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

Abstract

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. A cross-sectional survey with instruments administered in random order during computer-assisted interviews. A midwestern US veteran SCI program. One hundred eighty-three veterans with SCI ranging in age from 21 to 81 yrs (mean = 50.5). 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). 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. 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.