Preferences of Adults with Spinal Cord Injury for Widely Used Health-Related Quality of Life and Subjective Well-Being Measures

Published in: The Journal of Spinal Cord Medicine (2018). doi: 10.1080/10790268.2018.1474691

by Alina I. Palimaru, William Cunningham, Marcus Dillistone, Arturo Vargas Bustamante, Honghu H. Liu, Ron D. Hays

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To describe preferences for survey instruments on health-related quality of life (HRQOL) and subjective well-being (SWB) among adults with spinal cord injury (SCI), and compare perspectives on the instruments between the United States and the United Kingdom.


We conducted 20 in-depth interviews. Setting: Participants were interviewed in their homes, some in person and some via Skype.


A convenience sample of 20 adults with SCI (10 in the US and 10 in the UK) were recruited via print and on-line advertisements. Interventions: Not applicable. Main Outcome Measures: Interviewees reviewed six instruments and rated how important it was for their medical providers to know answers to each survey. Two coders analyzed verbatim transcriptions independently using an inductive approach. Keyword-in-context (KWIC) analysis identified the most frequently used words by interviewees to discuss the merits of each instrument.


Participants in both samples identified the Fatigue Severity Scale (FSS) as "vital" that their medical providers know about it. This was followed by the Spinal Cord Injury Independence Measure III, and a standalone Eudaimonic Well-Being question. The KWIC analysis showed that the most distinctive words used to discuss FSS were "fatigue" and "pain."


Understanding what HRQOL and SWB measures are valued by adults living with SCI can lead to selection of informative instruments, which could help clinicians to complement and tailor established care and rehabilitation protocols for individual needs. Participants identified fatigue as a significant issue, and the FSS as a vitally important instrument to share with medical providers.

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