Factors associated with perceived social isolation among veterans with spinal cord injury and disorders: Cross sectional survey.

Wirth M, Motl RW, Bombardier CH, Bartle B, Wong AWK, Aguina K, LaVela SL. Factors associated with perceived social isolation among veterans with spinal cord injury and disorders: Cross sectional survey. The journal of spinal cord medicine. 2024 Feb 5; 1-10.

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Abstract:

CONTEXT/OBJECTIVE: Examine demographics, injury characteristics, objective measures of social isolation and health factors that are associated with perceived social isolation (PSI) among Veterans with spinal cord injury and disorders (SCI/D). DESIGN: Cross-sectional survey. SETTING: The Veterans Health Administrations (VHA) SCI/D system of care. PARTICIPANTS: Veterans with SCI/D who have used the VHA health care system. INTERVENTION: Not applicable. OUTCOMES MEASURES: We assessed unadjusted associations of high PSI (above population mean) vs low (normative/below population mean), and multivariable logistic regression for independent associations with PSI. RESULTS: Out of 1942 Veterans with SCI/D, 421 completed the survey (22% response rate). Over half (56%) had PSI mean scores higher than the general population. Among the objective measures, having a smaller social network size was associated with increased odds of high PSI (OR 3.59, P < .0001); additionally, for health factors, having depression (OR 3.98, P < 0.0001), anxiety (OR 2.29, P = 0.009), and post-traumatic stress (OR 2.56, P = 0.003) in the previous 6 months, and having 4 or more chronically occurring secondary conditions (OR 1.78, P = 0.045) was associated with increased odds of high PSI. The most commonly identified contributors to feelings of PSI included mobility concerns (63%), having a SCI/D (61%), and concerns about being a burden on others (57%). CONCLUSIONS: Factors such as social network size may be used to identify individuals with SCI/D at risk for PSI. Additionally, by identifying mental health problems, presence of multiple chronically occurring secondary conditions, and Veteran-identified contributors of PSI, we can target these factors in a patient-centered interventions to identify and reduce PSI.