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The Development of a New Computer Adaptive Test to Evaluate Anxiety in Caregivers of Individuals With Traumatic Brain Injury: TBI-CareQOL Caregiver-Specific Anxiety

      Highlights

      • Caregivers of persons with traumatic brain injury often have heightened anxiety.
      • A new self-report measure of caregiver-specific anxiety was developed.
      • This new measure can help identify caregivers with significant anxiety.

      Abstract

      Objective

      To design a new measure of caregiver-specific anxiety for use in caregivers of individuals with traumatic brain injury (TBI), the Traumatic Brain Injury Caregiver Quality of Life (TBI-CareQOL) Caregiver-Specific Anxiety item bank.

      Design

      Cross-sectional survey study.

      Setting

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

      Participants

      Three hundred forty-four caregivers of civilians with TBI and 216 caregivers of service members/veterans with TBI (N=560).

      Interventions

      Not applicable.

      Main Outcome Measures

      TBI-CareQOL Caregiver-Specific Anxiety item bank.

      Results

      The retention of 40 Caregiver-Specific Anxiety items was supported by exploratory and confirmatory factor analyses. Graded response model (GRM) and differential item functioning analyses supported the retention of 33 items in the final measure. Expert review and GRM calibration data was used to select a 6-item static short form, and GRM calibration data was used to program the TBI-CareQOL Caregiver-Specific Anxiety computer adaptive test (CAT).

      Conclusions

      Established, rigorous measurement development standards were used to develop the new TBI-CareQOL Caregiver-Specific Anxiety CAT and corresponding 6-item short form. This measure is the first patient-reported outcome measure designed to assess caregiver-specific anxiety in caregivers of individuals with TBI. The measure exhibits strong psychometric properties.

      Keywords

      List of abbreviations:

      CAT (computer adaptive test), CFA (confirmatory factor analysis), CFI (comparative fit index), DIF (differential item functioning), EFA (exploratory factor analysis), IRT (item response theory), PRO (patient-reported outcome), RMSEA (root mean squared error of approximation), SMV (service member/veteran), TBI (traumatic brain injury), TBI-CareQOL (Traumatic Brain Injury Caregiver Quality of Life), TLI (Tucker-Lewis index)
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