Considerations on the psychometric properties and validity of the Spinal Cord Injury Secondary Conditons Scale

• Published in: Spinal cord Vol. 59; no. 8; pp. 894 - 901
• Main Authors: Jørgensen, Vivien, von Rosen, Philip, Butler Forslund, Emelie
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.08.2021; Nature Publishing Group
• Subjects: 692/499; 692/617; 692/700/228; Adult; Anatomy; Biomedical and Life Sciences; Biomedicine; Chronic Pain; Correlation analysis; Cross-Sectional Studies; Datasets; Factor analysis; Floors; Human Physiology; Humans; Medicin och hälsovetenskap; Middle Aged; Neurochemistry; Neuropsychology; Neurosciences; Pain; Psychometrics; Quality of Life; Quantitative psychology; Rehabilitation; Reliability analysis; Reliability aspects; Reproducibility of Results; Spasms; Spinal cord injuries; Spinal Cord Injuries - complications; Spinal Cord Injuries - epidemiology
• ISSN: 1362-4393; 1476-5624; 1476-5624
• DOI: 10.1038/s41393-021-00655-z

Study design Cross-sectional validation study. Objectives Explore psychometric properties of Spinal Cord Injury Secondary Conditions Scale (SCI-SCS). Setting Two Scandinavian rehabilitation centres. Methods Included were 224 consecutive patients attending regular follow-up at least 1 year after a traumatic SCI. Mean age was 49.6 (SD 14.9) years. SCI-SCS floor and ceiling effect examined. Construct validity was investigated by confirmatory factor analysis and correlation analysis, and reliability by Cronbach’s alpha. Results SCI-SCS showed no floor or ceiling effect. Two out of four earlier reported latent factors (“Genitourinary and bowel”, “Muscle structures and pain”) were confirmed. The global Cronbach’s alpha of SCI-SCS was 0.65 and 0.22–0.61 for the four latent factors. The SCI-SCS sum score showed low correlation to quality of life (QoL) measured by EQ5 VAS ( r s  = −0.47, p  < 0.001). Likewise, the sum score correlations to QoL-general and QoL-physical health (International SCI QoL Basic Dataset) were low ( r s  = −0.36, p  < 0.001 and r s  = −0.37, p  < 0.001, respectively). The scale item Muscle Spasms correlated moderately to ratings on Spasm Frequency ( r s  = 0.59, p  < 0.001) and Spasm Intensity ( r s  = 0.56, p  < 0.001) scales. Chronic Pain and Joint and Muscle Pain correlated to patient reported number of pain sites and level of pain (International SCI Pain Basic Dataset 1.0) ( r s  = 0.31 p  < 0.001 and r s  = 0.47, p  < 0.001, respectively). Conclusion SCI-SCS is a relevant instrument for giving clinicians and researchers an overview of the individual recent experiences with secondary conditions. However, the instrument could benefit from a clearer definition of the construct secondary conditions, a scale revision and a consideration of whether to add other experienced secondary conditions.