Spinal Cord Injury Lifestyle Scale (SCILS)

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Tool Description

  • Measures the frequency of health-related behaviour performance in individuals with SCI
  • Designed to enable examination of the effectiveness of clinical and educational efforts for health maintenance and prevention of secondary impairments.
  • Items were developed from a review of the literature on secondary impairments related to SCI.  In addition, expert clinicians (physician assistants, nurses and physiotherapists) generated items describing health related behaviours. Each item describes different health behaviours.
  • The 5 subscales include:

1) Cardiovascular
2) Genitourinary
3) Neuromuscular
4) Skin
5) Psychosocial.

ICF Domain:

Activity – Subcategory: Self-Care.

Number of Items:

25

Brief Instructions for Administration & Scoring

Administration:

  • Self-report
  • Administration time is usually 5-10 minutes.

Equipment:None.

Scoring:

  • A score is generated for each subscale by totaling scores of each item in the subscale.
  • The frequency with which each behaviour has been performed over the past 3 months is rated using an ordinal scale where 4-‘almost always’, 3-‘frequently’, 2-‘sometimes’, 1-‘rarely’ and 0-‘never’.
  • One item (genitourinary) is reverse scored.
  • A total score ranging from 0-100 is calculated by summing the 5 subscale scores.
  • Sub-scale scores may be used to identify/address specific areas of concern.

Interpretability

MCID: not established in SCI
SEM: not established in SCI
MDC: not established in SCI

  • Higher total scores are intended to indicate better performance of behaviours which promote health in individuals with SCI.
  • The scores could be used for each sub-scale or as a tool for general overall health.
  • There are no norms or reported cut scores for the SCI population
  • Published data for the SCI population is available for comparison (see Interpretability section in the Study Details sheet).

Languages:

English.

Training Required:

None formally required.

Availability:

See the ‘How-to use’ page of this tool.

Clinical Considerations

  • Although the authors identified a comprehensive list of secondary conditions, only some of these impairments have been included in the tool. For example, some of the missed items include autonomic dysreflexia, deep vein thrombosis, pressure relief in bed, and adjustment to disability.
  • Individuals with SCI participated in item elimination during tool development therefore the included items should resonate with the population.

Measurement Property Summary

# of studies reporting psychometric properties: 1

Reliability:

  • Internal consistency is high for the total SCILS (Cronbach’s a=0.81) and low to high for the SCILS subscales (Cronbach’s a=0.31-0.86).

[Pruitt et al. 1998]

Validity:

  • SCILS was tested against instruments measuring constructs other than that of the SCILS; correlations of the SCILS are low and non-significant for the following instruments as expected:

o   Functional Independence Measure (Pearson’s r=-0.06)

o   Brief Symptom Inventory (Pearson’s r=-0.16- -0.13)

o   Impact of Event Scale (Pearson’s r=-0.16)

o   Beck Depression Inventory (Pearson’s r=-0.17).

  • SCILS was tested against instruments measuring the same construct as that of the SCILS; correlations of the SCILS were moderate with:

o   Self-assessment of overall health behaviour (Pearson’s r=0.51) (P<0.005)

o   Physician assistant’s assessment of overall health behaviours (Pearson’s r=0.41) (P<0.005)

and low with:

o   Physical therapist’s assessment of overall health behaviour (Pearson’s r=0.30)(non-significant)

o   Nurse’s assessment of overall health behaviour (Pearson’s r=-0.18).

[Pruitt et al. 1998]

Responsiveness:

No values were reported for the responsiveness of the SCILS for the SCI population.

Floor/ceiling effect:

No values were reported for the presence of floor/ceiling effects in the SCILS for the SCI population.

Reviewer

Dr. Ben Mortenson, John Zhu, Matthew Querée

Date Last Updated:

Mar 2, 2017

Download the measure

Download Worksheet:

Worksheet Document

Video

n/a

Scoring

A total score is comprised of the sum of the five scale scores. Higher scores on the SCILS are indicative of higher performance of behaviors that promote health in persons with SCI.

Equipment Needed

SCILS:

Pruitt SD, Wahlgren DR, Epping-Jordan JE, Rossi AL. Health behavior in persons with spinal cord injury: development and initial validation of an outcome measure. Spinal Cord 1998;36:724-731
http://www.ncbi.nlm.nih.gov/pubmed/9800276