Changes in life satisfaction in persons with spinal cord injury during and after inpatient rehabilitation: adaptation or measurement bias?

PURPOSE: To analyze changes in life satisfaction (LS) scores over time in persons with spinal cord injury (SCI) and to interpret what these changes mean. METHODS: Multicenter, prospective cohort study of persons with SCI (n = 96) classified into 3 life satisfaction trajectories identified earlier. Assessment took place 6 times from the start of active rehabilitation up to 5 years after discharge. Three LS scores were compared: (1) LS ‘now’ score, (2) ‘comparison’ score between LS ‘now’ and LS ‘before the SCI’, and (3) retrospective score of LS ‘before the SCI’. RESULTS: Persons in the low LS trajectory showed increase in the LS ‘now’ score, but not in the LS ‘comparison’ score and retrospective score. Persons in the recovery trajectory showed increase in the LS ‘now’ and LS ‘comparison’ scores, but not in the retrospective score. Persons in the high LS trajectory showed increase in the ‘comparison’ LS score and decrease in the retrospective score, but no change in the LS ‘now’ score. CONCLUSIONS: Diverging patterns of change were found and that were interpreted as adaptation or scale recalibration. Recalibration could also be considered healthy rebalancing after SCI. Being able to compare different LS ratings can facilitate the interpretation of change in and stability of LS.