Psychometric Properties of Two Participation Measures in Veterans with Mild Traumatic Brain Injury

Publication date: Available online 3 June 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Pey-Shan Wen, J. Kay Waid-Ebbs, David P. Graham, Drew A. Helmer
ObjectiveTo compare the psychometric properties of two commonly used participation measures: the Community Reintegration of Service Members (CRIS) and the Participation Assessment with Recombined Tools-Objective (PART-O) in Veterans with mild traumatic brain injury (mTBI).DesignThe data were collected from two cross-sectional observation studies conducted in two Veterans Affairs medical centers.SettingQuestionnaires were completed in-person or by mail.ParticipantsVeterans with mild TBI were recruited from the Michael E. DeBakey Veterans Affairs Medical Center in Houston (N=94) and the Malcom Randall North Florida/South Georgia Veterans Health System (N=107).InterventionsNot applicable.Main Outcome Measures:CRIS and PART-O.ResultsWe conducted Rasch analysis on the PART-O and on three subscales of the CRIS (Extent of Participation, Perceived Limitation, and Satisfaction). For PART-O, results showed PART-O has questionable unidimensionality. For both instruments, some rating categories were under used and rating scales did not advance accordingly. Compared with PART-O, the CRIS was able to distinguish more categories of a person's ability (>5 vs 2 by PART-O ) and had better internal consistency as indicated by higher Cronbach's Alpha (0.96-0.98vs 0.65 for PART-O).ConclusionsTo capture participation unique to Veterans with mTBI, CRIS has greater potential to detect a change in participation and is therefore recommended over PART-O. Rating scales of both instruments, however, need further refinement. We suggest future studies examine collapsed rating categories and use qualitative methods to redefine categories.



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