Appraisals of life transition events and associations with quality of life at 3- and 12-months post-discharge following spinal cord injury

Published 3rd November 2026

Purpose
This study examined the occurrence of life transition events during the first 12-months post-discharge after spinal cord injury (SCI) and determined whether appraisals of the impact and coping related to these events were associated with quality of life (QoL).

Methods
Recruited at discharge, adults with SCI completed telephone-based or online surveys at 3-months (n = 47) and 12-months (n = 39) post-discharge. Participants completed the Sentinel Events Questionnaire regarding the occurrence (Yes/No) of life transitions, including core events (i.e., return-to-work, return to driving, home independence, independence in the community) and other stressors, and rated the positive impact, negative impact, and coping for core events. QoL was measured using the EUROHIS-QoL-8.

Results
At 3-months post-discharge, the occurrence of each core event was associated with more positive appraisals of impact (p < 0.01). At 12-months, return-to-work and driving were more positively appraised than resuming home or community independence (p < 0.05). Across events, coping appraisals were consistently and positively associated with QoL, after controlling for event occurrence (sr2 = 8–22%, p < 0.05).

Conclusion
The finding that more positive appraisals of impact and coping regarding core events are associated with better QoL highlights the importance of understanding the subjective meaning of life transition events to inform person-centred interventions.

IMPLICATIONS FOR REHABILITATION
Individuals with spinal cord injury who positively appraise the impact of life transition events and their ability to cope with these may experience better quality of life in the first 12-months post-discharge.
Low self-efficacy or coping perceptions regarding either progress or lack of progress in resuming occupations may negatively affect quality of life.
It may be beneficial for clinicians to explore the subjective meaning of life transition events for individuals with spinal cord injury to normalise the challenges of community integration.
It is recommended that clinicians support self-efficacy for coping with life transitions by promoting self-advocacy skills, improving access to resources, and facilitating alternative pathways to meaningful participation.

Citation

Yi, J., Hogan, C., Brough, R., Bray, E., Mitchell, J., Jones, R., … Ownsworth, T. (2026). Appraisals of life transition events and associations with quality of life at 3- and 12-months post-discharge following spinal cord injury. Disability and Rehabilitation, 1–19. https://doi.org/10.1080/09638288.2026.2744808

Authors

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