PTOTSurveyJournal of rehabilitation medicine2025

A path analysis of the healthcare utilization and services satisfaction among community-dwelling individuals with spinal cord injury in Malaysia.

Muhamad F Zainudin, Natiara M Hashim, Wan N W M Zohdi and 2 others

PMID 39998490

WHAT IT FOUND

For Malaysian adults with spinal cord injury, the severity of health problems drove healthcare utilization, while activity and participation restrictions drove satisfaction with services.

Sexual dysfunction was the most severe health problem reported. These are correlations, not proof of cause.

Key findings

01The severity of health problems significantly predicted healthcare utilization, whereas independence in daily activities and activity/participation restrictions did not.

02Satisfaction with healthcare services was predicted only by activity and participation restrictions, with lower restrictions associated with higher satisfaction.

03Sexual dysfunction was rated the most severe health problem, followed by muscle spasm and spasticity, contractures, pain, and bladder dysfunction.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The study used convenience sampling, which may introduce self-selection bias. All participating institutions were in urban areas, limiting generalizability to rural populations. The cross-sectional design cannot prove causality, only associations between variables. Women made up only 21.1% of participants, limiting the robustness of gender-specific findings.

Declared interests

The authors have no conflicts of interest to declare, and the research received no specific grant from any funding agency.

The easy way to misread this

Do not interpret the path analysis as proving that health problems cause higher healthcare utilization or that activity restrictions cause lower satisfaction. The study is cross-sectional, so it only shows associations at one point in time, not the direction of cause and effect.

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