Quality of Life Concepts

Secondary Health Conditions

Life Situation Questionnaire - Revised (LSQ-R)

Description: A measure of subjective well-being that assesses an individual’s current level of satisfaction with various domains of life.  It also requires individuals to rate the degree to which different areas of their lives have caused them problems.  The LSQ-R is embedded into a larger survey, the Life Situation Questionnaire (LSQ), which measures a broad range of long-term spinal cord injury (SCI) outcomes, including those related to employment, medical treatments, social activities, and subjective well-being.

Format: 50 items divided into two parts:
Part 1 (Satisfaction; 20 items) on a five point scale:

1 = Very Dissatisfied
2 = Dissatisfied 
3 = Neutral
4 = Satisfied
5 = Very Satisfied

Part 2 (Problems; 30 items) on a five point scale anchored by two statements (1 = No Problem; 5 = Major Problem).

Scoring: Eight subjective well-being scales are embedded into the LSQ-R derived from the two major parts of the scale (Satisfaction and Problems).

Administration and Burden: Interviewer-administered; Self-administered.  Approximately 10 minutes.

Psychometrics for SCI: The LSQ or its revised form has not been used consistently in the SCI population, with discrepancies being found with the number of items used and scales developed, but has high levels of reliability (Cronbach’s α =.76-.86) [1].

Language(s):  English.

QoL Concept: The LSQ-R is a measure of Subjective Well-Being, which corresponds to Box E (subjective evaluations and reactions) of Dijker’s Model.

Permissions/Where to Obtain: The LSQ-R may be obtained by contacting Dr. James Krause at the Medical University of South Carolina.


  1. Hallin P, Sullivan M, Kreuter M. Spinal cord injury and quality of life measures: a review of instrument psychometric quality. Spinal Cord 2000;38:509-23.


Pressure Ulcer SCI Studies: Two cross-sectional observational studies:

  1. Saladin LK, Krause JS. Pressure ulcer prevalence and barriers to treatment after spinal cord injury: Comparisons of four groups based on race-ethnicity. NeuroRehabi 2009;24:57-66.

  2. Krause JS. Skin sores after spinal cord injury: relationship to life adjustment. Spinal Cord 1998;36:51-6.

Sensitivity to Impact:  Krause (1998) found in a sample of community-dwelling persons with spinal cord injury (SCI; N = 1,017) that sores (pressure ulcers) were related to a lesser quality of life (QoL) as measured by the Life Situation Questionnaire – Revised (LSQ-R). Specifically, having at least one skin sore over a 2-year period was associated with lower levels of subjective well-being and activity, and greater health problems. 

Saladin and Krause (2009) compared prevalence of pressure ulcer and barriers to treatment in a sample of community-dwelling persons with SCI (N = 475) but did not use the LSQ-R to assess subjective well-being. Rather, they modified the LSQ-R to independently focus on societal barriers to maintaining bed rest and seeking treatment in the event of an open sore. Although the items used were found to be sensitive to barriers that were societal in nature, these additions are study specific, raising issues of reliability, validity and generalizability to the larger SCI population. These additional items related to pressure ulcers can be found in the article by Saladin and Krause (2009).

Suggestions for Use: The LSQ-R was developed for the SCI population and has been used in several SCI studies [1]. A strength of the tool is that it includes condition-specific items (e.g., pressure ulcers noted as ‘skin sores’), but has not been used consistently (modifications, addition of items, etc.). The evidence suggests that the LSQ-R is an appropriate measure to assess impact of pressure ulcers on subjective well-being but may need to be used in conjunction with the larger survey (LSQ) to detect an effect or with another measure of subjective well-being validated for the SCI population. 

Additional References:

  1. Hallin P, Sullivan M, Kreuter M. Spinal cord injury and quality of life measures: a review of instrument psychometric quality. Spinal Cord 2000;38:509-23.
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