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Arch Phys Med Rehabil. 2019 Apr;100(4S):S94-S101. doi: 10.1016/j.apmr.2018.05.021. Epub 2018 Jun 19.

Understanding Health-related Quality of Life in Caregivers of Civilians and Service Members/Veterans With Traumatic Brain Injury: Establishing the Reliability and Validity of PROMIS Mental Health Measures.

Author information

1
Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI. Electronic address: carlozzi@med.umich.edu.
2
Department of Psychology and Neuropsychology, Rehabilitation Institute of Michigan, Detroit, MI; Department of Physical Medicine and Rehabilitation, Wayne State University, Detroit, MI.
3
Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD; National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD; University of British Columbia, Vancouver, British Columbia, Canada.
4
Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD; National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD; Uniformed Services University of the Health Sciences, Bethesda, MD.
5
Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI.
6
Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL.
7
H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine & Harris Health System, Houston, TX; Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX.

Abstract

OBJECTIVE:

To provide important reliability and validity data to support the use of the Patient-Reported Outcomes Measurement Information System (PROMIS) mental health measures in caregivers of civilians or service members/veterans (SMVs) with traumatic brain injury (TBI).

DESIGN:

Patient-reported outcome surveys administered through an electronic data collection platform.

SETTING:

Three TBI model systems rehabilitation hospitals, an academic medical center, and a military medical treatment facility.

PARTICIPANTS:

Caregivers (N=560) of individuals with a documented TBI (344 civilians and 216 military).

INTERVENTION:

Not applicable.

MAIN OUTCOME MEASURES:

PROMIS anxiety, depression, and anger item banks.

RESULTS:

Internal consistency for all the PROMIS Mental Health item banks was very good (all α>.86) and 3-week test-retest reliability was good to adequate (ranged from .65 to .85). Convergent validity and discriminant validity of the PROMIS measures were also supported. Caregivers of individuals who were low functioning had worse emotional health-related quality of life (HRQOL) (as measured by the 3 PROMIS measures) than caregivers of high-functioning individuals, supporting known groups validity. Finally, levels of distress, as measured by the PROMIS measures, were elevated for those caring for low-functioning individuals in both samples (rates ranged from 26.2% to 43.6% for caregivers of low-functioning individuals).

CONCLUSIONS:

Results support the reliability and validity of the PROMIS anxiety, depression, and anger item banks in caregivers of civilians and SMVs with TBI. Ultimately, these measures can be used to provide a standardized assessment of HRQOL because it relates to mental health in these caregivers.

KEYWORDS:

Anger; Anxiety; Caregiver; Depression; Emotion; Patient reported outcome measures; Psychometrics; Rehabilitation; Traumatic brain injury

PMID:
29932885
PMCID:
PMC6301134
[Available on 2020-04-01]
DOI:
10.1016/j.apmr.2018.05.021

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