Quality of Life Concepts

Secondary Health Conditions

Human Service Scale (HSS)

Description: An assessment instrument for measuring the progress of the rehabilitation client and the effectiveness of rehabilitation programs [1]. The theory behind the scale is based on Maslow's hierarchy of human needs.

Format: 80-items that assess psycho-social adjustment, which is determined by scores on seven scales (‘Physiological’, ‘Emotional Security’, ‘Social’, ‘Family’, ‘Economic Security’, ‘Economic’, ‘Self-Esteem’, and ‘Vocational Self-Actualization’).

Scoring: No information available.

Administration and Burden: Approximately 20 minutes.

Psychometrics for SCI: The content validity from other health populations was computed at .91. The psychometric properties have not been established for use with the spinal cord injury (SCI) population.

Language(s): English.

QoL Concept: The HSS is a measure of Subjective Well-Being that encompasses social support, which corresponds to Boxes C (achievements; relationships) and E (subjective evaluations and reactions) of Dijker’s Model.

Permissions/Where to Obtain: Information not available.

References:

Reagles KW, Butler AS. The Human Service Scale: A new measure for evaluation. J Rehab 1976;42:34-48.

CLICK ON THE LISTED SECONDARY HEALTH CONDITIONS ON THE LEFT TO READ HOW THE HSS HAS BEEN USED WITH A PARTICULAR CONDITION


Pressure Ulcer SCI Studies: One cross-sectional observational study:

  1. Gordon WA, Harasymiw S, Bellile S, Lehman L, Sherman B. The relationship between pressure sores and psychosocial adjustment in persons with spinal cord injury. Rehab Psychol 1982; 27:185-91.

Sensitivity to Impact: Gordon and colleagues (1982) found that having a pressure ulcer as a spinal cord injured (SCI) in-patient (N = 566) was associated with lower scores on psychosocial adjustment, assessed via the Human Service Scale (HSS), one to four years later post-injury. They also found that ‘Economic Self-Esteem’ was negatively affected, and were also related to other independent factors (i.e., sex, race, impairment, and occupation). The findings replicated and extended those of Anderson and Andberg [1], who examined the impact of pressure ulcers on self-esteem and life satisfaction in people with SCI, but the relationships and effect sizes detected were not straightforward or as strong as expected. This suggested that the association between pressure ulcers and social adjustment is complex, and mediated by other factors.

Suggestions for Use: Although the HSS was developed for use in rehabilitation populations, it has not been used widely with SCI samples. The findings by Gordon et al. (1982) do not provide strong support that the presence of pressure ulcers negatively impact scores on the HSS. It is strongly recommended that if the HSS is used, then it should be paired with another measure of subjective well-being that has been validated for the SCI population.    

Additional References:

  1. Anderson TP, Andberg MM. Psychosocial factors associated with pressure sores. Arch Phys Med Rehabil 1979;60:341-6.
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