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Performance of health-related quality-of-life instruments in a spinal cord injured population
E M Andresen1, B S Fouts, J C Romeis
1Saint Louis University School of Public Health, MO 63108, USA.
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.