The Development of a New Computer-Adaptive Test to Evaluate Strain in Caregivers of Individuals With TBI: TBI-CareQOL Caregiver Strain

Publication date: Available online 25 August 2018

Source: Archives of Physical Medicine and Rehabilitation

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

Abstract

Objective

To develop a new measure of caregiver strain for use in caregivers of individuals with traumatic brain injury (TBI), Traumatic Brain Injury Caregiver Quality of Life (TBI-CareQOL) Caregiver Strain.

Design

Qualitative data, literature reviews, and cross-sectional survey study.

Setting

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

Participants

Caregivers (N=560) of civilians (n=344) or service members/veterans (SMVs) with TBI (n=216).

Interventions

Not applicable.

Main Outcome Measure

TBI-CareQOL Caregiver Strain Item Bank.

Results

Exploratory and confirmatory factor analyses, a graded response model (GRM) and differential item functioning supported the retention of 33 items in the final measure. GRM calibration data was used to inform the selection of a 6-item static short form, and to program the TBI-CareQOL Caregiver Strain computer-adaptive test (CAT). CAT simulation analyses indicated a 0.97 correlation between the CAT scores and the full item-bank. Three-week test-retest reliability was strong (r=0.83).

Conclusions

The new TBI-CareQOL Caregiver Strain CAT and corresponding 6-item short form were developed using established rigorous measurement development standards; this is the first self-reported measure developed to evaluate caregiver strain in caregivers of individuals with TBI.

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