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Arch Phys Med Rehabil. 2019 Apr;100(4S):S13-S21. doi: 10.1016/j.apmr.2018.05.033. Epub 2018 Aug 25.

The Development of a New Computer-Adaptive Test to Evaluate Strain in Caregivers of Individuals With TBI: TBI-CareQOL Caregiver Strain.

Author information

1
Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI. Electronic address: carlozzi@med.umich.edu.
2
Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL.
3
Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI.
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
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.
6
Rehabilitation Institute of Michigan, Department of Psychology and Neuropsychology, Detroit, MI; Department of Physical Medicine and Rehabilitation, Wayne State University, Detroit, MI.
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 develop a new measure of caregiver strain for use in caregivers of individuals with traumatic brain injury (TBI), Traumatic Brain Injury Caregiver Quality of Life (TBI-CareQOL) Caregiver Strain.

DESIGN:

Qualitative data, literature reviews, and cross-sectional survey study.

SETTING:

Three TBI Model Systems rehabilitation hospitals, an academic medical center, and a military medical treatment facility.

PARTICIPANTS:

Caregivers (N=560) of civilians (n=344) or service members/veterans (SMVs) with TBI (n=216).

INTERVENTIONS:

Not applicable.

MAIN OUTCOME MEASURE:

TBI-CareQOL Caregiver Strain Item Bank.

RESULTS:

Exploratory and confirmatory factor analyses, a graded response model (GRM) and differential item functioning supported the retention of 33 items in the final measure. GRM calibration data was used to inform the selection of a 6-item static short form, and to program the TBI-CareQOL Caregiver Strain computer-adaptive test (CAT). CAT simulation analyses indicated a 0.97 correlation between the CAT scores and the full item-bank. Three-week test-retest reliability was strong (r=0.83).

CONCLUSIONS:

The new TBI-CareQOL Caregiver Strain CAT and corresponding 6-item short form were developed using established rigorous measurement development standards; this is the first self-reported measure developed to evaluate caregiver strain in caregivers of individuals with TBI.

KEYWORDS:

Caregiver; Health-related quality of life; Military family; Patient reported outcome; Rehabilitation; Traumatic brain injury; Veterans

PMID:
29966647
PMCID:
PMC6389439
[Available on 2020-04-01]
DOI:
10.1016/j.apmr.2018.05.033

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