Spinal cord injury (SCI) is a severe traumatic Disability that occurs suddenly and affects both sensory and Motor functions. According to the National Spinal Cord Injury Statistical Center 1999), there are about 203,000 persons in the U.S. who have sustained a spinal cord injury and approximately 10,000 new injuries occurr each year. Although medical advances have increased the life expectancies of people with SCI, there has been a limited amount of research addressing life satisfaction in people with SCI (Krause, 1992).
Life satisfaction, an individual's cognitive evaluation of his or her life, is considered an important Rehabilitation goal of people with SCI by many rehabilitation professionals (Boswell, Dawson, & Heininger, 1998; Christopher, 1999; Krause, 1992). Previous studies in the U.S. on life satisfaction have found positive relationships between employment status, age at the onset of disability, marital status, educational attainment, social support, and life satisfaction (Boschen, 1996; Decker & Schulz, 1985; Krause & Dawis, 1992; Mehnert, Krauss, Nadler, & Boyd, 1990). On the other hand, the severity of the injury did not appear to be associated with life satisfaction (Cushman & Hassett, 1992; Schulz & Decker, 1985).
Researchers also point out that individuals' cognitive evaluation of their lives is influenced by their salient values and that these values are learned through socialization in their culture (Diener & Diener, 1995; Keith, Heal, & Schalock, 1996; Oishi, Diener, Suh, & Lucas, 1999). When studying life satisfaction, one needs to take both culture and value perspectives into consideration (Krause & Dawis, 1992). However, culture is a difficult construct to define (Triandis et al., 1986). The majority of culture-related studies have focused on the individualism- collectivism dimension of cultures (Hofstede, 1980; Schaller, Parker, Garcia, 1998; Thompson, 1997; Triandis et al., 1986). It was found that people in individualistic cultures tend to give priority to the goals of individuals, feel personally responsible for their successes and failures, and experience some separation and distance from their ingroups. In contrast, people in collectivistic cultures tend to give priority to the goals of collectives, share both successes and failures with others, and have close relationships with members of their ingroups (Triandis et al., 1986).
Further, social psychologists found that culturally different nations have demonstrated notable variations in reported life satisfaction (Diener, Sandvik, Seidlitz, & Diener, 1993; Veenhoven, 1991). Poorer countries tend to possess lower life satisfaction than richer ones. For instance, Leelakulthanit and Day (1993) investigated the differences in lite satisfaction between Americans and Thais. They reported that Americans were more satisfied with their lives than Thais. Similarly, Diener, Suh, Smith, and Shao (1995) conducted a survey of life satisfaction among American, Korean, and Chinese college students. They found that Chinese and Korean college students scored much lower than Americans on both life satisfaction and positive feelings after other influential factors (e.g., income and wealth of the countries) were controlled. In a study of the cross-cultural correlates of life satisfaction, Diener and Diener (1995) found that four variables (satisfaction with self, family, friends, and finances) were related to life satisfaction for all participants in 31 nations. However, the size of the correlation between life satisfaction and satisfaction with the self was higher in individualistic countries (e.g., the United States) and lower in collectivistic countries (e.g., Korea). We were not able to locate any cross-cultural study on life satisfaction of people with disabilities in the rehabilitation literature, indicating a need for future investigations in this area.
Diener et al. (1995) suggested that the cultural differences between these countries might be responsible for the differences in reported life satisfaction. In the American culture, individual happiness and satisfaction are considered very important in one's life and people are socialized to attend to their own needs and satisfaction. In contrast, the Chinese and Korean are socialized to fit into the community and life satisfaction is related to fulfilling one's responsibilities to his or her family, community, and country (Diener et al., 1995). However, empirical investigations are needed to examine this hypothesis. It should be noted that, in Diener et al.'s study, the participants were college students. If one wants to examine influences of culture and values on life satisfaction of rehabilitation clients cross culturally, one should recruit adults with disabilities in these explorations.
In addition, researchers pointed out that the life satisfaction of women with SCI is a much neglected but critically needed area of research (Krause & Anson, 1997; Trieschmann, 1992). In a national survey of the general public, Gurin, Veroff, and Feld (1960) found that American women had more emotional problems than men. Campbell (1981) reported that American women were more dissatisfied with their lives than men. However, recent studies indicated that American women did not differ from men on most of the general measures of happiness, although they scored much higher on both negative and positive measures of emotions (Fujita, Diener, & Sandvik, 1991). For example, Diener and Diener (1995) reported that the levels of life satisfaction of female college students from 31 countries were similar to the levels of male students and the correlational patterns between life satisfaction and the predictors (satisfaction with self, family, friends, and finances) were similar for men and women across nations.
Further, the few studies which explore the life satisfaction of women with SCI have reported inconsistent findings. Fuhrer, Rintala, Jart, Clearman, and Young (1993) found that women were more likely to have negative feelings and were more at risk for serious Depression than men following SCI. Krause and Anson (1997) indicated that minority women with SCI appeared to experience greater emotional distress than minority men, Caucasian men, and Caucasian women with SCI. On the other hand, minority men with SCI tended to experience less emotional distress than either of the other three groups (Krause & Anson, 1997). These studies contradicted the findings of earlier study by Woodrich and Patterson (1983) which reported that female participants with SCI were more likely to accept their disabilities than male participants.
It appears that gender is an important but less understood factor in life satisfaction of people with SCI. The limited studies on the relationship between gender and life satisfaction, however, do merit further explorations in this area. Moreover, previous investigations indicated that self-efficacy - a person's beliefs about his or her abilities to cope with life's exigencies - had an influence on life satisfaction. For instance, Waltz and Bandura (1988) reported that the life satisfaction of cardiac male patients appeared to be influenced by a sense of efficacy, subjective health perceptions, and relatively stable socio-environmental conditions. Arns and Linney (1993) found that a change in vocational status had an impact on self-efficacy which then affected life satisfaction through its influence on self-esteem. In a qualitative study of life satisfaction and psychological well-being in Chinese with SCI, Hampton (1998) reported that self-efficacy was an important predictor of life satisfaction in the Chinese people with SCI. However, more investigations are needed to explore the influence of self-efficacy on life satisfaction in people with SCI.
In summary, although previous research implies that culture and values may have an impact on life satisfaction, no empirical work has directly addressed these issues in people with SCI. Further, the impact of gender and self-efficacy beliefs on life satisfaction of people with SCI is not clear. Accordingly, the purposes of this study were to examine value differences between Americans and Chinese people with SCI, to assess culture and gender effects on life satisfaction, and to explore patterns of correlates of life satisfaction in the two groups.
