COSMIN database

Spinal cord injury and quality of life measures: a review of instrument psychometric quality

Hallin, P., Sullivan, M., and Kreuter, M.
INTRODUCTION: Quality of life (QOL) is often considered the primary endpoint in research, clinical medicine, and health promotion when impairments are incurable or insufficiently understood. For spinal cord injured (SCI) persons extended life spans and the need for life-long follow-up make it important to expand the outcome parameters of medical care and health services to include QOL measures.


OBJECTIVES: The aim of this study was to evaluate QOL research in SCI persons from the perspective of current criteria for instrument psychometric quality developed by Medical Outcomes Trust (MOT).

METHODS: Relevant articles were extracted from the Medline, Cinahl, and PsycLit databases for approximately a recent 30-year period (1966 - 1999). The keyword 'spinal cord injuries' was cross-indexed with 'quality of life', 'personal satisfaction' and 'life satisfaction'. A total of 105 articles were identified and 46 met our inclusion criteria: (a) report of original research; (b) evaluation of QOL by self-report questionnaires or scales; and (c) publication in English.

RESULTS: The quality of the research designs varied widely. Most of studies were cross-sectional with limited study populations. The number of instruments or different combinations of instruments nearly equalled the number of studies conducted. Most questionnaires were condition-specific and only used by the developers. The variety of instruments and the diversity of their core content made results difficult to compare, and evaluations and conclusions unpredictable and sometimes contradictory. The low psychometric standard of many instruments used further aggravates the interpretation of results.

CONCLUSION: To improve future research in special populations such as the SCI, the MOT criteria for review of QOL instruments should be further disseminated and applied to reach desirable consensus of a limited number of standardised generic and condition-specific QOL measures.
Spinal Cord
1362-4393 (Print)
Publication year:
General health perceptions / HRQoL:
Health-related quality of life
Overall quality of life:
Overall quality of life
Adults (18-65)
Seniors (65+)
Diseases of and symptoms related to the nervous system
Injury, poisoning and certain other consequences of external causes
PRO / non-PRO:
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
6 - Clinical rating scales
15D - 15-Dimensional Health-Related Quality Of Life Measure   
Activity of Daily Living Scale 35-items
AD Scale - Acceptance of Disability Scale
Cantril’s Ladder
CES-D - Centre for Epidemiologic Studies-Depression Scale   
CHART - Craig Handicap Assessment and Reporting Technique   
Coping E€ffectiveness Questionnaire
Family Satisfaction Scale
FIM - Functional Independence Measure (Also modified version exists)
FPQOLI - Ferrans and Powers Quality of Life Index
GHQ - General Health Questionnaire
GLETQ - Godin Leisure-Time Exercise Questionnaire
HADS - Hospital Anxiety and Depression Scale   
High Quadriplegia Questionnaire
HSS - Human Service Scale (HSS)
James Locus of Control Scale
Latitude of Choice Scale
Level of Free Time Activities Scale Modified version
Life 3 Measure
LSES - Life Satisfaction in the Elderly Scale
LSIA - Life Satisfaction Index Adolescents
LSQ - Life Satisfaction Questionnaire   
LSQ - Life Situation Questionnaire
LSQ-R - Life Situation Questionnaire-Revised
LSS - Life Situation Survey
LSS - Lifestyle Satisfaction Scale
MACL - Mood Adjective Check List
MAP - Multidimensional Adjustment Profile
Mastery Scale
Modified Activity Cofiguration Log
MPQ - Multidimensional personality Questionnaire
PAIS - Psychosocial Adjustment to Illness Scale (versions: PAIS-SR - PAIS-Self Report)
Pandilla/Grant's Quality of Life Index-revised version
Perceived Control Scale
PSS - Perceived Stress Scale (versions: PSS-10 items)
QOLI - Lehman Quality of Life Interview/Index
Residential Choice Scale
Rotter I-E Scale
RSES - Rosenberg Self-Esteem Scale
SCI Problem Scale
SCI Specific Measure - Spina Cord Injury Specific Measure
Self-assessed health status
Self-care and Mobility Index
Self-concept Semantic Di€ffential Scale
Sexual Interest and Satisfaction Scale
SF-36 - 36-item Short Form Health Survey [alias: RAND-36][alias: Medical Outcomes Study (MOS) SF-36]]    |  | also see:
SHB - Social Health Battery
SIP-136 - Sickness Impact Profile 136
SIP - Sickness Impact Profile   
Social Support Scale
SPSQ - The Satisfaction with Performance Scaled Questionnaire
SWLS - Satisfaction With Life Scale
VAS - Visual Analogue Scale