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Serpanou I, Sakellari E, Fradelos EC, Galanis P, Tzavella F, Sapountzi-Krepia D, Zyga S. The Association Between Spirituality, Self-Esteem, Anxiety and Depression: A Comparative Exploratory Study Between People with a Spinal Cord Injury and Healthy Subjects in Greece. JOURNAL OF RELIGION AND HEALTH 2024:10.1007/s10943-024-02092-7. [PMID: 39030422 DOI: 10.1007/s10943-024-02092-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/10/2024] [Indexed: 07/21/2024]
Abstract
The purpose of this study was to evaluate spirituality, religiosity, self-esteem, depression, and stress in people with spinal cord injuries. The Royal Free Questionnaire for Spiritual and Religious Beliefs, the Rosenberg Self-Esteem Scale, the Center for Epidemiologic Studies Depression Scale, and the Spielberger State-Trait Anxiety Scale were all designed for the current study to collect demographic and injury-related information. In the study, 88 patients with traumatic SCI and 88 healthy subjects were included. Half of the participants and healthy subjects were women, while the mean age of the healthy subjects was 42.8 years and that of the subjects was 42.4 years. The majority of participants were Greek (97.2%), while 44.1% were married or with a partner and 43.2% were single. The mean depression and stress score was higher in patients than in healthy subjects, and the mean score of self-esteem was lower in patients than healthy subjects. Multivariable linear regression model showed that patients who believed more that a spiritual force or power outside of ourselves can influence what happens in everyday life had less depression and stress. People with spinal cord injuries experience extreme stress, anxiety, and depression. Spirituality and religiosity can play a significant role in their recuperation, rehabilitation, and adaptation.
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Affiliation(s)
- Ismini Serpanou
- Department of Physiotherapy, Pammakaristos General Hospital, Athens, Greece
| | - Evanthia Sakellari
- Department of Public and Community Health, University of West Attica, Athens, Greece
| | | | - Petros Galanis
- Faculty of Nursing, Center for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece
| | - Foteini Tzavella
- Department of Nursing, University of Peloponnese, Tripoli, Greece
| | | | - Sofia Zyga
- Department of Nursing, University of Peloponnese, Tripoli, Greece
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Baehr LA, Bruneau M, Finley M. Baseline Comparison of Exercisers and Nonexercisers With Spinal Cord Injury Enrolled in a Group Tele-Exercise Program. Top Spinal Cord Inj Rehabil 2023; 29:27-36. [PMID: 38076490 PMCID: PMC10704214 DOI: 10.46292/sci23-00027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Background Individuals with SCI are 1.5 times more likely to be sedentary compared to adults without disabilities or chronic health conditions. It is therefore imperative to develop and evaluate innovative facilitation strategies for physical activity behavior in this population. Objectives As an insightful step to creating and evaluating tailored physical activity interventions for individuals with SCI, we evaluated demographic, psychosocial, and physical characteristics of those who choose to engage in physical activity by enrolling in a group exercise study. Design/Methods We conducted a cross-sectional analysis detailing demographic features and baseline outcomes of those with SCI enrolled in a group tele-exercise study who were classified as regular exercisers versus nonregular exercisers per the American College of Sports Medicine exercise guidelines. Between-group differences for psychosocial and physical outcomes were assessed with chi-square and Mann-Whitney U tests (p < .05). Results Twenty-seven adult volunteers enrolled in the study (exercisers = 14, nonexercisers = 13). Groups were comparable for biological sex, gender identity, self-reported racial group(s), and current age. Exercisers demonstrated significantly shorter duration of injury compared to nonexercisers (p = .012). Exercisers exhibited significantly higher exercise self-efficacy (p = .017) and increased reported weekly minutes in vigorous intensity leisure time physical activity (p = .029). Conclusion Nonexercisers with SCI demonstrate increased injury duration and reduced exercise self-efficacy compared to active peers. These factors should be addressed in the design and delivery of SCI-specific physical activity interventions to increase the likelihood of this critical health behavior over time.
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Affiliation(s)
- Laura A. Baehr
- Department of Health and Rehabilitation Sciences, Temple University, Philadelphia, Pennsylvania
| | - Michael Bruneau
- Department of Health Sciences, Drexel University, Philadelphia, Pennsylvania
| | - Margaret Finley
- Department of Physical Therapy and Rehabilitation Sciences, Philadelphia, Pennsylvania
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3
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Ziegeler B, D' Souza W, Vinton A, Mulukutla S, Shaw C, Carne R. Neurological Health: Not Merely the Absence of Disease: Current Wellbeing Instruments Across the Spectrum of Neurology. Am J Lifestyle Med 2023; 17:299-316. [PMID: 36896041 PMCID: PMC9989493 DOI: 10.1177/15598276221086584] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Well-being and quality of life can vary independently of disease. Instruments measuring well-being and quality of life are commonly used in neurology, but there has been little investigation into the extent in which they accurately measure wellbeing/quality of life or if they merely reflect a diseased state of an individual. DESIGN Systematic searches, thematic analysis and narrative synthesis were undertaken. Individual items from instruments represented in ≥ 5 publications were categorised independently, without prior training, by five neurologists and one well-being researcher, as relating to 'disease-effect' or 'Well-being' with a study-created instrument. Items were additionally categorised into well-being domains. DATA SOURCES MEDLINE, EMBASE, EMCARE and PsycINFO from 1990 to 2020 were performed, across the 13 most prevalent neurological diseases. RESULTS 301 unique instruments were identified. Multiple sclerosis had most unique instruments at 92. SF-36 was used most, in 66 studies. 22 instruments appeared in ≥ 5 publications: 19/22 'well-being' outcome instruments predominantly measured disease effect (Fleiss kappa = .60). Only 1/22 instruments was categorised unanimously as relating to well-being. Instruments predominantly measured mental, physical and activity domains, over social or spiritual. CONCLUSIONS Most neurological well-being or quality-of-life instruments predominantly measure disease effect, rather than disease-independent well-being. Instruments differed widely in well-being domains examined.
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Affiliation(s)
| | | | | | | | - Cameron Shaw
- University Hospital Geelong, Deakin University, Geelong, VIC, Australia
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Tyner CE, Slotkin J, Kisala PA, Levin LS, Tintle SM, Tulsky DS. Assessment of quality of life after upper extremity transplantation: Framework for patient-reported outcome scale domains. Front Psychol 2023; 13:989593. [PMID: 36760917 PMCID: PMC9902934 DOI: 10.3389/fpsyg.2022.989593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 08/31/2022] [Indexed: 01/26/2023] Open
Abstract
Upper extremity transplantation offers the promise of restored function and regained quality of life (QOL) for individuals who have sustained hand or arm amputation. However, a major challenge for this procedure becoming an accessible treatment option for patients is the lack of standard measures to document benefits to QOL. Patient-reported outcomes (PRO) measures are well-suited for this kind of intervention, where the perspective of the patient is central to defining treatment success. To date, qualitative work with experts, clinicians, and patients has been used to identify the most important domains of QOL for PRO item development. Specifically, our group's qualitative work has identified several domains of QOL that are unique to individuals who have received upper extremity transplants, which are distinct from topics covered by existing PRO measures. These include emotional and social aspects of upper extremity transplant, such as Expectations and Perceived Outcomes, Integration and Assimilation of Transplant, Fitting in, and Post-Surgical Challenges and Complications. The broad topic of Satisfaction with Transplant was subdivided into three subtopics: Function, Sensation, and Aesthetics. Satisfaction with Sensation was also identified as a unique domain not evaluated by existing PRO measures. This report operationalizes these eight QOL domains by presenting scoping definitions. This manuscript describes the work that has been completed for domain characterization as an early step toward developing standardized PRO measures to evaluate these important outcomes specific to upper extremity transplantation.
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Affiliation(s)
- Callie E. Tyner
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, United States,*Correspondence: Callie E. Tyner,
| | - Jerry Slotkin
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, United States
| | - Pamela A. Kisala
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, United States
| | - L. Scott Levin
- Department of Orthopedic Surgery, Penn Medicine, Philadelphia, PA, United States,Department of Surgery, Division of Plastic Surgery, Penn Medicine, Philadelphia, PA, United States
| | - Scott M. Tintle
- Department of Orthopedic Surgery, Walter Reed National Military Medical Center, Bethesda, MD, United States,Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - David S. Tulsky
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, United States,Department of Physical Therapy, University of Delaware, Newark, DE, United States,Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, United States
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Coker J, Charlifue S, Botticello A, Tate DG, Philippus A, Strober L, Forchheimer M, Monden KR. A Study Protocol for a Multisite Randomized Controlled Trial of an Intervention to Improve Outcomes After Spinal Cord Injury. Top Spinal Cord Inj Rehabil 2022; 28:44-55. [PMID: 36457362 PMCID: PMC9678223 DOI: 10.46292/sci22-00013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background The consequences of spinal cord injury (SCI) can place significant demands on an individual's coping mechanisms. Interventions to promote psychological adjustment and coping are often included in inpatient rehabilitation programs; however, following discharge, many individuals with SCI do not receive ongoing counseling or education about psychological adjustment to disability. Effective postacute treatment models are needed to help individuals with SCI build skills that help them adapt to the stresses associated with a chronic physical disability, alleviate the consequences of anxiety and depression, and enhance subjective well-being. Objectives To describe the protocol for a randomized clinical trial (RCT) of a 6-week intervention designed to improve psychosocial outcomes after SCI. Methods To test efficacy and replicability of the intervention, we designed a three-arm, multisite RCT with assessments conducted at six time points. Our primary hypothesis is that participants in the Group arm will report greater improvements in psychosocial outcomes than participants who complete the intervention individually via video (Individual arm) or those who do not receive the intervention (Control arm). We also hypothesize that participants in the Group arm will maintain greater improvements in psychosocial outcomes longer than those in the individual or control arms. Conclusion Results of the RCT will be presented and published to professionals and consumers, and intervention training and materials will be made available upon request.
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Affiliation(s)
| | | | | | | | - Angela Philippus
- Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, Minnesota
| | | | | | - Kimberley R. Monden
- Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, Minnesota
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Hakbijl AJ, van Diemen T, Dompeling S, Oner FC, Post MWM, Sadiqi S. Applicability of the AO Spine Patient Reported Outcome Spine Trauma (PROST) in people with motor-complete spinal cord injury: a cognitive interview study. Spinal Cord 2022; 60:911-916. [PMID: 35798872 PMCID: PMC9261216 DOI: 10.1038/s41393-022-00829-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 06/21/2022] [Accepted: 06/21/2022] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN This is a cognitive interview study. OBJECTIVES To examine the applicability of the Patient Reported Outcome Spine Trauma (AO Spine PROST) in people with motor-complete traumatic or non-traumatic spinal cord injury (SCI). SETTING Two rehabilitation centers in The Netherlands. METHOD Semi-structured cognitive interviews were conducted with 29 adults with a motor-complete SCI (AISA Impairment Scale A or B). Participants were asked to complete the AO Spine PROST and four additional evaluation questions rated on a 1-5-point Likert scale (5 most positive), while verbalizing their thoughts about their answers. Interviews were audio-recorded and transcribed. Codes were identified and linked to a coding scheme. Qualitative data were used to interpret the quantitative results. RESULTS Almost three-quarters of the participants (71.4%) had a traumatic SCI. Positive ratings of the measure were obtained regards comprehensibility (mean 4.0), non-offensiveness (4.6), relevance (4.2), and completeness (3.6). A question about the emotional impact of SCI was indicated to be missing. How using an assistive device should weigh in the score was a recurring topic. The use of multiple examples per item raised uncertainty, mostly solved by averaging their score. Some individuals indicated that the possibility to express even better function compared to before the onset of injury would be valuable. CONCLUSIONS Overall, the AO Spine PROST appears applicable in adults with a motor-complete traumatic or non-traumatic SCI. Recommendations are made for improvement in instructions, terminology, and examples used in the tool. This study contributes to the further development of the AO Spine PROST in spine trauma care and research.
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Affiliation(s)
- Aline J Hakbijl
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
| | - Tijn van Diemen
- Department of Spinal Cord Injury Rehabilitation, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - Stephanie Dompeling
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - F Cumhur Oner
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marcel W M Post
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Said Sadiqi
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
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Dutch-Flemish translation and cross-cultural adaption of the Spinal Cord Injury-Quality of Life (SCI-QOL) short forms. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2022; 31:1349-1357. [PMID: 35376985 DOI: 10.1007/s00586-022-07190-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/25/2022] [Accepted: 03/12/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE A spinal cord injury (SCI) has a large impact on a person's physical, psychological, and social health. Previous studies focused on physical recovery in patients with SCI and assessed their health-related quality of life (HRQOL) with general questionnaires, which often contain irrelevant questions. The SCI-QOL questionnaire was developed to specifically assess the HRQOL of the SCI population. A comprehensive translation and cross-cultural adaptation are required to use this questionnaire in the Netherlands and Flanders, Belgium. METHODS All 23 short forms of the SCI-QOL for adults were translated from English into Dutch-Flemish using the Functional Assessment of Chronic Illness Therapy translation methodology, with a cognitive debriefing being performed with 10 patients with SCI and 10 persons from the general population. RESULTS The Dutch-Flemish PROMIS group previously translated 46 of the 207 items in the 23 short forms. Here, we achieved an acceptable translation of the other 161 items. A single Dutch-Flemish translation was obtained for 20 short forms, while separate Dutch and Flemish translations were necessary for the short forms Ambulation, Manual Wheelchair, and Stigma. CONCLUSION The Dutch-Flemish translation of the SCI-QOL is now available for clinical and research purposes. Future studies should focus on the psychometric properties of this cross-culturally adapted version.
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8
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Tulsky DS, Kisala PA. Overview of the Spinal Cord Injury-Functional Index (SCI-FI): Structure and Recent Advances. Arch Phys Med Rehabil 2021; 103:185-190. [PMID: 34756875 DOI: 10.1016/j.apmr.2021.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 10/18/2021] [Indexed: 11/02/2022]
Abstract
The Spinal Cord Injury - Functional Index is a system of patient reported outcomes (PRO) measures of functional activities developed specifically with and for individuals with spinal cord injury (SCI). The SCI-FI was designed to overcome limitations in measurement of the full range of activities and breadth of content of physical functioning commonly used in SCI research. Generic measurement tools of physical function (i.e., those focused on the general population) tend to overemphasize mobility and do not contain enough items at the lower end of the functional range (e.g., appropriate for individuals with tetraplegia). The SCI-FI consists of nine item response theory (IRT)-calibrated item banks that represent relevant and meaningful item content for individuals with SCI, span a wide range of functional abilities, and subdivide physical functioning into important subdomains, including basic mobility, self-care, and fine motor function. Since the original publication of the SCI-FI in 2012, there have been significant advances in and publications on the reliability and psychometric properties of the measures. The manuscripts presented in this special section clarify the SCI-FI structure and present new research on the SCI-FI measurement system.
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Affiliation(s)
- David S Tulsky
- Center for Health Assessment Research and Translation (CHART), University of Delaware, Newark, DE; Departments of Physical Therapy and Psychological and Brain Sciences, University of Delaware, Newark, DE.
| | - Pamela A Kisala
- Center for Health Assessment Research and Translation (CHART), University of Delaware, Newark, DE
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Mehta S, Hadjistavropoulos H, Nugent M, Karin E, Titov N, Dear BF. Guided internet-delivered cognitive-behaviour therapy for persons with spinal cord injury: a feasibility trial. Spinal Cord 2020; 58:544-552. [DOI: 10.1038/s41393-019-0398-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 10/22/2019] [Accepted: 11/14/2019] [Indexed: 11/09/2022]
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Cohen ML, Kisala PA, Dyson-Hudson TA, Tulsky DS. Measuring pain phenomena after spinal cord injury: Development and psychometric properties of the SCI-QOL Pain Interference and Pain Behavior assessment tools. J Spinal Cord Med 2018; 41:267-280. [PMID: 28185477 PMCID: PMC6055945 DOI: 10.1080/10790268.2017.1279805] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To develop modern patient-reported outcome measures that assess pain interference and pain behavior after spinal cord injury (SCI). DESIGN Grounded-theory based qualitative item development; large-scale item calibration field-testing; confirmatory factor analyses; graded response model item response theory analyses; statistical linking techniques to transform scores to the Patient Reported Outcome Measurement Information System (PROMIS) metric. SETTING Five SCI Model Systems centers and one Department of Veterans Affairs medical center in the United States. PARTICIPANTS Adults with traumatic SCI. INTERVENTIONS N/A. OUTCOME MEASURES Spinal Cord Injury - Quality of Life (SCI-QOL) Pain Interference item bank, SCI-QOL Pain Interference short form, and SCI-QOL Pain Behavior scale. RESULTS Seven hundred fifty-seven individuals with traumatic SCI completed 58 items addressing various aspects of pain. Items were then separated by whether they assessed pain interference or pain behavior, and poorly functioning items were removed. Confirmatory factor analyses confirmed that each set of items was unidimensional, and item response theory analyses were used to estimate slopes and thresholds for the items. Ultimately, 7 items (4 from PROMIS) comprised the Pain Behavior scale and 25 items (18 from PROMIS) comprised the Pain Interference item bank. Ten of these 25 items were selected to form the Pain Interference short form. CONCLUSIONS The SCI-QOL Pain Interference item bank and the SCI-QOL Pain Behavior scale demonstrated robust psychometric properties. The Pain Interference item bank is available as a computer adaptive test or short form for research and clinical applications, and scores are transformed to the PROMIS metric.
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Affiliation(s)
- Matthew L. Cohen
- Department of Communication Sciences and Disorders, University of Delaware, Newark, Delaware, USA,Department of Psychological and Brain Sciences, University of Delaware, Newark, Delaware, USA,Center on Assessment Research and Translation, University of Delaware, Newark, Delaware, USA,Correspondence to: Matthew L. Cohen, 540 S. College Ave, Newark, DE 19713, USA.
| | - Pamela A. Kisala
- Center on Assessment Research and Translation, University of Delaware, Newark, Delaware, USA
| | - Trevor A. Dyson-Hudson
- Kessler Foundation, West Orange, New Jersey, USA,Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - David S. Tulsky
- Department of Psychological and Brain Sciences, University of Delaware, Newark, Delaware, USA,Center on Assessment Research and Translation, University of Delaware, Newark, Delaware, USA
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Tulsky DS, Kisala PA. The Spinal Cord Injury--Quality of Life (SCI-QOL) measurement system: Development, psychometrics, and item bank calibration. J Spinal Cord Med 2015; 38:251-6. [PMID: 26010961 PMCID: PMC4445017 DOI: 10.1179/2045772315y.0000000035] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- David S. Tulsky
- Correspondence to: David S. Tulsky, Department of Physical Therapy, University of Delaware, College of Health Sciences, 540 S. College Ave., Newark, DE 19713.
| | - Pamela A. Kisala
- Department of Physical Therapy, University of Delaware, College of Health Sciences, Newark, DE, USA
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12
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Kisala PA, Tulsky DS, Pace N, Victorson D, Choi SW, Heinemann AW. Measuring stigma after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Stigma item bank and short form. J Spinal Cord Med 2015; 38:386-96. [PMID: 26010973 PMCID: PMC4445029 DOI: 10.1179/1079026815z.000000000410] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE To develop a calibrated item bank and computer adaptive test (CAT) to assess the effects of stigma on health-related quality of life in individuals with spinal cord injury (SCI). DESIGN Grounded-theory based qualitative item development methods, large-scale item calibration field testing, confirmatory factor analysis, and item response theory (IRT)-based psychometric analyses. SETTING Five SCI Model System centers and one Department of Veterans Affairs medical center in the United States. PARTICIPANTS Adults with traumatic SCI. MAIN OUTCOME MEASURES SCI-QOL Stigma Item Bank RESULTS A sample of 611 individuals with traumatic SCI completed 30 items assessing SCI-related stigma. After 7 items were iteratively removed, factor analyses confirmed a unidimensional pool of items. Graded Response Model IRT analyses were used to estimate slopes and thresholds for the final 23 items. CONCLUSIONS The SCI-QOL Stigma item bank is unique not only in the assessment of SCI-related stigma but also in the inclusion of individuals with SCI in all phases of its development. Use of confirmatory factor analytic and IRT methods provide flexibility and precision of measurement. The item bank may be administered as a CAT or as a 10-item fixed-length short form and can be used for research and clinical applications.
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Affiliation(s)
- Pamela A. Kisala
- Department of Physical Therapy, University of Delaware, College of Health Sciences, Newark, DE, USA
| | - David S. Tulsky
- Correspondence to: David S. Tulsky, Professor and Director of the Center on Assessment Research and Translation, STAR Campus, University of Delaware, 540 S. College Ave, Newark, DE 19713, USA.
| | - Natalie Pace
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - David Victorson
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Tulsky DS, Kisala PA, Victorson D, Tate DG, Heinemann AW, Charlifue S, Kirshblum SC, Fyffe D, Gershon R, Spungen AM, Bombardier CH, Dyson-Hudson TA, Amtmann D, Z. Kalpakjian C, W. Choi S, Jette AM, Forchheimer M, Cella D. Overview of the Spinal Cord Injury--Quality of Life (SCI-QOL) measurement system. J Spinal Cord Med 2015; 38:257-69. [PMID: 26010962 PMCID: PMC4445018 DOI: 10.1179/2045772315y.0000000023] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
CONTEXT/OBJECTIVE The Spinal Cord Injury--Quality of Life (SCI-QOL) measurement system was developed to address the shortage of relevant and psychometrically sound patient reported outcome (PRO) measures available for clinical care and research in spinal cord injury (SCI) rehabilitation. Using a computer adaptive testing (CAT) approach, the SCI-QOL builds on the Patient Reported Outcomes Measurement Information System (PROMIS) and the Quality of Life in Neurological Disorders (Neuro-QOL) initiative. This initial manuscript introduces the background and development of the SCI-QOL measurement system. Greater detail is presented in the additional manuscripts of this special issue. DESIGN Classical and contemporary test development methodologies were employed. Qualitative input was obtained from individuals with SCI and clinicians through interviews, focus groups, and cognitive debriefing. Item pools were field tested in a multi-site sample (n=877) and calibrated using item response theory methods. Initial reliability and validity testing was performed in a new sample of individuals with traumatic SCI (n=245). SETTING Five Model SCI System centers and one Department of Veterans Affairs Medical Center across the United States. PARTICIPANTS Adults with traumatic SCI. INTERVENTIONS n/a OUTCOME MEASURES n/a RESULTS The SCI-QOL consists of 19 item banks, including the SCI-Functional Index banks, and 3 fixed-length scales measuring physical, emotional, and social aspects of health-related QOL (HRQOL). CONCLUSION The SCI-QOL measurement system consists of psychometrically sound measures for individuals with SCI. The manuscripts in this special issue provide evidence of the reliability and initial validity of this measurement system. The SCI-QOL also links to other measures designed for a general medical population.
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Affiliation(s)
- David S. Tulsky
- Correspondence to: David S. Tulsky, Professor and Director of the Center on Assessment Research and Translation, STAR Campus, University of Delaware, 540 S. College Ave, Newark, DE 19713, USA.
| | - Pamela A. Kisala
- Department of Physical Therapy, University of Delaware, College of Health Sciences, Newark, DE, USA
| | - David Victorson
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Denise G. Tate
- University of Michigan Medical School, Ann Arbor, MI, USA
| | | | | | | | | | - Richard Gershon
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | | | | | | | | | | | - Alan M. Jette
- Boston University School of Public Health, Boston, MA, USA
| | | | - David Cella
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Tulsky DS, Kisala PA, Victorson D, Choi SW, Gershon R, Heinemann AW, Cella D. Methodology for the development and calibration of the SCI-QOL item banks. J Spinal Cord Med 2015; 38:270-87. [PMID: 26010963 PMCID: PMC4445019 DOI: 10.1179/2045772315y.0000000034] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE To develop a comprehensive, psychometrically sound, and conceptually grounded patient reported outcomes (PRO) measurement system for individuals with spinal cord injury (SCI). METHODS Individual interviews (n=44) and focus groups (n=65 individuals with SCI and n=42 SCI clinicians) were used to select key domains for inclusion and to develop PRO items. Verbatim items from other cutting-edge measurement systems (i.e. PROMIS, Neuro-QOL) were included to facilitate linkage and cross-population comparison. Items were field tested in a large sample of individuals with traumatic SCI (n=877). Dimensionality was assessed with confirmatory factor analysis. Local item dependence and differential item functioning were assessed, and items were calibrated using the item response theory (IRT) graded response model. Finally, computer adaptive tests (CATs) and short forms were administered in a new sample (n=245) to assess test-retest reliability and stability. PARTICIPANTS AND PROCEDURES A calibration sample of 877 individuals with traumatic SCI across five SCI Model Systems sites and one Department of Veterans Affairs medical center completed SCI-QOL items in interview format. RESULTS We developed 14 unidimensional calibrated item banks and 3 calibrated scales across physical, emotional, and social health domains. When combined with the five Spinal Cord Injury--Functional Index physical function banks, the final SCI-QOL system consists of 22 IRT-calibrated item banks/scales. Item banks may be administered as CATs or short forms. Scales may be administered in a fixed-length format only. CONCLUSIONS The SCI-QOL measurement system provides SCI researchers and clinicians with a comprehensive, relevant and psychometrically robust system for measurement of physical-medical, physical-functional, emotional, and social outcomes. All SCI-QOL instruments are freely available on Assessment CenterSM.
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Affiliation(s)
- David S. Tulsky
- Correspondence to: David S. Tulsky, Professor and Director of the Center on Assessment Research and Translation, STAR Campus, University of Delaware, 540 S. College Ave, Newark, DE 19713, USA.
| | - Pamela A. Kisala
- Department of Physical Therapy, University of Delaware, College of Health Sciences, Newark, DE, USA
| | - David Victorson
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Richard Gershon
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - David Cella
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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