Rehabilitation Measures Database
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  2. Spinal Cord Injury – Quality of Life Anxiety

Spinal Cord Injury – Quality of Life Anxiety

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Purpose

The SCI-QOL Anxiety instrument is used to assess symptoms of anxiety in individuals with spinal cord injury (SCI).

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Instrument Details

Acronym SCI-QOL Anxiety

Area of Assessment

Mental Health
Quality of Life
Negative Affect
Stress & Coping

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

Spinal Injuries

Key Descriptions

  • The SCI-QOL Anxiety measure is an item response theory (IRT)-calibrated item bank with 25 items that is available for administration as a computer adaptive test (CAT; range 4-12 items) or short form (SF). Many items are shared with the PROMIS (15 of 25 items) and Neuro-QOL (20 of 25 items) Anxiety item banks.

Number of Items

25

Short form: 9

CAT: 4-12

Equipment Required

  • The Short Form requires only the printed form and a pencil.
  • A CAT administration requires a desktop, laptop, or tablet computer with internet connection.
  • Please see 'Cost Description' for more information on how to obtain copies/electronic versions of this test

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 Pamela Kisala, M.A. and Matthew Cohen, Ph.D.

ICF Domain

Body Function

Measurement Domain

Emotion

Considerations

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

Spinal Injuries

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Standard Error of Measurement (SEM)

Depends on the mode of administration:

  • Full Item Bank: Mean SEM= 0.22
  • 9-Item Fixed-length CAT: Mean SEM= 0.29
  • Variable-length CAT (Min 4): Mean SEM= 0.32
  • Variable-length CAT (Min 8): Mean SEM= 0.29
  • 9-Item Short Form: Mean SEM= 0.33

Minimal Detectable Change (MDC)

Calculated from SEM:

  • Full Item Bank: MDC= 0.51
  • 9-Item Fixed-length CAT: MDC= 0.63
  • Variable-length CAT: MDC= 0.67

Cut-Off Scores

Kisala et al. (2015) created a "cross-walk" table to transform SCI-QOL Anxiety scores to scores on the GAD-7, a gold standard measure of anxiety with well-established cut scores.

The SCI-QOL Anxiety scores below are the equivalent of GAD-7 cutoff scores:

  • Mild Anxiety: T-score of 49-55
  • Moderate Anxiety: T-score of 56-61
  • Severe Anxiety: T-Score of 62+

Normative Data

General population (2000 U.S. Census). The normative data reference the calibration sample from PROMIS, which matches the demographics of the 2000 U.S. Census.

Test/Retest Reliability

Traumatic SCI (Kisala et al., 2015)

Full Item Bank:

  • Excellent: (Pearson's r= 0.80)
  • Excellent: (ICC = .80)

Internal Consistency

Traumatic SCI (Kisala et al., 2015)

  • Full Item Bank - Excellent: (Cronbach’s alpha= .95)
  • 9-Item Fixed CAT - Excellent: (Cronbach's alpha= .92)
  • Variable-length CAT (Min 4) - Excellent: (Cronbach's alpha= .91)
  • Variable-length CAT (Min 8) - Excellent: (Cronbach's alpha= .92)
  • 9-Item Short Form - Excellent: (Cronbach's alpha= .90)

Criterion Validity (Predictive/Concurrent)

 Traumatic SCI (Kisala et al., 2015)

  • Excellent: Predicting GAD-7 scores (r= .67)

Construct Validity

Traumatic SCI (Tulsky et al., in preparation)

The SCI-QOL Anxiety item bank demonstrated good convergent validity by correlating strongly with measures of:

  • Depression (PHQ-9 r= .61)
  • Life Satisfaction (Satisfaction with Life Scale r= -.53),
  • Resilience (SCI-QOL Resilience r= -.68),
  • Positive affect (SCI-QOL Positive Affect r= -.59).

The SCI-QOL Anxiety item bank demonstrated good discriminant validity by not correlating with measures of:

  • Fine motor functioning (SCI-QOL Fine Motor r= -.046)

Content Validity

Some SCI-QOL items were derived from the focus groups and cognitive interviews that founded the PROMIS and/or Neuro-QOL measurement systems. The Neuro-QOL focus groups comprised patients with neurological illness (n= 64) and caregivers (n= 19).

Other SCI-QOL items were derived from focus groups and interviews with individuals with traumatic SCI (n=65) and clinicians who specialize in SCI (n=42).

Face Validity

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

Floor/Ceiling Effects

Traumatic SCI (Kisala et al., 2015)

 

Full Item Bank:

  • Floor Effects: Adequate to Excellent (2.8%)
  • Ceiling Effects: Excellent (0.1%)

9-Item Fixed-length CAT:

  • Floor Effects: Adequate to Excellent (7.5%)
  • Ceiling Effects: Excellent (0.1%)

Variable-length CAT (Min 4):

  • Floor Effects: Adequate to Excellent (6.8%)
  • Ceiling Effects: Excellent (0.1%)

Variable Length CAT (Min 8):

  • Floor Effects: Adequate to Excellent (6.8%)
  • Ceiling Effects: Excellent (0.1%)

9-Item Short Form:

  • Floor Effects: Adequate to Excellent (6.4%)
  • Ceiling Effects: Excellent (0.1%)

Bibliography

Kisala et al. (2015). Measuring anxiety after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Anxiety item bank and linkage with GAD-7. Journal of Spinal Cord Medicine, 38(3), 315-325.

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