Quality of life and stress in wheelchair-users

Many diseases and injuries result in the need for either temporary or permanent wheelchair use and research now confirms that multiple dimensions of life are affected when significant disability occurs. These dimensions typically include increases in health concerns and health care burden; loss of >functional independence; reduced participation in social, occupational and recreational opportunities; and subsequent association with psychosocial sequelae. This chapter summarizes current literature on Quality of Life (QoL) in wheelchair-users. The review highlights that a wide range of generic QoL, health-related QoL and disability-specific QoL instruments are used across studies with largely inconsistent findings. There is now a growing movement towards the development of valid and reliable measures for use with people with a range of disabilities. Given the observed challenges of measuring the broad QoL construct in populations of wheelchair-users, more specific aspects of QoL such as levels of stress are now being investigated. It is proposed that these more specific QoL domains may be more accessible to measurement and to therapeutic interventions aiming to improve adjustment to disability. The development of the >Physical Disability Stress Scale (PDSS) is described with recommendations for future clinical and research application. A copy of the PDSS and its scoring instructions are appended