Performance of health-related quality-of-life instruments in a spinal cord injured population

Arch Phys Med Rehabil. 1999 Aug;80(8):877-84. doi: 10.1016/s0003-9993(99)90077-1.


Objective: General health-related quality-of-life (HRQoL) surveys have not been well tested in populations with spinal cord injury (SCI). This study evaluated the performance of 5 such instruments.

Design: A cross-sectional survey with instruments administered in random order during computer-assisted interviews.

Setting: A midwestern US veteran SCI program.

Subjects: One hundred eighty-three veterans with SCI ranging in age from 21 to 81 yrs (mean = 50.5).

Measures: The Behavioral Risk Factor Surveillance System (BRFSS) HRQoL modules, the Quality of Well-Being scale (QWB), the Medical Outcomes Study Short-Form 36 and Short-Form 12 (SF-36, SF-12), and instrumental activities of daily living (IADL).

Results: Construct validity was supported by scores from the QWB, IADL, and physical health measures of the BRFSS and SF-36 showing greater impairment for quadriplegia than paraplegia. Similar constructs on the SF-36 and BRFSS were more strongly correlated than between the IADL and QWB; eg, correlation between the SF-36 Vitality scale and the BRFSS "Days full of energy" question was r = .789 (p < .01), whereas correlation between the IADL and QWB was r = -.454 (p < .01). Longer surveys (SF-36, QWB) were rated lower in subject acceptability.

Conclusions: These instruments have potential for research use among patients with SCI. More studies are needed to explore the best use of instruments with apparently different domains.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chi-Square Distribution
  • Chronic Disease
  • Confidence Intervals
  • Cross-Sectional Studies
  • Female
  • Health Status Indicators*
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Midwestern United States
  • Quality of Life*
  • Random Allocation
  • Spinal Cord Injuries / psychology*
  • Surveys and Questionnaires*