Implementing the Adapted Flanagan Quality of Life Scale in Persons with Spinal Cord Injury Living in Taipei: A Psychometric Study

Abstract

Purpose: The purpose of this study was to gather knowledge about implementing the adapted Flanagan Quality of Life Scale (QOLS, 1987), in spinal cord injured (SCI) outpatients in Taiwan. Methods: The study was a non-experimental psychometric assessment design. In the preliminary stage, a number of translations and back-translations were carried out to ensure a refined and accurate Chinese-language version QOLS. Fifty-nine bilingual persons examined the reliability and concurrent validity of the Chinese version. In the main study, content analysis was used to analyze the qualitative data in order to assure the content validity. Results: Pearson's correlation coefficients between the English and Chinese (E & C ) versions were 0.84 to 0.98. The internal consistency reliability in the E & C versions both was 0.88. The content validity of the QOLS was confirmed with 39 SCI outpatients by asking three open-ended questions about quality of life (QOL). All the major components of the QOL identified in the QOLS were also identified by SCI outpatients as components of their QOL except item #8”participating in organization or public affairs”. The additional four domains identified by the SCI outpatients were as follows: (1) freedom from environment barriers, convenient equipment and transportation, (2)psychological adaptation, (3) freedom from complications and(4) good relationships with caregivers. In addition, Cronbach's alpha was 0.85 on the first testing and 0.83 on the second testing. The test-retest correlation with a two-to-three week interval was 0.83. Conclusions: Overall, the reliability and validity of the Chinese version of adapted Flanagan QOLS were high. The additional four domains may be added to the adapted Flanagan QOLS when implemented with the SCI outpatients.