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

Abstract

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 81yrs (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.