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RehabMeasures Instrument

Satisfaction With Life Scale

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Purpose

A subjective quality of life measure designed to measure global life satisfaction, a subjective cognitive assessment, in contrast to an objective quality of life survey (e.g. Sickness Impact Profile, Short Form-36).

Link to Instrument

Instrument Details

Acronym SWLS

Area of Assessment

Life Participation
Quality of Life

Assessment Type

Performance Measure

Administration Mode

Paper & Pencil

Cost

Free

Diagnosis/Conditions

  • Brain Injury
  • Spinal Cord Injury

Key Descriptions

  • The SWLS contains five statements about life satisfaction: three set in the present, one in the past, and one in the future.
  • Can be self-administered or completed by interview.
  • 7-point Likert scale from “strongly disagree” to “strongly agree”, 5 items:
    1) In most ways my life is close to my ideal
    2) The conditions of my life are excellent
    3) I am satisfied with my life
    4) So far I am getting the important things I want in life
    5) If I could live my life over, I would change almost nothing
  • Scoring:
    1) Global score is computed
    2) Higher scores indicate better health
    3) Scores range from 5 to 35
    4) A score of 20 represents a neutral point at which the respondent is equally satisfied and dissatisfied
  • Translated into a number of languages.

Number of Items

5

Equipment Required

  • Survey form

Time to Administer

Less than 5 minutes

Required Training

No Training

Age Ranges

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Initially reviewed by Susan Deems-Dluhy, PT, NCS in 7/2011; Updated by Anna de Joya, PT, MS, NCS and the TBI EDGE task force of the Neurology Section of the APTA in 5/2012; Reviewed by Rie Yoshida and Heather D Anderson 4/11/16 and the Stroke Edge II Task Force

ICF Domain

Participation

Professional Association Recommendation

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

For detailed information about how recommendations were made, please visit:  http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations

Abbreviations:

 

HR

Highly Recommend

R

Recommend

LS / UR

Reasonable to use, but limited study in target group  / Unable to Recommend

NR

Not Recommended

 

Recommendations for use based on acuity level of the patient:

 

Acute

(CVA < 2 months post)

(SCI < 1 month post) 

(Vestibular < 6 weeks post)

Subacute

(CVA 2 to 6 months)

(SCI 3 to 6 months)

Chronic

(> 6 months)

SCI EDGE

LS

LS

R

StrokEDGE

UR

UR

UR

 

Recommendations based on level of care in which the assessment is taken:

 

Acute Care

Inpatient Rehabilitation

Skilled Nursing Facility

Outpatient

Rehabilitation

Home Health

StrokEDGE

UR

UR

UR

UR

UR

TBI EDGE

NR

NR

NR

LS

LS

 

Recommendations based on SCI AIS Classification: 

 

AIS A/B

AIS C/D

SCI EDGE

R

R

 

Recommendations for use based on ambulatory status after brain injury:

 

Completely Independent

Mildly dependant

Moderately Dependant

Severely Dependant

TBI EDGE

N/A

N/A

N/A

N/A

 

Recommendations for entry-level physical therapy education and use in research:

 

Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)

SCI EDGE

No

Yes

Yes

Not reported

StrokEDGE

No

No

No

Not reported

TBI EDGE

No

Yes

Yes

Not reported

Considerations

  • Not recommended for use as a physical therapy outcome measure at this time; may be useful as a team screening tool
  • Studied mainly in general population
  • Some questions may be inappropriate in rehab population

Brain Injury

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Normative Data

Traumatic Brain Injury: (Corrigan et al, 1998; n = 95 adults with traumatic brain injuries, 6 months to 5 years after inpatient rehabilitation; mean age = 32.4 years) 

  • Mean score of 19.0 (7.6) 
  • Time post-injury was significantly associated with higher SWLS total score

Criterion Validity (Predictive/Concurrent)

Traumatic Brain Injury: (Hanks et al, 2008; n = 174 who met criteria for admission to inpatient brain injury rehabilitation; mean age = 38.15 (18.07) years) 

  • Poor predictive validity for quality of life 1 year post-injury

Floor/Ceiling Effects

Traumatic Brain Injury: (Corrigan et al, 1998)

  • Mean score declines at year 1 post injury with a subsequent gradual increase over five years post injury

Spinal Injuries

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Test/Retest Reliability

Spinal Cord Injury: (Hill et al, 2010; n = 14 articles reporting on 13 QOL measures)

  • Poor two week test-retest reliability (ICC = 0.39 - 0.65)

Face Validity

Spinal Cord Injury: (Hill et al, 2010)

  • Level of injury, number of hospitalizations and number of pressure ulcers related to life satisfaction (p < 0.05), but completeness of injury did not

Non-Specific Patient Population

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Normative Data

Undergraduate students: (Diener et al, 1985; n = 176 undergraduates at University of Illinois who were enrolled in psychology classes) 

  • Mean score of 23.5 (6.43)

Cross-sectional assessment of the SWLS: (Durak et al, 2010; study assessed difference in life satisfaction between three groups; = 547 university students, n = 166 correctional officers, n = 123 elderly persons; mean age = 68.18 (5.10) years; for the elderly population 2 reported their health as "very poor", 10 as "poor", 51 as "average", 46 as "well" and 14 as "very well"; Turkish sample)

SWLS Item Level Norms

 

 

 

Item #

Mean

SD

ITC*

1

4.77

1.80

0.68

2

4.82

1.72

0.78

3

5.18

1.58

0.70

4

4.91

1.70

0.78

5

4.14

2.11

0.72

All Items

23.8

7.44

 

* ITC item total correlation

 

 

 

 

SWLS and Other Major Life Outcomes:

 

 

 

Scale

Range

Mean

SD

SWLS

5 to 35

23.82

7.44

Self esteem

10 to 50

36.94

6.84

Perceived current health status

1 to 5

3.49

0.86

Late-life depression

0 to 30

11.13

5.70

Test/Retest Reliability

Undergraduate Students:(Diener et al, 1985) 

  • Adequate two month test-retest reliability (ICC = 0.82)

Interrater/Intrarater Reliability

General population: (Pavot et al, 1993; A review of the SWLS) 

  • Adequate to Excellent item total correlations (ICC = 0.51 - 0.80)

Internal Consistency

Undergraduate students: (Diener et al, 1985) 

  • Adequate to Excellent internal consistency (Chronbach's alpha = 0.61 - 0.89)

Cross-sectional assessment of the SWLS: (Durak et al, 2010; only assessing internal consistency for elderly respondents)

  • Adequate internal consistency (Chronbach's alpha = 0.72)

Construct Validity

Undergraduate students: (Diener et al, 1985) 

  • Adequate correlation with Life Satisfaction Index (= 0.46)
  • Adequate correlation with interviewer (= 0.43)

Correlations between the SWLS and other measures of subject well-being:

 

Sample 1 (n = 176)

Sample 2 (n = 163)

Fordyce 1

0.58 (Adequate)

0.57 (Adequate)

Fordyce (%)

0.58 (Adequate)

0.62 (Excellent)

DPQ

0.68 (Excellent)

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Cantril

0.62 (Excellent)

0.66 (Excellent)

Gurin

0.59 (Adequate)

0.47 (Adequate)

Andrews and Withey

0.68 (Excellent)

0.62 (Excellent)

Campbell

0.75 (Excellent)

0.59 (Adequate)

Bradburn-PAS

0.50 (Adequate)

0.51 (Adequate)

Bradburn-NAS

0.37 (Adequate)

-0.32 (Adequate)

Summed Domain Satisfaction

-----

0.57 (Adequate)

AIM

0.09 (Poor)

-----

DPQ = Differential Personality Questionnaire; PAS = Positive Affect Scale; NAS = Negative Affect Scale; AIM = Affect Intensity Measure; Sample 2 was not administered to the the DPQ or AIM, and Sample1 did not complete the domain satisfaction items

    Older Adults and Geriatric Care

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    Test/Retest Reliability

    Older Adults and College Students: (Pavot et al, 1991; Study 1:  n = 39 older members of the Champaign-Urbana community; mean age = 74 (8.97); sex = 16 males, 23 females; Study 2:  n = 125 University of Illinois at Champaign-Urbana students; sex = 51 males, 85 females)

    • Excellent overall test-retest reliability (ICC = 0.83)
    • Study 2:  Excellent test-retest reliability (ICC = 0.84)

    Construct Validity

    Older Adults: (Pavot et al, 1991)

    • Adequate convergent validity with Life Satisfaction Index (= 0.81)

    Bibliography

    Corrigan, J. D., Smith-Knapp, K., et al. (1998). "Outcomes in the first 5 years after traumatic brain injury." Arch Phys Med Rehabil 79(3): 298-305. Find it on PubMed

    Diener, E., Emmons, R. A., et al. (1985). "The Satisfaction With Life Scale." J Pers Assess 49(1): 71-75. Find it on PubMed

    Durak, M., Senol-Durak, E., et al. (2010). "Psychometric properties of the Satisfaction with Life Scale among Turkish university students, correctional officers, and elderly adults." Social indicators research 99(3): 413-429. Find it Here

    Hanks, R. A., Millis, S. R., et al. (2008). "The predictive validity of a brief inpatient neuropsychologic battery for persons with traumatic brain injury." Arch Phys Med Rehabil 89(5): 950-957. Find it on PubMed

    Hill, M. R., Noonan, V. K., et al. (2010). "Quality of life instruments and definitions in individuals with spinal cord injury: a systematic review." Spinal Cord 48(6): 438-450. Find it on PubMed

    Pavot, W. and Diener, E. (1993). "Review of the satisfaction with life scale." Psychological Assessment 5(2): 164. Find it Here

    Pavot, W., Diener, E., et al. (1991). "Further validation of the Satisfaction with Life Scale: evidence for the cross-method convergence of well-being measures." J Pers Assess 57(1): 149-161. Find it on PubMed

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