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Rehabilitation Measures

Spinal Cord Injury - Quality of Life Bowel Management Difficulties

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Purpose

The SCI-QOL Bowel Management Difficulties instrument assesses difficulties associated with bowel management in individuals with spinal cord injury (SCI).

Link to Instrument

Acronym SCI-QOL Bowel Management Difficulties

Area of Assessment

Quality of Life
Incontinence

Assessment Type

Patient Reported Outcomes

Administration Mode

Computer

Cost

Free

Cost Description

Paper copies of short forms are available. PDFs can be requested through emails to sci-qol@udel.edu and tbi-qol@udel.edu

Electronic versions can be found in the NIH Toolbox or the PROMIS app. Either app is $500/yr, and covers up to 10 iPads on a single license. The SCI-QOL and TBI-QOL CATs can be administered directly through these apps. It is important to note that using the app requires you to be physically with the participant or read the questions aloud by interview over the phone - there is no way to send a link to have someone complete the measures at home.

Free electronic versions are available. If your institution has REDCap, the CATs and short forms can be accessed through the REDCap instrument library by searching for the specific measure you want and adding them to your REDCap project. For non-REDCap alternatives, the SCI-QOL and TBI-QOL short forms can be imported into an alternative electronic administration platform such as Qualtrics, SurveyMonkey, Google Forms, etc. Email sci-qol@udel.edu or tbi-qol@udel.edu to request PDF versions.

Diagnosis/Conditions

  • Spinal Cord Injury

Populations

Key Descriptions

  • The SCI-QOL Bowel Management Difficulties measure is an item response theory (IRT)-calibrated item bank with 26 items that is available for administration as a computer adaptive test (CAT; range 4-12 items) or 9 item short form (SF).

Number of Items

26

Short form: 9

CAT: 4-12

Equipment Required

  • The Short Form (SF) requires only the printed form and a pencil
  • Access to the short form, and administration of CATs is available online. Email SCI-QOL@udel.edu to request versions.
  • Please see 'Cost Description' for more information on how to access this measure

Time to Administer

Less than 5 minutes

Required Training

Reading an Article/Manual

Age Ranges

Adults

18 - 64

years

Elderly Adults

65 +

years

Instrument Reviewers

Review completed by Kelsey Stipp, MS and Kristian Nitsch, MS for the Rehabilitation Measures Database Team.

ICF Domain

Body Function

Measurement Domain

General Health

Considerations

Do you see an error or have a suggestion for this instrument summary? Please e-mail us!

Spinal Injuries

back to Populations

Standard Error of Measurement (SEM)

Depends upon mode of administration:

  • Full Item Bank: Mean SEM= 0.28 (Range= 0.10-0.59)

  • 9-Item Short Form: Mean SEM= 0.36 (Range= 0.15 - 0.60)

  • 9-Item Fixed CAT: Mean SEM= 0.34 (Range= 0.12-0.59)

  • Variable-length CAT: Mean SEM= 0.33 (Range= 0.13 - 0.56)

  • Variable Length CAT (Min 4): Mean SEM= 0.35 (0.17-0.56) 

Minimal Detectable Change (MDC)

Calculated Using Mean SEM:

  • Full Item Bank: MDC= 12.27

  • 9-Item Fixed CAT: MDC= 11.8

  • Variable Length CAT: MDC= 11.91

Normative Data

(n= 757; Mean Age= 42.9, SD= 15.5; Time Post Injury= 6.7, SD= 9.9; 42% Paraplegia, 58% Tetraplegia)

Test/Retest Reliability

Traumatic SCI(Tulsky et al., 2015)

  • Adequate: (Pearson's r= 0.74)
  • Adequate: (ICC= 0.74)

Internal Consistency

Traumatic SCI(Tulsky et al., 2015)

  • Full Item Bank - Excellent: (Cronbach's Alpha= 0.95)

Content Validity

Items were derived from focus groups and interviews with individuals with traumatic SCI (n=65) and clinicians who specialize in SCI care (n=42). (see Tulsky et al., 2011).

Face Validity

Not statistically assessed, but content was generated in collaboration with SCI patients and expert clinicians, so face validity is believed to be strong.

Floor/Ceiling Effects

Traumatic SCI(Tulsky et al., 2015)

 

Full Item Bank:

  • Floor Effect: Adequate (16%)

  • Ceiling Effect: Excellent (0.13%)

9-Item Short Form:

  • Floor Effect: Poor (30%)

  • Ceiling Effect: Excellent (0.4%)

9-Item Fixed-length CAT:

  • Floor Effect: Poor (28.5%)

  • Ceiling Effect: Excellent (0.13%)

Variable Length CAT (Min 8):

  • Floor Effect: Adequate to Excellent (2.64%)

  • Ceiling Effect: Excellent (0.13%)

Variable-length CAT (Min 4):

  • Floor Effect: Adequate to Excellent (2.64%)

  • Ceiling Effect: Excellent (0.13%)

Bibliography

Tulsky, D.S., Kisala, P. Tate, D.G., Spungen, A.M., & Kirshblum, S.C. (2015). Development and psychometric characteristics of the SCI-QOL Bladder Management Difficulties and Bowel Management Difficulties item banks and short forms and the SCI-QOL Bladder Complications Scale. Journal of Spinal Cord Medicine, 38(3), 288-302.

Tulsky, D.S., Kisala, P.A., Victorson, D. Tate, D., Heinemann, A.W., Amtmann, D., & Cella, D. (2011). Developing a contemporary patient-reported outcomes measure for spinal cord injury. Archives of Physical Medicine and Rehabilitation, 92(10), S44-S51.

Tulsky, D.S., Kisala, P.A., Victorson, D. Tate, D., Heinemann, A.W., Amtmann, D., & Cella, D. (2011). Developing a contemporary patient-reported outcomes measure for spinal cord injury. Archives of Physical Medicine and Rehabilitation, 92(10), S44-S51.