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Measuring Community Integration in Persons With Limb Trauma and Amputation: A Systematic Review

Published:September 06, 2016DOI:https://doi.org/10.1016/j.apmr.2016.08.463

      Abstract

      Objectives

      To conduct a systematic review of community integration measures used with populations with limb trauma, amputation, or both, and to evaluate each measure's focus, content, and psychometric properties.

      Data Sources

      Searches of PubMed and CINAHL for the terms social participation, community integration, social function, outcome assessment, wounds and injuries, and amputation/rehabilitation.

      Study Selection

      Included English-language articles with a sample size of ≥20 adults with limb trauma or amputation. Measures were deemed eligible if they contained a majority of items related to the construct of participation as defined by the International Classification of Functioning, Disability and Health.

      Data Extraction

      Data on internal consistency; test-retest, interrater, and intrarater reliability; content, structural, construct, concurrent, and predictive validity; responsiveness; and floor/ceiling effects were extracted from each article and confirmed by a second investigator.

      Data Synthesis

      A total of 156 articles containing 34 measures and 94 subscales were reviewed. Psychometric properties were rated, and an overall score was calculated for each measure. Content of the highest scoring measures was examined. Scant evidence was found regarding the psychometric properties of most measures. Eight scales from 5 instruments had the strongest measurement properties: the Trinity Amputation and Prosthesis Experience (TAPES) social restriction and adjustment to limitation scales; Community Reintegration of Injured Service Members (CRIS) extent of participation and perceived limitations scales; Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) role-physical and social functioning scales; the 136-item Sickness Impact Profile (SIP) psychosocial domain scale; and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS-II) 12-item total score.

      Conclusions

      Eights scales from 5 instruments—the TAPES, CRIS, SF-36, the 136-item SIP, and the WHODAS-II 12-item measure—had the strongest measurement properties.

      Keywords

      List of abbreviations:

      CRIS (Community Reintegration of Injured Service Members), ICF (International Classification of Functioning, Disability, and Health), QOL (quality of life), SF-36 (Medical Outcomes Study 36-Item Short-Form Health Survey), SIP (Sickness Impact Profile), TAPES (Trinity Amputation and Prosthesis Experience Scales), TBI (traumatic brain injury), WHODAS-II (World Health Organization Disability Assessment Scale 2.0)
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