children and adolescents with SCI. Conclusions: The quality of life in psychosocial health functioning status is higher than other functioning dimension such as emotional, social, school functioning among children and adolescents with SCI in Bangladesh. The quality of life in physical functioning is moderate level and the emotional functioning & Social functioning is on average level. Quality of life in school functioning is also lower level and slightly better than emotional & social functioning status among children and adolescents with SCI in Bangladesh. Social functioning shows a statistically significant association with the living area among children and adolescents with SCI in Bangladesh. So, understanding a more accurate picture the Quality of Life of children and adolescents with SCI in physical health, emotional functioning, social functioning and school functioning status will help to set holistic approach to rehabilitation, and help to set multidisciplinary team (MDT) rehabilitation goal effectively for children and adolescents with SCI in Bangladesh. Key words: Quality of life, Children & adolescents with spinal cord injury, physical health, psychosocial health, and emotional, social & school functioning