Health Related Quality of Life of Primary Caregivers of Persons with Tetraplegia Attending at a Specialized Rehabilitation Centre in Bangladesh

Health Related Quality of Life of Primary Caregivers of Persons with Tetraplegia Attending at a Specialized Rehabilitation Centre in Bangladesh | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Health Related Quality of Life of Primary Caregivers of Persons with Tetraplegia Attending at a Specialized Rehabilitation Centre in Bangladesh MD NAZMUL HASSAN, Parvin Akter, Ehsanur Rahman, Firoz Ahmed Mamin, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2390266/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract Study design: The study design was cross-sectional. Objective: Assessment of the health-related quality of life (HRQoL) of primary caregivers of people with tetraplegia owing to traumatic SCI. Setting: A total of 48 samples were selected conveniently for this study from the Centre for the Rehabilitation of the Paralysed (CRP), spinal cord injury unit, at Savar. Methods: Data was collected by using a questionnaire, and health-related quality of life (HRQoL) was assessed by the Short Form-36 (SF-36) health survey questionnaire. Descriptive statistics using SPSS software version 16.0 were used for data analysis, which focused on columns, pie charts, and doughnuts. Results: Among 48 caregivers evaluated, 39 (81.2%) were female and 9 (18.8%) were male, where 22 people (45.8%) were either husbands or wives and 15 people (31.2%) were parents of people with tetraplegia. It was found that most of the caregivers (62.5%) spend about 13–18 hrs/day caring for individuals with tetraplegia. The participants reported lower scores on social functioning and emotional well-being than the other dimensions of SF-36. Conclusion: Primary caregivers of spinal-cord injury patients had low scores on all SF-36 aspects, including social functioning and emotional well-being. Sponsorship: This does not include funding from grants or other sources. Health sciences/Health care/Quality of life Health sciences/Health care/Disease prevention/Lifestyle modification Health sciences/Risk factors Health sciences/Signs and symptoms/Fatigue Health sciences/Signs and symptoms/Pain/Chronic pain Introduction: Spinal cord injury (SCI) is the most common type and is a traumatic disorder that typically impairs physical, psychological, and social functioning. 1 As this usually occurs suddenly and unexpectedly, with paralysis being a common factor in SCI, this commonly has the most major impact on the patient’s lifestyle and quality of life. 2 Spinal cord injury frequently results in impermanence or disability, which has a significant impact on the individual's lifestyle. 3 A person with SCI commonly lives with their disability for an extended period of time until the end of their course of life. 4 Because of the level of impact the injury causes, people with SCI often have significant functional limitations and lack of independence, 5 which means these patients will be supported by a carer for a longer duration of time. As the care givers become a huge part of the patient’s everyday life, it is of great importance that caregiver is fit and healthy. 6 A primary caregiver is "the person who is primarily involved in the care of the patient and provides the most support and/or assistance". 7 At times, the patient’s family members will take the role of primary caregiver, which largely impacts their lifestyle. 8 Most commonly, when the carer lives with the patient, they will often take over their responsibilities prior to injury. 9 Being a primary caregiver can sometimes lead to physical injury as they become responsible for not only themselves but the patient as well. 6 Multiple studies suggest that the primary caregiver and/or spouse of SCI survivors usually experiences various problems due to this disorder. There has been relatively limited research literature which explains the quality of life for the primary caregiver of an SCI survivor. SCI has a great impact on the caregiver's lives, regardless of the severity of the injury. 10 Quality of life refers to an individual’s satisfaction, which includes the person’s health, relationships, emotionally, socially, their physical function, happiness, fitness, and satisfaction with living situations and finances. 11 The caregivers’ satisfaction can all correlate with the patient’s quality of life. 12 Health status and health-related quality of life (HRQoL) can vary from individual to individual, as well as different disease conditions. 13 Many studies have been conducted on the standard of living for caregivers of SCI patients in their communities. 14 However, there have been few studies that examine the quality of life for caregivers of tetraplegic patients residing at a rehabilitation centre. The key aim of this study was to assess the health-related quality of life (HRQoL) among caregivers of tetraplegic spinal cord injury patients. Materials And Methods: Study site: This study was conducted at the Centre for the Rehabilitation of the Paralysed (CRP), Savar, Dhaka, Bangladesh. CRP is the only rehabilitation centre for spinal cord injuries in Bangladesh and is one of the biggest in South Asia. The Savar facility is a 100-bed inpatient rehabilitation centre situated near Bangladesh’s capital city, Dhaka. Participants: This was a cross-sectional study among the caregivers of traumatic tetraplegic SCI patients. Both female and male caregivers who had a duration of at least one month of caregiving experience were considered for this study. The caregivers who had previous experience in patient care with on-going health conditions were excluded. Measurement tools: This study was conducted with a pre-set questionnaire, including information on the socio-demography of participants and a Bengali version of SF 36. The SF 36 was used to identify the HRQoL of caregivers. SF 36 is a reliable tool to assess standards of living in various groups and is used in different studies in Bangladesh. This scale has eight dimensions and can express a physical and mental component summary. Data analysis: A descriptive analysis was conducted to represent the data precisely. A spearman correlation test was conducted to see the relation between various socio-demographic characteristics and different dimensions of quality of life. For data analysis, The Statistical Package for the Social Sciences (SPSS), version 20, was used. Ethical permission: Ethical permission was taken from the Institutional Review Board (IRB) of the Bangladesh Health Professions Institute. A written consent was taken from each participant prior to the interview. The interview was taken only when the participant gave their consent willingly. Data Availability: All the data in hard copies with SPSS data sets are available in a reasonable request through google drive platform. Results: A total of 48 caregivers took part in this study who were primarily engaged in the care of their patients at CRP between January to June 2015. The patients for whom they took care had different levels of impairment based on the American Spinal Cord Injury Association (ASIA) scale. According to the ASIA scale, about 66% (n = 32) of patients were complete A, 13% (n = 6) were incomplete B, 17% (n = 8) were complete C, and 4% (n = 2) were incomplete D. All patients had traumatic causes of injury. About 46% of caregivers were spouses, 31% of caregivers were parents, 12.5% were siblings, and 10% had other relationships with their patients. The mean age of caregivers was 41.52 (± 12.268) years, and the minimum age was 15 and the maximum was 70 years. Among the participants, the highest numbers of the participants were in the age group of 31–40 years. The majority of the caregivers were female, at 69%. In this study, about 38% (n = 18) of caregivers never attended school. Please see Table 1 for detailed socio-demographic information of the participants. Table 1 Socio-demographic characteristics of participants of participants (caregivers) Variables Categories Frequency Percentage Age 15–29 years 15 31% 30–44 years 20 42% 45–59 years 8 17% > 60 years 5 10% Education No formal education 18 37.5 Primary level 22 45.8 Secondary level 5 10.4 Graduation and above 3 6.2 Duration of Care Giving 1–2 months 19 39.6 3–4 months 19 39.6 5–6 months 9 18.8 > 6 months 1 2.1 Quality Of Life Of Participants: In the present study, participants had lower scores in all dimensions of quality of life. The highest mean score was found in the role of emotion in quality of life, and the lowest was found in physical functioning over quality of life. Both the physical and mental summary components were lower; the physical component summary (PCS) was comparatively lower than the mental component summary (MCS). However, the correlation with different socio-demographic characteristics and quality of life was not significant. Detail scores of SF-36 are given in Table 2 . Table 2 Quality of life of caregivers according to SF 36 scores Variables Categories Frequency Percentage % Physical Functioning Score < 50 6 12.5 Score < 100 42 87.5 Role Physical Score < 50 16 33.3 Score < 75 26 54.2 Score < 100 6 12.5 Role Emotion Score < 50 2 4.2 Score < 75 27 56.2 Score < 100 19 39.6 Total 48 100.0 Vitality Score < 25 2 4.2 Score < 50 40 83.3 Score < 75 4 8.3 Score < 100 2 4.2 Bodily Pain Score < 25 4 8.3 Score < 50 19 39.6 Score < 75 16 33.3 Score < 100 9 18.8 General health Score < 50 43 89.6 Score < 75 4 8.3 Score < 100 1 2.1 Discussion: The key objective of the study was to determine the HRQoL of carers of tetraplegic spinal cord injury patients using the SF 36 questionnaire. The caregivers were from a wide range of socioeconomic backgrounds and were the primary full-time caregivers of their patients at CRP. Each caregiver that was examined was a first-time caregiver. The majority of caregivers were the patients' spouses; this information is consistent with previous studies; typically, caregivers are family members. 15 A large number of care givers had no formal education or were only at primary level. In comparison to care givers of other countries, Bangladesh carers are at a lower educational level. 16 Findings suggest that the quality of life was lower in caregivers of SCI patients during rehabilitation at a rehabilitation center. Our study indicates population general health, vitality, and role limitations were due to emotional and physical problems being mostly affected. The study's findings revealed that the care of SCI patients has a negative impact on HRQoL. In comparison to mental health components, physical health of the caregiver's quality of life had more of an effect. The majority of HRQoL studies on care givers of SCI were conducted at a community level. Findings from numerous studies supported that the HRQoL was lower in carers compared to a controlled group. In Turkey, a study found the quality of life of primary care givers of SCI patients was lower than that of healthy controls. 10 Another study also found similar results; each found that SCI injury had a negative effect on the standard of living in carers. 17 Associative associations between different socio-demographic characteristics and quality of life were identified. However, no significant relation was found. This study had several limitations. We only recruited a small number of participants from a single rehabilitation center. We also collected limited information from them, and participants were not studied for a long time. A further longitudinal study with a larger sample is recommended. Conclusion: Caregivers play a vital role in spinal cord injury patient’s rehabilitation; their quality of life need to be identified. We have found that HRQoL was lower in primary caregivers of tetraplegic SCI patients during the duration of rehabilitation. Care giving of patients with long term conditions is largely dependent on family members in Bangladesh. Therefore, it is vital that the qualities of life for care givers are improved. Declarations: Acknowledgements: We thank Centre for the Rehabilitation of the Paralysed (CRP) for the data collection approval and procedures. Author Contribution Statement: Funding: There is no funding in this study. Competing interest: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The authors have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript. I hereby disclose all of my conflicts of interest and other potentially conflicting interests, including specific financial interests and relationships and affiliations relevant to Spinal Cord (eg, employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or stock options, expert testimony, royalties, or patents filed, received, or pending). This applies to the past 5 years and the foreseeable future. I agree that I will disqualify myself from reviewing, editing, or participating in editorial decisions about Spinal Cord submission that deals with a matter in which either I or a member of my immediate family (ie, my spouse, domestic partner, or minor children) have direct financial interest or a competing financial interest (eg, employment or affiliation, grants or funding, consultancies, honoraria, stock ownership or stock options, expert testimony, royalties, or patents filed, received, or pending). References: Islam, M.S., Hafez, M.A., and Akter, M., (2011). Characterization of spinal cord lesion in patients attending a specialized rehabilitation centre in Bangladesh. Spinal Cord, 49(7):783–6. Smith TF, Russell HF, Kelly EH, Mulcahey MJ, Betz RR, Vogel LC. Examination and measurement of coping among adolescents with spinal cord injury. Spinal cord. 2013 Sep;51(9):710–4. Kawanishi CY, Greguol M. Physical activity, quality of life, and functional autonomy of adults with spinal cord injuries. Adapted Physical Activity Quarterly. 2013 Oct 1;30(4):317 – 37. Chan, R.C., (2000). Stress and coping in spouses of persons with spinal cord injuries. Clinical Rehabilitation, 14(2):137–144. Notara, V., Vagka, E., and Kotroni, A., (2012). Health-related Quality of Life in caregivers of patients with spinal cord injury (SCI). A Greek review. International Journal of Caring Sciences, 5(3):348–354. Bardak AN, Erhan B, Gündüz B. Low back pain among caregivers of spinal cord injured patients. Journal of Rehabilitation medicine. 2012 Oct 1;44(10):858 – 61. Blanes L, Carmagnani MI, Ferreira LM. Health-related quality of life of primary caregivers of persons with paraplegia. Spinal Cord. 2007 Jun;45(6):399–403. Ebrahimzadeh MH, Golhasani-Keshtan F, Shojaee BS. Correlation between health-related quality of life in veterans with chronic spinal cord injury and their caregiving spouses. Archives of trauma research. 2014 Nov;3(4). Ma VY, Chan L, Carruthers KJ. Incidence, prevalence, costs, and impact on disability of common conditions requiring rehabilitation in the United States: stroke, spinal cord injury, traumatic brain injury, multiple sclerosis, osteoarthritis, rheumatoid arthritis, limb loss, and back pain. Archives of physical medicine and rehabilitation. 2014 May 1;95(5):986 – 95. Unalan, H., Gençosmanoğlu, B., Akgün, K., Karamehmetoğlu, S., Tuna, H., Ones, K., and Tüzün, F., (2001). Quality of life of primary caregivers of spinal cord injury survivors living in the community: controlled study with short form-36 questionnaire. Spinal Cord, 39(6):318–322. Kelley-Gillespie N. An integrated conceptual model of quality of life for older adults based on a synthesis of the literature. Applied Research in Quality of life. 2009 Sep;4(3):259–82. Manns PJ, Chad KE. Determining the relation between quality of life, handicap, fitness, and physical activity for persons with spinal cord injury. Archives of physical medicine and rehabilitation. 1999 Dec 1;80(12):1566-71. Andresen EM, Fouts BS, Romeis JC, Brownson CA. Performance of health-related quality-of-life instruments in a spinal cord injured population. Archives of physical medicine and rehabilitation. 1999 Aug 1;80(8):877 – 84. Thrush A, Hyder A. The neglected burden of caregiving in low-and middle-income countries. Disability and health journal. 2014 Jul 1;7(3):262 – 72. Yang X, Hao Y, George SM, Wang L. Factors associated with health-related quality of life among Chinese caregivers of the older adults living in the community: a cross-sectional study. Health and quality of life outcomes. 2012 Dec;10(1):1–2. Adams MS, Khan NZ, Begum SA, Wirz SL, Hesketh T, Pring TR. Feeding difficulties in children with cerebral palsy: low-cost caregiver training in Dhaka, Bangladesh. Child: care, health and development. 2012 Nov;38(6):878 – 88. Graça Á, Nascimento MA, Lavado EL, Garanhani MR. Quality of life of primary caregivers of spinal cord injury survivors. Revista brasileira de enfermagem. 2013;66:79–84. Additional Declarations There is no duality of interest Cite Share Download PDF Status: Under Review Version 1 posted Unknown event 28 Jan, 2023 Editorial decision: Reject before peer review 24 Jan, 2023 Submission checks completed at journal 20 Dec, 2022 Editor assigned by journal 18 Dec, 2022 First submitted to journal 18 Dec, 2022 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2390266","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":160978827,"identity":"f4862878-bf15-4387-afca-3c1fa30ef879","order_by":0,"name":"MD NAZMUL 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(CRP)","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Parvin","middleName":"","lastName":"Akter","suffix":""},{"id":160978829,"identity":"5e469957-88c0-405a-a56c-27654a8bc0d3","order_by":2,"name":"Ehsanur Rahman","email":"","orcid":"https://orcid.org/0000-0001-6738-8079","institution":"Bangladesh Health Professions Institute (BHPI)","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Ehsanur","middleName":"","lastName":"Rahman","suffix":""},{"id":160978830,"identity":"cdd4b08a-86e0-458f-91f6-15418c65d2d3","order_by":3,"name":"Firoz Ahmed Mamin","email":"","orcid":"","institution":"Centre for the Rehabilitation of the Paralysed (CRP)","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Firoz","middleName":"Ahmed","lastName":"Mamin","suffix":""},{"id":160978831,"identity":"195de9e9-a16e-4aa9-9b53-0767270e94ca","order_by":4,"name":"Lori 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Persons with Tetraplegia Attending at a Specialized Rehabilitation Centre in Bangladesh","fulltext":[{"header":"Introduction:","content":"\u003cp\u003eSpinal cord injury (SCI) is the most common type and is a traumatic disorder that typically impairs physical, psychological, and social functioning.\u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e As this usually occurs suddenly and unexpectedly, with paralysis being a common factor in SCI, this commonly has the most major impact on the patient\u0026rsquo;s lifestyle and quality of life.\u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e Spinal cord injury frequently results in impermanence or disability, which has a significant impact on the individual's lifestyle.\u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eA person with SCI commonly lives with their disability for an extended period of time until the end of their course of life.\u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e Because of the level of impact the injury causes, people with SCI often have significant functional limitations and lack of independence,\u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e which means these patients will be supported by a carer for a longer duration of time. As the care givers become a huge part of the patient\u0026rsquo;s everyday life, it is of great importance that caregiver is fit and healthy.\u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eA primary caregiver is \"the person who is primarily involved in the care of the patient and provides the most support and/or assistance\".\u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e At times, the patient\u0026rsquo;s family members will take the role of primary caregiver, which largely impacts their lifestyle.\u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e Most commonly, when the carer lives with the patient, they will often take over their responsibilities prior to injury.\u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e Being a primary caregiver can sometimes lead to physical injury as they become responsible for not only themselves but the patient as well.\u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eMultiple studies suggest that the primary caregiver and/or spouse of SCI survivors usually experiences various problems due to this disorder. There has been relatively limited research literature which explains the quality of life for the primary caregiver of an SCI survivor. SCI has a great impact on the caregiver's lives, regardless of the severity of the injury.\u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e Quality of life refers to an individual\u0026rsquo;s satisfaction, which includes the person\u0026rsquo;s health, relationships, emotionally, socially, their physical function, happiness, fitness, and satisfaction with living situations and finances.\u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e The caregivers\u0026rsquo; satisfaction can all correlate with the patient\u0026rsquo;s quality of life.\u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e Health status and health-related quality of life (HRQoL) can vary from individual to individual, as well as different disease conditions.\u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e Many studies have been conducted on the standard of living for caregivers of SCI patients in their communities.\u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e However, there have been few studies that examine the quality of life for caregivers of tetraplegic patients residing at a rehabilitation centre. The key aim of this study was to assess the health-related quality of life (HRQoL) among caregivers of tetraplegic spinal cord injury patients.\u003c/p\u003e"},{"header":"Materials And Methods:","content":"\u003cp\u003eStudy site:\u003c/p\u003e\n\u003cp\u003eThis study was conducted at the Centre for the Rehabilitation of the Paralysed (CRP), Savar, Dhaka, Bangladesh. CRP is the only rehabilitation centre for spinal cord injuries in Bangladesh and is one of the biggest in South Asia. The Savar facility is a 100-bed inpatient rehabilitation centre situated near Bangladesh\u0026rsquo;s capital city, Dhaka.\u003c/p\u003e\n\u003cp\u003eParticipants:\u003c/p\u003e\n\u003cp\u003eThis was a cross-sectional study among the caregivers of traumatic tetraplegic SCI patients. Both female and male caregivers who had a duration of at least one month of caregiving experience were considered for this study. The caregivers who had previous experience in patient care with on-going health conditions were excluded.\u003c/p\u003e\n\u003cp\u003eMeasurement tools:\u003c/p\u003e\n\u003cp\u003eThis study was conducted with a pre-set questionnaire, including information on the socio-demography of participants and a Bengali version of SF 36. The SF 36 was used to identify the HRQoL of caregivers. SF 36 is a reliable tool to assess standards of living in various groups and is used in different studies in Bangladesh. This scale has eight dimensions and can express a physical and mental component summary.\u003c/p\u003e\n\u003cdiv class=\"Section2\" id=\"Sec3\"\u003e\n \u003cp\u003eData analysis:\u003c/p\u003e\n \u003cp\u003eA descriptive analysis was conducted to represent the data precisely. A spearman correlation test was conducted to see the relation between various socio-demographic characteristics and different dimensions of quality of life. For data analysis, The Statistical Package for the Social Sciences (SPSS), version 20, was used.\u003c/p\u003e\n \u003cp\u003eEthical permission:\u003c/p\u003e\n \u003cp\u003eEthical permission was taken from the Institutional Review Board (IRB) of the Bangladesh Health Professions Institute. A written consent was taken from each participant prior to the interview. The interview was taken only when the participant gave their consent willingly.\u003c/p\u003e\n \u003cp\u003eData Availability:\u003c/p\u003e\n \u003cp\u003eAll the data in hard copies with SPSS data sets are available in a reasonable request through google drive platform.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Results:","content":"\u003cp\u003eA total of 48 caregivers took part in this study who were primarily engaged in the care of their patients at CRP between January to June 2015.\u003c/p\u003e\n\u003cp\u003eThe patients for whom they took care had different levels of impairment based on the American Spinal Cord Injury Association (ASIA) scale. According to the ASIA scale, about 66% (n\u0026thinsp;=\u0026thinsp;32) of patients were complete A, 13% (n\u0026thinsp;=\u0026thinsp;6) were incomplete B, 17% (n\u0026thinsp;=\u0026thinsp;8) were complete C, and 4% (n\u0026thinsp;=\u0026thinsp;2) were incomplete D. All patients had traumatic causes of injury. About 46% of caregivers were spouses, 31% of caregivers were parents, 12.5% were siblings, and 10% had other relationships with their patients.\u003c/p\u003e\n\u003cp\u003eThe mean age of caregivers was 41.52 (\u0026plusmn;\u0026thinsp;12.268) years, and the minimum age was 15 and the maximum was 70 years. Among the participants, the highest numbers of the participants were in the age group of 31\u0026ndash;40 years. The majority of the caregivers were female, at 69%. In this study, about 38% (n\u0026thinsp;=\u0026thinsp;18) of caregivers never attended school. Please see Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e for detailed socio-demographic information of the participants.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab1\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eSocio-demographic characteristics of participants of participants (caregivers)\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eVariables\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eCategories\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eFrequency\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003ePercentage\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eAge\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e15\u0026ndash;29 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e15\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e31%\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e30\u0026ndash;44 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e20\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e42%\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e45\u0026ndash;59 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e17%\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026gt;\u0026thinsp;60 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e10%\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eEducation\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo formal education\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e18\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e37.5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePrimary level\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e22\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e45.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSecondary level\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e10.4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eGraduation and above\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6.2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eDuration of Care Giving\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u0026ndash;2 months\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e39.6\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u0026ndash;4 months\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e39.6\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5\u0026ndash;6 months\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e18.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026gt;\u0026thinsp;6 months\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ch3\u003eQuality Of Life Of Participants:\u003c/h3\u003e\n\u003cp\u003eIn the present study, participants had lower scores in all dimensions of quality of life. The highest mean score was found in the role of emotion in quality of life, and the lowest was found in physical functioning over quality of life. Both the physical and mental summary components were lower; the physical component summary (PCS) was comparatively lower than the mental component summary (MCS). However, the correlation with different socio-demographic characteristics and quality of life was not significant. Detail scores of SF-36 are given in Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab2\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eQuality of life of caregivers according to SF 36 scores\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eVariables\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCategories\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFrequency\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003ePercentage\u003c/p\u003e\n\u003cp\u003e%\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003ePhysical Functioning\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eScore\u0026thinsp;\u0026lt;\u0026thinsp;50\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e12.5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eScore\u0026thinsp;\u0026lt;\u0026thinsp;100\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e42\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e87.5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eRole Physical\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eScore\u0026thinsp;\u0026lt;\u0026thinsp;50\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e16\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e33.3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eScore\u0026thinsp;\u0026lt;\u0026thinsp;75\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e26\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e54.2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eScore\u0026thinsp;\u0026lt;\u0026thinsp;100\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e12.5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eRole Emotion\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eScore\u0026thinsp;\u0026lt;\u0026thinsp;50\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4.2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eScore\u0026thinsp;\u0026lt;\u0026thinsp;75\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e27\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e56.2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eScore\u0026thinsp;\u0026lt;\u0026thinsp;100\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e39.6\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eTotal\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003e48\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003e100.0\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eVitality\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eScore\u0026thinsp;\u0026lt;\u0026thinsp;25\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4.2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eScore\u0026thinsp;\u0026lt;\u0026thinsp;50\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e40\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e83.3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eScore\u0026thinsp;\u0026lt;\u0026thinsp;75\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8.3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eScore\u0026thinsp;\u0026lt;\u0026thinsp;100\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4.2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eBodily Pain\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eScore\u0026thinsp;\u0026lt;\u0026thinsp;25\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8.3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eScore\u0026thinsp;\u0026lt;\u0026thinsp;50\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e39.6\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eScore\u0026thinsp;\u0026lt;\u0026thinsp;75\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e16\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e33.3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eScore\u0026thinsp;\u0026lt;\u0026thinsp;100\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e18.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eGeneral health\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eScore\u0026thinsp;\u0026lt;\u0026thinsp;50\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e43\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e89.6\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eScore\u0026thinsp;\u0026lt;\u0026thinsp;75\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8.3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eScore\u0026thinsp;\u0026lt;\u0026thinsp;100\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e"},{"header":"Discussion:","content":"\u003cp\u003eThe key objective of the study was to determine the HRQoL of carers of tetraplegic spinal cord injury patients using the SF 36 questionnaire. The caregivers were from a wide range of socioeconomic backgrounds and were the primary full-time caregivers of their patients at CRP. Each caregiver that was examined was a first-time caregiver. The majority of caregivers were the patients' spouses; this information is consistent with previous studies; typically, caregivers are family members.\u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e A large number of care givers had no formal education or were only at primary level. In comparison to care givers of other countries, Bangladesh carers are at a lower educational level.\u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eFindings suggest that the quality of life was lower in caregivers of SCI patients during rehabilitation at a rehabilitation center. Our study indicates population general health, vitality, and role limitations were due to emotional and physical problems being mostly affected. The study's findings revealed that the care of SCI patients has a negative impact on HRQoL.\u003c/p\u003e \u003cp\u003eIn comparison to mental health components, physical health of the caregiver's quality of life had more of an effect. The majority of HRQoL studies on care givers of SCI were conducted at a community level. Findings from numerous studies supported that the HRQoL was lower in carers compared to a controlled group. In Turkey, a study found the quality of life of primary care givers of SCI patients was lower than that of healthy controls.\u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e Another study also found similar results; each found that SCI injury had a negative effect on the standard of living in carers.\u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e Associative associations between different socio-demographic characteristics and quality of life were identified. However, no significant relation was found.\u003c/p\u003e \u003cp\u003eThis study had several limitations. We only recruited a small number of participants from a single rehabilitation center. We also collected limited information from them, and participants were not studied for a long time. A further longitudinal study with a larger sample is recommended.\u003c/p\u003e"},{"header":"Conclusion:","content":"\u003cp\u003eCaregivers play a vital role in spinal cord injury patient\u0026rsquo;s rehabilitation; their quality of life need to be identified. We have found that HRQoL was lower in primary caregivers of tetraplegic SCI patients during the duration of rehabilitation. Care giving of patients with long term conditions is largely dependent on family members in Bangladesh. Therefore, it is vital that the qualities of life for care givers are improved.\u003c/p\u003e"},{"header":"Declarations:","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u003c/strong\u003e We thank Centre for the Rehabilitation of the Paralysed (CRP) for the data collection approval and procedures.\u003c/p\u003e\n\u003cp\u003eAuthor Contribution Statement:\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e There is no funding in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interest:\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cp\u003eThe authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003eThe authors have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers\u0026rsquo; bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003eI hereby disclose all of my conflicts of interest and other potentially conflicting interests, including specific financial interests and relationships and affiliations relevant to \u003cem\u003eSpinal Cord\u003c/em\u003e (eg, employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or stock options, expert testimony, royalties, or patents filed, received, or pending). This applies to the past 5 years and the foreseeable future. I agree that I will disqualify myself from reviewing, editing, or participating in editorial decisions about \u003cem\u003eSpinal Cord\u003c/em\u003e submission that deals with a matter in which either I or a member of my immediate family (ie, my spouse, domestic partner, or minor children) have direct financial interest or a competing financial interest (eg, employment or affiliation, grants or funding, consultancies, honoraria, stock ownership or stock options, expert testimony, royalties, or patents filed, received, or pending).\u003c/p\u003e\n\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"References:","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eIslam, M.S., Hafez, M.A., and Akter, M., (2011). Characterization of spinal cord lesion in patients attending a specialized rehabilitation centre in Bangladesh. Spinal Cord, 49(7):783\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSmith TF, Russell HF, Kelly EH, Mulcahey MJ, Betz RR, Vogel LC. Examination and measurement of coping among adolescents with spinal cord injury. Spinal cord. 2013 Sep;51(9):710\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKawanishi CY, Greguol M. Physical activity, quality of life, and functional autonomy of adults with spinal cord injuries. Adapted Physical Activity Quarterly. 2013 Oct 1;30(4):317 \u0026ndash; 37.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChan, R.C., (2000). Stress and coping in spouses of persons with spinal cord injuries. Clinical Rehabilitation, 14(2):137\u0026ndash;144.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNotara, V., Vagka, E., and Kotroni, A., (2012). Health-related Quality of Life in caregivers of patients with spinal cord injury (SCI). A Greek review. International Journal of Caring Sciences, 5(3):348\u0026ndash;354.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBardak AN, Erhan B, G\u0026uuml;nd\u0026uuml;z B. Low back pain among caregivers of spinal cord injured patients. Journal of Rehabilitation medicine. 2012 Oct 1;44(10):858 \u0026ndash; 61.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBlanes L, Carmagnani MI, Ferreira LM. Health-related quality of life of primary caregivers of persons with paraplegia. Spinal Cord. 2007 Jun;45(6):399\u0026ndash;403.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEbrahimzadeh MH, Golhasani-Keshtan F, Shojaee BS. Correlation between health-related quality of life in veterans with chronic spinal cord injury and their caregiving spouses. Archives of trauma research. 2014 Nov;3(4).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMa VY, Chan L, Carruthers KJ. Incidence, prevalence, costs, and impact on disability of common conditions requiring rehabilitation in the United States: stroke, spinal cord injury, traumatic brain injury, multiple sclerosis, osteoarthritis, rheumatoid arthritis, limb loss, and back pain. Archives of physical medicine and rehabilitation. 2014 May 1;95(5):986 \u0026ndash; 95.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUnalan, H., Gen\u0026ccedil;osmanoğlu, B., Akg\u0026uuml;n, K., Karamehmetoğlu, S., Tuna, H., Ones, K., and T\u0026uuml;z\u0026uuml;n, F., (2001). Quality of life of primary caregivers of spinal cord injury survivors living in the community: controlled study with short form-36 questionnaire. Spinal Cord, 39(6):318\u0026ndash;322.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKelley-Gillespie N. An integrated conceptual model of quality of life for older adults based on a synthesis of the literature. Applied Research in Quality of life. 2009 Sep;4(3):259\u0026ndash;82.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eManns PJ, Chad KE. Determining the relation between quality of life, handicap, fitness, and physical activity for persons with spinal cord injury. Archives of physical medicine and rehabilitation. 1999 Dec 1;80(12):1566-71.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAndresen EM, Fouts BS, Romeis JC, Brownson CA. Performance of health-related quality-of-life instruments in a spinal cord injured population. Archives of physical medicine and rehabilitation. 1999 Aug 1;80(8):877 \u0026ndash; 84.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eThrush A, Hyder A. The neglected burden of caregiving in low-and middle-income countries. Disability and health journal. 2014 Jul 1;7(3):262 \u0026ndash; 72.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYang X, Hao Y, George SM, Wang L. Factors associated with health-related quality of life among Chinese caregivers of the older adults living in the community: a cross-sectional study. Health and quality of life outcomes. 2012 Dec;10(1):1\u0026ndash;2.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAdams MS, Khan NZ, Begum SA, Wirz SL, Hesketh T, Pring TR. Feeding difficulties in children with cerebral palsy: low-cost caregiver training in Dhaka, Bangladesh. Child: care, health and development. 2012 Nov;38(6):878 \u0026ndash; 88.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGra\u0026ccedil;a \u0026Aacute;, Nascimento MA, Lavado EL, Garanhani MR. Quality of life of primary caregivers of spinal cord injury survivors. Revista brasileira de enfermagem. 2013;66:79\u0026ndash;84.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"spinal-cord-series-and-cases","isNatureJournal":false,"hasQc":false,"allowDirectSubmit":false,"externalIdentity":"scsandc","sideBox":"Learn more about [Spinal Cord Series and Cases](http://www.nature.com/scsandc/)","snPcode":"41394","submissionUrl":"https://mts-scsandc.nature.com/cgi-bin/main.plex","title":"Spinal Cord Series and Cases","twitterHandle":"@spinalcord_scsc","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"ejp","reportingPortfolio":"Nature AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-2390266/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2390266/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003eStudy design: \u003c/strong\u003e\u003c/em\u003eThe study design was cross-sectional.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eObjective:\u003c/strong\u003e\u003c/em\u003e\u003cem\u003e \u003c/em\u003eAssessment of the health-related quality of life (HRQoL) of primary caregivers of people with tetraplegia owing to traumatic SCI.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eSetting:\u003c/strong\u003e\u003c/em\u003e A total of 48 samples were selected conveniently for this study from the Centre for the Rehabilitation of the Paralysed (CRP), spinal cord injury unit, at Savar.\u003cem\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eMethods: \u003c/strong\u003e\u003c/em\u003eData was collected by using a questionnaire, and health-related quality of life (HRQoL) was assessed by the Short Form-36 (SF-36) health survey questionnaire. Descriptive statistics using SPSS software version 16.0 were used for data analysis, which focused on columns, pie charts, and doughnuts.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eResults: \u003c/strong\u003e\u003c/em\u003eAmong 48 caregivers evaluated, 39 (81.2%) were female and 9 (18.8%) were male, where 22 people (45.8%) were either husbands or wives and 15 people (31.2%) were parents of people with tetraplegia. It was found that most of the caregivers (62.5%) spend about 13–18 hrs/day caring for individuals with tetraplegia. The participants reported lower scores on social functioning and emotional well-being than the other dimensions of SF-36.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003e\u003c/em\u003ePrimary caregivers of spinal-cord injury patients had low scores on all SF-36 aspects, including social functioning and emotional well-being.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eSponsorship: \u003c/strong\u003e\u003c/em\u003eThis does not include funding from grants or other sources.\u003c/p\u003e","manuscriptTitle":"Health Related Quality of Life of Primary Caregivers of Persons with Tetraplegia Attending at a Specialized Rehabilitation Centre in Bangladesh","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2022-12-20 10:08:55","doi":"10.21203/rs.3.rs-2390266/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"transferred","content":"Spinal Cord Series and Cases","date":"2023-01-28T17:10:38+00:00","index":"","fulltext":""},{"type":"decision","content":"Reject before peer review","date":"2023-01-24T17:33:04+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2022-12-20T10:45:21+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2022-12-18T10:09:19+00:00","index":"","fulltext":""},{"type":"submitted","content":"Spinal Cord","date":"2022-12-18T10:09:18+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"spinal-cord-series-and-cases","isNatureJournal":false,"hasQc":false,"allowDirectSubmit":false,"externalIdentity":"scsandc","sideBox":"Learn more about [Spinal Cord Series and Cases](http://www.nature.com/scsandc/)","snPcode":"41394","submissionUrl":"https://mts-scsandc.nature.com/cgi-bin/main.plex","title":"Spinal Cord Series and Cases","twitterHandle":"@spinalcord_scsc","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"ejp","reportingPortfolio":"Nature AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"c27b1485-d66d-4213-953d-f2e89ecfe0c6","owner":[],"postedDate":"December 20th, 2022","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":17790170,"name":"Health sciences/Health care/Quality of life"},{"id":17790171,"name":"Health sciences/Health care/Disease prevention/Lifestyle modification"},{"id":17790172,"name":"Health sciences/Risk factors"},{"id":17790173,"name":"Health sciences/Signs and symptoms/Fatigue"},{"id":17790174,"name":"Health sciences/Signs and symptoms/Pain/Chronic pain"}],"tags":[],"updatedAt":"2023-04-26T20:55:41+00:00","versionOfRecord":[],"versionCreatedAt":"2022-12-20 10:08:55","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-2390266","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2390266","identity":"rs-2390266","version":["v1"]},"buildId":"WrCJVZZCHTDjtuVLN7oU0","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}