Quality of Life Concepts

Secondary Health Conditions

International Support Evaluation List (ISEL)

Description: A measure of the perceived availability of support.

Format: 40 items, separated into 4 sub-scales of 10 items assessing the perceived availability of different functions of social support: appraisal, belonging, self-esteem, and tangible.

Scoring: The ISEL yields a total score by summing each item.  As well, sub-scales are calculated by summing relevant items.

Administration and Burden: Self-administered.

Psychometrics for SCI: The appraisal sub-scale of the ISEL showed satisfactory internal consistency (Cronbach α =.82) in a sample of spinal cord injury (SCI) subjects with chronic pain [1].

Languages: English.

QoL Concept: The ISEL measures life satisfaction, which corresponds to Boxes C (achievements) and E (subjective evaluations and reactions) of Dijker’s Model.

Permissions/Where to Obtain: Public Domain; The ISEL can be found as an appendix in the original publication:

Sarason IG, Levine HM, Basham RB, Sarason BR. Assessing social support: The social support questionnaire. J Pers Soc Psychol 1983;44:127-39.


  1. Widerström-Noga EG, Cruz-Almeida Y, Martinez-Arizala A, Turk DC. Internal consistency, stability, and validity of the spinal cord injury version of the multidimensional pain inventory. Arch Phys Med Rehabil 2006;87:516-23.


Pain SCI Studies: Three cross-sectional surveys.

  1. Pang MYC, Eng JJ, Lin K-H, Tang P-F, Hung C, Wang Y-H. Association of depression and pain interference with disease-management self-efficacy in community dwelling individuals with spinal cord injury. J Rehabil Med 2009;41:1068-73.

  2. Widerstrom-Noga EG, Cruz-Almeida Y, Martinez-Arizala A, Turk DC. Internal consistency, stability, and validity of the spinal cord injury version of the multidimensional pain inventory. Arch Phys Med Rehabil 2006; 87:516-23.

  3. Widerstrom-Noga EG, Felix ER, Cruz-Almeida Y, Turk DC. Psychosocial subgroups in persons with spinal cord injuries and chronic pain. Arch Phys Med Rehabil 2007;88:1628-35.

Sensitivity to Impact: Pang and colleagues (2009) evaluated associations between depression and pain interference with disease management self-efficacy in persons with spinal cord injury (SCI; N = 49). Their main outcome measure was the Self-Efficacy for Managing Chronic Disease (SMCD) survey, the International Support Evaluation List (ISEL), and the Chronic Pain Grading System (CPGS). Results showed that higher self-efficacy was correlated with longer time since injury, better social support, lower pain interference, and less severe depressive symptoms. In regression analyses, only lower pain interference and less severe depressive symptoms were significantly associated with higher disease-management self-efficacy.

Widerstrom-Noga and colleagues (2006) used the Pain Disability Index (PDI), the appraisal subscale of the ISEL, and the Satisfaction with Life Scale (SWLS) to evaluate the internal consistency, stability, and construct validity of Multidimensional Pain Inventory - SCI Version (MPI-SCI; N = 161). Convergent validity was demonstrated through a strong correlation between the life interference sub-scale of the MPI-SCI and scores on the PDI. The MPI-SCI showed good convergent, discriminative, and concurrent reliability.

Widerstrom-Noga and colleagues (2007) used a battery of tests including the MPI-SCI, the PDI, the ISEL, and the SWLS to define adaptational sub-groups in males with chronic pain and SCI (N = 89), and to compare these sub-groups in terms of their demographic factors, level of injury, functional independence, pain disability, depressed mood, social support, and life satisfaction. Cluster analysis identified three subgroups: dysfunctional copers, interpersonally supported, and adaptive copers. Severe pain was found to decrease life satisfaction after SCI, however the effect was mediated by perceived social support.

Suggestions for Use: The ISEL has been shown to be sensitive to the impact of pain, and is a tool that has been validated for the SCI population.  Howeve, the ISEL has been primarily used to help validate the MPI-SCI rather than to evaluate the impact of pain per se.

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