Quality of Life Concepts

Secondary Health Conditions

Satisfaction with Life Scale (SWLS)

Description: The SWLS is a global measure of life satisfaction [1]. Life satisfaction is one of three factors in the more general construct of subjective well-being (the others being positive and negative affective appraisal), but is thought to be more cognitive than emotionally driven.

Format: 5 items rated on a scale from 1 (strongly disagree) to 7 (strongly agree).

Scoring: The SWLS yields a global score by summing the scores of each question.  Scores may range from 5 to 35, with higher scores corresponding to greater life satisfaction.

Administration and Burden: Interviewer-administered; Self-administered. Approximately 5 minutes.

Psychometrics for SCI: The SWLS has favourable reliability and is associated with other measures of subjective well-being, including the General Health Questionnaire and the Symptom Checklist-90-R, as well as health attitudes, providing evidence for construct validity. Internal reliability is typically between .80 and .89, and test-retest reliability ranges from .83 (for a 2-week interval) to .54 (for a 4-year interval). Scores do not appear to be affected by sex, age, educational level, health insurance status, or social desirability, but are affected by marital status [2].

Languages: It is available in multiple languages.

QoL Concept: The SWLS is a global measure of Subjective Well-Being (Life Satisfaction), which corresponds to Box E (subjective evaluations and reactions; life satisfaction) of Dijker’s Model.

Permissions/Where to Obtain: Public Domain; The SWLS can be obtained at the Centre for Outcome Measurement in Brain Injury at:http://www.tbims.org/combi/swls/.


  1. Diener E, Emmons RA, Larsen RJ, Griffin S. The satisfaction with life scale. J Pers Assess 1985;49:71-5.

  2. Dijkers MPJM. Correlates of Life Satisfaction among Persons with Spinal Cord Injury. Arch Phys Med Rehabil 1999;80:867-76.


Bowel Dysfunction SCI Studies: One case-control study.

  1. Hicken BL, Putzke JD, Richards JS. Bladder management and quality of life after spinal cord injury. Am J Phys Med Rehabil 2001;80:916-22.

Sensitivity to Impact: Hicken et al. (2001) found that persons with spinal cord injury (SCI; n = 53) who were dependent for assistance in relation to their bladder and bowel care had significantly lower scores on the Satisfaction with Life Scale (SWLS) than matched pairs who were independent in their control (n = 53).  

Suggestions for Use: The SWLS is a reliable and valid measure for the SCI population [1], and appears sensitive to the impact of bowel dysfunction, although it may not be sensitive to different types of bladder dysfunction in people with SCI.  However, one item asks whether individuals would make changes in their life, which has been criticized as being irrelevant for this population [2].  This raises the question of whether a better subjective well-being measure could be developed. In addition, the SWLS only yields a total score, so that it is impossible to differentiate between domains that persons with SCI may be more or less satisfied with [3].

Despite these limitations, the SWLS is part of the data set collected by the National Spinal Cord Injury Statistical Centre (NSCISC) Database, and has been endorsed by the Spinal Cord Outcomes Partnership Endeavor (SCOPE) [4], which is a broad-based international consortium of scientists and clinical researchers representing academic institutions, industry, government agencies, not-for-profit organizations and foundations. However, the endorsement has not been specific to assess the impact of bowel dysfunction.  

Additional References:

  1. Dijkers MPJM. Correlates of Life Satisfaction among Persons with Spinal Cord Injury. Arch Phys Med Rehabil 1999;80:867-76.

  2. Tulsky DS, Rosenthal M. Quality of life measurement in rehabilitation medicine: Building an agenda for the future. Arch Phys Med Rehabil 2002;83:S1-S3.

  3. Post M, Noreau L. Quality of life after spinal cord injury. J Neurol Phys Ther 2005;29:139-46.

  4. Alexander MS, et al. Outcome measures in spinal cord injury: Recent assessments and recommendations for future directions. Spinal Cord 2009:1-10.

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