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Patterns of internet use by persons with spinal cord injuries and relationship to health-related quality of life

https://doi.org/10.1016/j.apmr.2004.07.350Get rights and content

Abstract

Drainoni M-L, Houlihan B, Williams S, Vedrani M, Esch D, Lee-Hood E, Weiner C. Patterns of Internet use by persons with spinal cord injuries and relationship to health-related quality of life. Arch Phys Med Rehabil 2004;85:1872–9.

Objectives

To examine patterns of computer and Internet use among persons with spinal cord injuries (SCI) and to assess the relationship between Internet use and health-related quality of life (HRQOL).

Design

Cross-sectional survey design.

Setting

National Model Spinal Cord Injury Systems.

Participants

People with SCI enrolled in a national database.

Interventions

Not applicable.

Main outcome measures

Patterns of Internet use and relationship to HRQOL indicators: self-perceived health status, health status compared with 1 year ago, severity of depression, social integration score, occupation score, contacts with friends, business contacts, and satisfaction with life.

Results

Most subjects owned computers, had Internet access, and used the Internet regularly—primarily for email, disability and health information, and shopping. Bivariate analysis revealed significant differences in Internet access based on sociodemographics, particularly among subjects with less education and among African Americans and Hispanics. In initial univariate analysis, most HRQOL indicators were significantly better for Internet users; once sociodemographic factors were included, 4 indicators remained significant.

Conclusions

Complex factors contribute to Internet access among people with SCI, with more barriers among specific subgroups. A significant HRQOL benefit from Internet use is suggested. Targeted interventions and studies of usage patterns are recommended.

Section snippets

Participants

Subjects were recruited from the pool of participants in the 16 national MSCIS programs. Participants in the MSCIS enroll within their first year after SCI and are required to respond to the MSCIS Follow-Up Survey every 5 years. For the current study, 2 groups of subjects were used, one being a subsample of the other. The total sample consisted of 516 individuals participating in 12 MSCIS programs who were asked to respond to the Pilot Technology Survey developed for this study. Data from the

Patterns of computer and Internet use

To examine the first research question, patterns of computer and Internet access and use by people with SCI, the total sample of 516 survey respondents were asked several questions about frequency and type of use (appendix 1). Two thirds (67%) reported owning a computer and 65% reported having an Internet connection at home. Of those with Internet access, 54% used a modem, whereas almost all of the remaining 46% had a high-speed connection. One respondent used Microsoft’s MSN TV rather than a

Discussion

Our study provided insight into patterns of computer and Internet use within the SCI population. Nearly two thirds of participants reported having Internet access at home, affirming previous findings of higher rather than lower rates of access for this population. For a small but critical mass, an assistive device was used to enable computer and Internet use. Most participants with access used the Internet at least weekly (81%) for interpersonal communication, health and disability and

Conclusions

The results aligned with those of the Internet pilot study,1 which found high levels of self-reported benefits. This present study showed a significant relationship between Internet use and several HRQOL indicators. People with SCI are using the Internet at higher and higher rates for interpersonal communication, entertainment, information, and commerce. Thus, the question becomes not only one of gaining access, but also one of determining the ways in which the Internet can be most beneficial

Acknowledgments

We thank Michael DeVivo, University of Alabama, and Peter Hunt, University of Pittsburgh, for their assistance with data collection and quality control and Daniel Graves, The Institute for Rehabilitation and Research, for his review and comments. We thank Cheryl Weiner from BUSPH and NERSCIC and Jane Wierbicky from NSRSCIC and BMC for their review and assistance. We also thank the staff from the 12 MSCIS programs who participated in data collection.

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    Supported by the National Institute on Disability and Rehabilitation Research (NIDRR), US Department of Education (DOE; grant no. H133N000024), and the Department of Veterans Affairs (DVA), Veterans Health Administration, Health Services Research and Development Service. The views expressed in this article are solely the responsibility of the authors and do not necessarily represent the views of NIDRR, DOE, or DVA.

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors(s) or upon any organization with which the author(s) is/are associated.

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