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SCI-QOL Bowel Management Difficulties
Availability
Please visit this website for more information about the SCI-QoL Bowel Management Difficulties
 
PDF copies of all SCI-QOL item banks and short forms are freely available to the public by contacting SCI-QOL@udel.edu.
Classification
Supplemental: Spinal Cord Injury (SCI)
Short Description of Instrument
The SCI-QoL Bowel Management Difficulties assesses difficulties with bowel management in individuals with spinal cord injury. (Tulsky et al., 2015) Difficulties with bowel management among persons with SCI including feelings of distress in daily life associated with bowel problems.
 
It is an item reponse theory (IRT)-calibrated bank with 26 items that is available for administration as a computer adaptive test (CAT, range 4-12 items) or 9 item short form. (Choukou et al., 2019; Tulsky et al., 2015)
Comments/Special Instructions
The Bowel Management Difficulties item banks can be administered as a CAT or 9-item short-form allowing researchers and clinicians to administer only the most precise and informative items based upon an individual's responses, thus reducing patient burden (Choukou et al., 2019). This may be clinically useful in symptom monitoring and self-management in post-acute care settings. (PAR-QOL, 2018a)
Scoring and Psychometric Properties
Scoring
 
Item bank of 26 items. With Computer Assisted Technology (CAT), minimum 4 items, minimum 8-items or complete variable length. Short-Form with 9 items. Response options in a 5-point scale (Tulsky et al., 2015). Reference scores available. (Tate et al., 2020)
 
1 = Never/Not at all
 
2 = Rarely / A little bit
 
3 = Somewhat / Sometimes
 
4 = Quite a bit/Often
 
5 = Very much/Always
 
Scoring for CAT 26-item Psychometrics for SCI: 26 item CAT administration, range 4-12 items: The complications experienced 'lately' are given a score between 1 (never/not at all) & 5 (always/very much). One item is reverse scored between 1 (always) & 5 (never). Items are summed then converted to a standardized T-metric score with a mean of 50 and a standard deviation of 10. Higher scores indicate higher degree of difficulty. (PAR-QoL, 2018a)
 
Scoring for Short Form Psychometrics for SCI: 9-item short form: The complications experienced 'lately' are given a score between 1 (never/not at all) & 5 (always/very much). One item is reverse scored between 1 (always) & 5 (never). Items are summed then converted to a standardized T-metric score with a mean of 50 and a standard deviation of 10. Higher scores indicate higher degree of difficulty. PAR-QoL, (2018b)
 
Psychometric Properties
 
Reliability: Moderate test-retest reliability. (ICC = 0.74) (Choukou et al., 2019; Tate et al., 2020; Tulsky et al., 2015)
 
Validity: High internal consistency (0.95), good fit to IRT model. (Choukou et al., 2019; Tate et al., 2020; Tulsky et al., 2015)
 
Responsiveness: Not yet reported (Tate et al., 2020)
 
CAT 26-item Psychometrics for SCI: a=0.91 for internal consistency, correlations (item/total) range from 0.38 to 0.78, Pearson's r is 0.77 (? < 0.01) for test-retest reliability, intra-class correlation coefficient (2.1) is 0.76 (95% CI=0.70 to 0.81), the fit to a unidimensional model is confirmed (CFI=0.965; RMSEA=0.093), the reliability is equivalent to a classical 0.95 (determined with measurement precision in the theta range). (PAR-QoL, 2018a; Tulsky et al., 2015)
 
Short Form Psychometrics for SCI: Correlation with full bank score = 0.963 (Tulsky et al., 2015). For the 15 items of the SCI-QoL Bladder Management Difficulties: a=0.91 for internal consistency, correlations (item/total) range from 0.38 to 0.78, Pearson's r is 0.77 (? < 0.01) for test-retest reliability, intra-class correlation coefficient (2.1) is 0.76 (95% CI=0.70 to 0.81), the fit to a unidimensional model is confirmed (CFI=0.965; RMSEA=0.093), the reliability is equivalent to a classical 0.95 (determined with measurement precision in the theta range). (PAR-QoL, 2018b; Tulsky et al., 2015)
Rationale/Justification
Strengths/Weaknesses: The SCI-QoL Bowel Management Difficulties was developed for use in SCI. It is easy to administer using CAT or short forms and reference scores are available.There has been one validation study published (Tulsky et al., 2015) and further SCI studies are needed to assess psychometric properties.
References
Key References:
 
Tulsky DS, Kisala PA, Tate DG, Spungen AM, Kirshblum SC. 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. J Spinal Cord Med. 2015;38:288-302.
 
Tulsky DS, Kisala PA, Victorson D, Tate D, Heinemann AW, Amtmann D, Cella D. Developing a contemporary patient-reported outcomes measure for spinal cord injury. Arch Phys Med Rehabil. 2011;92(10 Suppl):S44-S51.
 
Additional References:
 
Choukou MA, Best KL, Craven BC, Hitzig SL. Identifying and classifying quality of life tools for assessing neurogenic bowel dysfunction after spinal cord injury. Top Spinal Cord Inj Rehabil 2019 WIN;25:1-22.
 
Dijkers MP. Individualization in quality of life measurement: instruments and approaches. Arch Phys Med Rehabil. 2003;84(4 Suppl 2):S3-S14.
 
Dijkers M. "What's in a name?" The indiscriminate use of the "Quality of life" label, and the need to bring about clarity in conceptualizations. Int J Nurs Stud. 2007;44(1):153-155.
 
PAR-QoL. (2018a) Spinal Cord Injury-Quality of Life (SCI-QoL) Bowel Management Difficulties. Accessed 27Oct2020 from: https://parqol.com/spinal-cord-injury-quality-of-life-sci-qol-bowel-management-difficulties/.
 
PAR-QoL. (2018b) Spinal Cord Injury-Quality of Life (SCI-QoL) Bladder Management Difficulties-Short Form. Accessed 03Feb2021 from: https://parqol.com/spinal-cord-injury-quality-of-life-sci-qol-bladder-management-difficulties-short-form/.
 
Tate DG, Wheeler T, Lane GI, Forchheimer M, Anderson KD, Biering-Sorensen F, Cameron AP, Santacruz BG, Jakeman LB, Kennelly MJ, Kirshblum S, Krassioukov A, Krogh K, Mulcahey MJ, Noonan VK, Rodriguez GM, Spungen AM, Tulsky D, Post MW. Recommendations for evaluation of neurogenic bladder and bowel dysfunction after spinal cord injury and/or disease. J Spinal Cord Med. 2020;43(2):141-164.
 
Document last updated November 2021