Highlights
- •Caregivers of persons with traumatic brain injury often feel trapped.
- •The Traumatic Brain Injury Caregiver Quality of Life Feeling Trapped item bank was developed to assess quality of life in caregivers.
- •This new measure addresses an important caregiver emotional concern.
Abstract
Objective
To develop a new patient-reported outcome measure that captures feelings of being
trapped that are commonly experienced by caregivers of individuals with traumatic
brain injury (TBI).
Design
Cross-sectional.
Setting
Three TBI Model Systems rehabilitation hospitals, an academic medical center, and
a military medical treatment facility.
Participants
Caregivers (N=560) of civilians with TBI (n=344) and caregivers of service members/veterans
with TBI (n=216).
Interventions
Not applicable.
Outcome Measures
Traumatic Brain Injury Caregiver Quality of Life (TBI-CareQOL) Feeling Trapped item
bank.
Results
From an initial item pool of 28 items, exploratory and confirmatory factor analyses
supported the retention of 16 items. After graded response model (GRM) and differential
item functioning analyses were conducted, 15 items were retained in the final measure.
GRM calibration data, along with clinical expert input, were used to choose a 6-item,
static short form (SF), and the calibration data were used for programming of the
TBI-CareQOL Feeling Trapped computer adaptive test (CAT). CAT simulation analyses
produced an r=0.99 correlation between CAT scores and the full item bank. Three-week short-form
test-retest reliability was very good (r=0.84).
Conclusions
The new TBI-CareQOL Feeling Trapped item bank was developed to provide a sensitive
and efficient examination of the effect that feelings of being trapped, due to the
caregiver role, have on health-related quality of life for caregivers of individuals
with TBI. Both the CAT and corresponding 6-item SF demonstrate excellent psychometric
properties. Future work is needed to establish the responsiveness of this measure
to clinical interventions for these caregivers.
Keywords
List of abbreviations:
CAT (computer adaptive test), CFA (confirmatory factor analysis), DIF (differential item functioning), EFA (exploratory factor analysis), GRM (graded response model), IRT (item response theory), SF (short form), SMV (service member/veteran), TBI (traumatic brain injury), TBI-CareQOL (Traumatic Brain Injury Caregiver Quality of Life)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 01, 2018
Footnotes
Supported by the National Institutes of Health-National Institute of Nursing Research (grant no. R01NR013658), the National Center for Advancing Translational Sciences (grant no. UL1TR000433), and the Defense and Veterans Brain Injury Center.
Disclosures: none.
Disclaimer: The identification of specific products or scientific instrumentation does not constitute endorsement or implied endorsement on the part of the author, Department of Defense, or any component agency. While we generally exercise reference to products, companies, manufacturers, organizations, etc in government-produced works, the abstracts produced and other similarly situated research present a special circumstance when such a product inclusions become an integral part of the scientific endeavor.
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© 2018 by the American Congress of Rehabilitation Medicine
