Primary Image

Rehabilitation Measures Database

Spinal Cord Injury - Quality of Life Bladder Management Difficulties

Last Updated


The SCI-QOL Bladder Management Difficulties instrument assesses difficulties associated with bladder management in individuals with spinal cord injury (SCI).

Link to Instrument

Instrument Details

Acronym SCI-QOL Bladder Management Difficulties

Area of Assessment

Quality of Life

Assessment Type

Patient Reported Outcomes

Administration Mode




Cost Description

Paper copies of short forms are available. PDFs can be requested through emails to and

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 or to request PDF versions.


  • Spinal Cord Injury


Key Descriptions

  • The SCI-QOL Bladder Management Difficulties measure is an item response theory (IRT)-calibrated item bank with 15 items that is available for administration as a computer adaptive test (CAT; range 4-12 items) or 8 item short form (SF).

Number of Items


Short form: 8

CAT: 4-12

Equipment Required

  • The Short Form (SF) version requires only the printed form and a pencil. A CAT administration requires a desktop, laptop, or tablet computer with internet connection and login to
  • Please see 'Cost Description' for more information on how to access this measure

Time to Administer

Less than 5 minutes

Required Training

Reading an Article/Manual

Age Ranges


18 - 64


Elderly Adult

65 +


Instrument Reviewers

Review completed by Kelsey Stipp, MS and Kristian Nitsch, MS for the Rehabilitation Measures Database Team.

ICF Domain

Body Function

Measurement Domain

General Health


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

Spinal Injuries

back to Populations

Standard Error of Measurement (SEM)

Depends upon mode of administration:

  • Full Item Bank: Mean SEM= 3.45 (Range= 1.5-6.3)

  • 8-Item Short Form: Mean SEM= 4.21 (Range= 1.9 - 6.4)

  • 8-Item Fixed CAT: Mean SEM= 0.38 (Range= 0.17-0.64)

  • Variable Length CAT (Min 8): Mean SEM= 0.36 (range= 0.17 - 0.63)

  • Variable Length CAT (Min 4): Mean SEM= 0.37 (0.21-0.63)

Minimal Detectable Change (MDC)

Calculated Using Mean SEM:

  • Full Item Bank: MDC= 12.41

  • 8-Item Fixed CAT: MDC= 12.3

  • Variable Length CAT: MDC= 12.36

Test/Retest Reliability

Traumatic SCI (Tulsky et al., 2015)

  • Excellent: (Pearson's r= 0.77)

  • Excellent: (ICC= 0.76)

Internal Consistency

Traumatic SCI (Tulsky et al., 2015)

  • Full Item Bank: Excellent (Cronbach's Alpha= 0.91)

Content Validity

Items were derived from focus groups and interviews with individuals with traumatic SCI and clinicians who specialize in SCI care (Tulsky et al., 2011).

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(Tulsky et al., 2015)


Variable-length CAT (Min 4):

  • Floor Effect: Adequate (17.4%)

  • Ceiling Effect: Excellent (0.13%)

Variable-length CAT (Min 8):

  • Floor Effect: Adequate (17.4%)

  • Ceiling Effect: Excellent (0.13%)

8-Item Fixed-length CAT:

  • Floor Effect: Adequate to Excellent (4.5%)

  • Ceiling Effect: Excellent (0.13%)

8-Item Short Form:

  • Floor Effect: Poor (30.7%)

  • Ceiling Effect: Excellent (0.13%)

Full Item Bank:

  • Floor Effect: Adequate (13.3%)

  • Ceiling Effect: Excellent (0.13%)


Tulsky, D.S., Kisala, P. Tate, D.G., Spungen, A.M., & Kirshblum, S.C. (2015). 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. Journal of Spinal Cord Medicine, 38(3), 288-302.

Tulsky, D.S., Kisala, P.A., Victorson, D. Tate, D., Heinemann, A.W., Amtmann, D., & Cella, D. (2011). Developing a contemporary patient-reported outcomes measure for spinal cord injury. Archives of Physical Medicine and Rehabilitation, 92(10), S44-S51.