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Measuring community integration after spinal cord injury: validation of the Sydney psychosocial reintegration scale and community integration measure

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Abstract

Objectives

To evaluate the reliability, validity, sensitivity to change, and clinical usefulness of the Sydney Psychosocial Reintegration Scale (SPRS) and Community Integration Measure (CIM) for people with spinal cord injury (SCI).

Methods

A sample of 58 people with recent traumatic SCI was followed up at 12 months post-discharge from inpatient rehabilitation. The SPRS, CIM, Craig Handicap Assessment and Reporting Technique (CHART) and SF-6D Health Utility Scale (SF-6D) were administered.

Results

The SPRS and CIM were internally consistent (α = .80 and .78, respectively). The SPRS showed greatest sensitivity to change as measured by percentage of participants meeting minimum difference in score change over time (21%). CIM and CHART had comparable sensitivity to change (14% minimum difference). SPRS correlated significantly with CHART (r = .72, P < .001), unlike CIM. Neither SPRS nor CIM discriminated between high and low impairment, unlike CHART. Correlations with CHART and SF-6D domains supported convergent and divergent validity of the SPRS domains.

Conclusions

Research should continue to develop conceptually and psychometrically valid instruments to capture the multidimensionality of community integration. The SPRS and CIM show potential to extend measurement of community reintegration following SCI.

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Abbreviations

ASIA:

American Spinal Injury Association

CIM:

Community Integration Measure

CHART:

Craig Handicap Assessment and Reporting Technique

ES:

Effect size

MD:

Minimum difference

MOS SF-36:

Medical outcomes study short-form health questionnaire

SCI:

Spinal cord injury

SF-6D:

Health Utility Scale

SPRS:

Sydney Psychosocial Reintegration Scale

TBI:

Traumatic Brain Injury

References

  1. Noreau, L., Fougeyrollas, P., Post, M., & Asano, M. (2005). Participation after spinal cord injury: The evolution of conceptualization and measurement. Journal of Neurologic Physical Therapy, 29(3), 147–156.

    PubMed  Google Scholar 

  2. Dijkers, M. (1998). Community integration: Conceptual issues and measurement. Topics in Spinal Cord Injury Rehabilitation, 4(1), 1–15.

    Article  Google Scholar 

  3. Gray, D. B., & Hendershot, G. E. (2000). The ICIDH-2: Developments for a new era of outcomes research. Archives of Physical Medicine and Rehabilitation, 81, S10–S14.

    Article  CAS  PubMed  Google Scholar 

  4. Cardol, M., Brandsma, J. W., de Groot, I. J. M., van den Bos, G. A. M., de Haan, R. J., & de Jong, B. A. (1999). Handicap questions: What do they assess? Disability and Rehabilitation, 21(3), 97–105.

    Article  CAS  PubMed  Google Scholar 

  5. Carr, A. J., & Thompson, P. W. (1994). Towards a measure of patient-perceived handicap in rheumatoid arthritis. British Journal of Rheumatology, 33, 378–382.

    Article  CAS  PubMed  Google Scholar 

  6. McColl, M. A., Carlson, P., Johnston, J., Minnes, P., Shue, K., Davies, D., et al. (1998). The definition of community integration: Perspectives of people with brain injuries. Brain Injury, 12(1), 15–30.

    Article  CAS  PubMed  Google Scholar 

  7. World Health Organization. (2001). International classification of functioning, disability and health. Geneva: World Health Organization.

    Google Scholar 

  8. Whiteneck, G. G., Charlifue, S. W., Gerhart, K. A., Drew, O. J., & Richardson, G. N. (1992). Quantifying handicap: A new measure of long-term rehabilitation outcomes. Archives of Physical Medicine and Rehabilitation, 73(June), 519–525.

    CAS  PubMed  Google Scholar 

  9. Mellick, D., Walker, N., Brooks, C., & Gale, W. (1999). Incorporating the cognitive independence domain into CHART. Journal of Rehabilitation Outcomes Measurements, 3(3), 12–21.

    Google Scholar 

  10. World Health Organization. (1980). International classification of impairments, disabilities, and handicap: A manual of classification relating to the consequences of disease. Geneva: World Health Organization.

    Google Scholar 

  11. Hall, K. M., Dijkers, M., Whiteneck, G. G., Brooks, C., & Krause, J. S. (1998). The Craig Handicap Assessment and Reporting Technique (CHART): Metric properties and scoring. Topics in Spinal Cord Injury Rehabilitation, 4(1), 16–30.

    Article  Google Scholar 

  12. Tate, R., Hodgkinson, A., Veerabangsa, A., & Maggiotto, S. (1999). Measuring psychosocial recovery after traumatic brain injury: Psychometric properties of a new scale. The Journal of Head Trauma Rehabilitation, 14(6), 543–557.

    Article  CAS  PubMed  Google Scholar 

  13. Tate, R., Pfaff, A., Veerabangsa, A., & Hodgkinson, A. (2004). Measuring psychosocial recovery after brain injury: Change versus competency. The Journal of Head Trauma Rehabilitation, 85(1), 538–545.

    Google Scholar 

  14. McColl, M. A., Davies, D., Carlson, P., Johnston, J., & Minnes, P. (2001). The community integration measure: Development and preliminary validation. Archives of Physical Medicine and Rehabilitation, 82, 429–434.

    Article  CAS  PubMed  Google Scholar 

  15. De Wolf, A. C., Cameron, I. D., Middleton, J. W., & Quirk, R. (2008). Community integration and participation following spinal cord injury: A 2 year follow-up. Journal of Rehabilitation Medicine, 40(suppl 47), 106.

    Google Scholar 

  16. Kuipers, P., Kendall, M., Fleming, J., & Tate, R. (2004). Comparison of the Sydney Psychosocial Reintegration Scale (SPRS) with the Community Integration Questionnaire (CIQ): Administration and psychometric properties of two outcome measures. Brain Injury, 18(2), 161–177.

    Article  PubMed  Google Scholar 

  17. Andresen, E. M. (2000). Criteria for assessing the tools of disability outcomes research. Archives of Physical Medicine and Rehabilitation, 81(S2), S15–S20.

    Article  CAS  PubMed  Google Scholar 

  18. Brazier, J., Roberts, J., & Deverill, M. (2002). The estimation of a preference-based measure of health from the SF-36. Journal of Health Economics, 21, 271–292.

    Article  PubMed  Google Scholar 

  19. Walker, N., Mellick, D., Brooks, C., & Whiteneck, G. G. (2003). Measuring participation across impairment groups using the Craig Handicap Assessment and Reporting Technique. American Journal of Physical Medicine and Rehabilitation, 82(12), 936–941.

    Article  PubMed  Google Scholar 

  20. Ware, J. E., Snow, K. K., Kolinski, M., & Gandeck, B. (1993). SF-36 Health survey manual and interpretation Guide. Boston, MA: The Health Institute, New England Medical Centre.

    Google Scholar 

  21. Lee, B. B., King, M. T., Haran, M. J., Stockler, M. R., Marial, O., & Salkeld, G. (2008). Validity, responsiveness, and minimal important difference for the SF-6D Health Utility Scale in a spinal cord injured population. Value Health, 11(4), 680–688.

    Article  PubMed  Google Scholar 

  22. Streiner, D. L. (2003). Staring at the beginning: An introduction to coefficient alpha and internal consistency. Journal of Personality Assessment, 80, 99–103.

    Article  PubMed  Google Scholar 

  23. Field, A. P. (2005). Discovering statistics using SPSS (2nd ed.). London: Sage.

    Google Scholar 

  24. Tate, R. L., Perdices, M., & Maggiotto, S. (1998). Stability of the Wisconsin Card Sorting Test and the determination of reliability of change scores. The Clinical Neuropsychologist, 12(3), 348–357.

    Google Scholar 

  25. Perdices, M. (2005). How do you know whether your patient is getting better (or worse)? A user’s guide. Brain Impairment, 6(3), 219–226.

    Article  Google Scholar 

  26. Ley, P. (1972). Quantitative aspects of psychological assessment. London: Gerald Duckworth.

    Google Scholar 

  27. Dijkers, M. (1991). Scoring CHART: Survey and sensitivity analysis. The Journal of the American Paraplegia Society, 14, 85–86.

    Google Scholar 

  28. Schuck, P., & Zwingmann, C. (2003). The ‘smallest real difference’ as a measure of sensitivity to change: A critical analysis. International Journal of Rehabilitation Research, 26(2), 85–91.

    Article  PubMed  Google Scholar 

  29. Betz, N. E. (2000). Test construction. In F. T. L. Leong & J. T. Austin (Eds.), The psychology research handbook: A guide for graduate students and research (pp. 239–250). Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  30. Dijkers, M. (1997). Quality of life after spinal cord injury: A meta analysis of the effects of disablement components. Spinal Cord, 35, 829–840.

    Article  CAS  PubMed  Google Scholar 

  31. Dijkers, M., Whiteneck, G. G., & El-Jaroudi, R. (2000). Measures of social outcomes in disability research. Archives of Physical Medicine and Rehabilitation, 81(Suppl 2).

  32. Iida, H., Tachibana, S., Kitahara, T., Horiike, S., Ohwada, T., & Fujii, K. (1999). Association of head trauma with cervical spine injury, spinal cord injury, or both. Journal of Trauma, 46(3), 450–452.

    Article  CAS  PubMed  Google Scholar 

  33. Roth, E., Davidoff, G., Thomas, P., Doljanac, R., Dijkers, M., Berent, S., et al. (1989). A controlled study of neuropsychological deficits in acute spinal cord injury patients. Paraplegia, 27(6), 480–489.

    CAS  PubMed  Google Scholar 

  34. Davidoff, G., Thomas, P., Johnson, M., Berent, S., Dijkers, M., & Doljanac, R. (1988). Closed head injury in acute traumatic spinal cord injury: Incidence and risk factors. Archives of Physical Medicine and Rehabilitation, 69(10), 869–872.

    CAS  PubMed  Google Scholar 

  35. Whiteneck, G. G., Tate, D., & Charlifue, S. W. (1999). Predicting community reintegration after spinal cord injury from demographic and injury characteristics. Archives of Physical Medicine and Rehabilitation, 80, 1485–1491.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Annelies De Wolf.

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De Wolf, A., Lane-Brown, A., Tate, R.L. et al. Measuring community integration after spinal cord injury: validation of the Sydney psychosocial reintegration scale and community integration measure. Qual Life Res 19, 1185–1193 (2010). https://doi.org/10.1007/s11136-010-9685-6

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  • DOI: https://doi.org/10.1007/s11136-010-9685-6

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