Continued from page 1. The U. S. and China were chosen for this comparison study because Americans scored particularly high on individualism and Chinese scored particularly low on individualism but high on collectivism when assessed with instruments which measured the individualism-collectivism construct (Triandis et al., 1986). A study of people from these two countries may provide insight about the roles of culture and values in life satisfaction. In addition, as we become more globally linked by travel, communication, and advancing technology, we must learn more about each other in order to communicate effectively and work well together to build a better world in which people with SCI can have a good quality of life.

Method

Participants

Two hundred and sixty-three individuals with SCI participated in the study. Of them, 133 were Americans and 130 were Chinese. The criteria for the participant recruitment included: (a) the person had a traumatic SCI but did not have any cognitive Impairment, (b) the injury duration was at least two years at the time of the study, and (c) the participant was at least 18 years of age at the time of the study. These criteria were consistent with those of previous studies (Hampton, 2000; Krause, 1992) done in the U.S. and China.

In the American group, 64% were males. The majority of the participants were Whites (87%), followed by African Americans (10%) and Hispanic Americans (3%). Of the participants, 37% were single, 40% were married, 19% were divorced or separated, and 4% were cohabitating. Their ages ranged from 20 to 69 years, with a mean age of 43 (SD = 10.92) years. The age at the time of injury ranged from 10 to 64 years, with a mean age of 29 (SD = 11.49) years. The educational levels ranged from 8 to 24 years with a mean of 16 years (SD = 3.05). Ninety-three percent of the participants lived in private non-institutional residences. Among them, 3% lived with friends, 5% lived with an attendant, 22% lived alone, and 62% lived with a spouse or parents. The remaining 7% of the participants lived in nursing homes. Of the participants, 43% were unemployed, 18% held part-time positions, and 39% held full-time positions. The income ranged from below $7,500 to more than $50,000 with a median of $35,001 (SD=I 8,720). The causes and levels of injury are listed in Table 1.

In the Chinese group, 60% were males; 27% were single, 70% were married, 2% were separated, and 1% was widowed. Their ages ranged from 18 to 58 years, with a mean age of 35 (SD = 9.08) years. The age at the time of injury ranged from 13 to 56 years, with a mean age of 31(SD = 8.59) years. The educational levels ranged from 6 to 18 years with a mean of 12 years (SD = 2.98). All participants lived in a non-institutional residence; 3% of them lived alone, 4% lived with their friends, 13% lived with an attendant, and 80% lived with a spouse or parents. Of the participants, 34% were unemployed, 18% held part-time positions, and 48% held full-time positions. Ninety-three percent of the participants were Han (the ethnic majority group in China) and 7% ,of them were descendants of other ethnic groups. The annual income ranged from 2,400 ($300) to 60,000 ($7,500) Chinese yuan with a median of 12,000 yuan ($1,500; SD = 861.88 yuan = $107.74.). The causes of the injury and the severity of the Disability are listed in Table 1.

Table 1

Causes and Severity of Disability In Americans and Chinese with Spinal Cord Injuries

Injury Americans (%) Chinese (%)

Causes

Diving 20 0
Fall 29 10
Gunshot 11 1
Job-related 3 39
Natural disaster 0 4
Vehicle 37 46

Levels

Cervical 59 23
Thoracic 34 51
Lumbar 7 26

Types

Complete 39 58
Incomplete 56 41
Missing 5 1

Instruments

The Life Situation Survey (LSS; Chubon, 1995) was used to assess life satisfaction. The LSS contains 20 items (Chubon, 1995; Clayton & Chubon, 1994). Participants are asked to indicate their agreement on a seven-point Likert scale ranging from "Agree Very Strongly" to "Disagree Very Strongly.' High scores reflect a higher level of life satisfaction. The LSS has been applied to people with SCI in both the U.S. and China (Clayton & Chubon, 1994; Hampton, 2000). In this study, the Cronbach alpha reliability coefficient of the LSS was .85.

The Individualism-Collectivism scale (Trandis et al., 1986) was used to measure the values of individualism-collectivism. The scale contains 21 items answered on a six-point scale (Extremely Agree to Extremely Disagree). A factor analysis indicated that the scale contained four factors: (a) self-reliance, (b) interdependence, (c) family integrity, and (d) separation from ingroups. Originally, family integrity and interdependence were designed to be the indicators of collectivism; self-reliance and separation from ingroups were indicators of individualism. However, previous studies indicated that (a) collectivism was best described by family integrity but not by interdependence, and (b) individualism was well-described by separation from ingroups but not by self-reliance (Triandis et al., 1993; Triandis, McCusker, & Hui, 1990).

The General Self-Efficacy Scale (GSES) was used to measure an individual's fundamental beliefs about his or her ability to cope with life's exigencies (Sherer, Maddux, Mercandante, PrenticeDunn, Jacobs, & Rogers, 1982). It consists of 17 items. Higher scores correspond with higher self-efficacy expectations. The Cronbach reliability of the GSES in this study was .79.

The Self-Rated Health Status scale (SRHS; Lawton, Moss, Fucomer, & Kleban, 1982) was used to measure perceived health. According to Lawton et al. (1982), the Cronbach alpha internal consistency of the scale was .76. The concurrent validity of the scale was supported by a moderate correlation (r = .63) between the scale and clinicians' rating of health status. The Cronbach reliability of the SRHS in this study was .75.

A demographic: information sheet containing the participants' age, age at the onset of disability, sex, educational level, marital and employment statuses, income, and injury level was developed. All instruments were translated into Chinese using a back translation method (English-Chinese-English) by a bilingual counseling psychology graduate student and a bilingual counseling psychologist. The Chinese versions of the instruments had been tested in a study of 40 people with SCI in China and the results indicated that the instruments were reliable (Hampton, 1998).

Procedures

The information regarding the study was published in the Newsletters of the National Spinal Cord Injury Association (NSCIA) in the U. S. Thirty local Chapters of the NSCIA across the U. S. were contacted by the phone. Fifteen Chapters agreed to participate in the study. Three hundred and eighty questionnaires in self-stamped envelopes were mailed to the coordinators of the local Chapters. The coordinators then distributed the questionnaires to members who met the recruitment criteria for participants. One hundred and thirty-three questionnaires were returned. The return rate was 35%. Meanwhile, the president and the chief psychologist of a Rehabilitation center for people with spinal cord injuries in Beijing, China were contacted. Because this center was the only rehabilitation facility that specialized in spinal cord injuries in China, its patients came from different geographic areas across China. Two hundred questionnaires were sent to outpatients of the center. One hundred and thirty questionnaires were returned with a return rate of 65%. All participants received $5.00 or 40 Chinese yuan.

Results

A preliminary analysis was conducted to examine variations in values and life satisfaction between majority and minority group members within each country. No significant difference was found. Thus, we decided not to conduct separate analysis for race or ethnicity within each country.

Differences in Values between Americans and Chinese