The development of a new computer adaptive test to evaluate feelings of being trapped in caregivers of individuals with traumatic brain injury: TBI-CareQOL Feeling Trapped Item Bank

Publication date: Available online 31 July 2018

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Noelle E. Carlozzi, Michael A. Kallen, Robin Hanks, Anna L. Kratz, Elizabeth A. Hahn, Tracey A. Brickell, Rael T. Lange, Louis M. French, Phillip A. Ianni, Jennifer A. Miner, Angelle M. Sander

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 of civilians with TBI (n=344) and caregivers of service members/veterans with TBI (n=216).

Interventions

Not applicable.

Outcome Measures

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 (DIF) analyses were conducted, 15 items were retained in the final measure. GRM calibration data, along with clinical expert input, was used to choose a 6-item, static short form, and the calibration data was utilized 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 impact that feelings of being trapped, due to the caregiver role, have on health-related quality of life (HRQOL) for caregivers of individuals with TBI. Both the CAT and corresponding 6-item short form demonstrate excellent psychometric properties. Future work is needed to establish the responsiveness of this measure to clinical interventions for these caregivers.

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