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.
Similar content being viewed by others
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
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.
Dijkers, M. (1998). Community integration: Conceptual issues and measurement. Topics in Spinal Cord Injury Rehabilitation, 4(1), 1–15.
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.
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.
Carr, A. J., & Thompson, P. W. (1994). Towards a measure of patient-perceived handicap in rheumatoid arthritis. British Journal of Rheumatology, 33, 378–382.
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.
World Health Organization. (2001). International classification of functioning, disability and health. Geneva: World Health Organization.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Andresen, E. M. (2000). Criteria for assessing the tools of disability outcomes research. Archives of Physical Medicine and Rehabilitation, 81(S2), S15–S20.
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.
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.
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.
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.
Streiner, D. L. (2003). Staring at the beginning: An introduction to coefficient alpha and internal consistency. Journal of Personality Assessment, 80, 99–103.
Field, A. P. (2005). Discovering statistics using SPSS (2nd ed.). London: Sage.
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.
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.
Ley, P. (1972). Quantitative aspects of psychological assessment. London: Gerald Duckworth.
Dijkers, M. (1991). Scoring CHART: Survey and sensitivity analysis. The Journal of the American Paraplegia Society, 14, 85–86.
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.
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.
Dijkers, M. (1997). Quality of life after spinal cord injury: A meta analysis of the effects of disablement components. Spinal Cord, 35, 829–840.
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).
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.
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.
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.
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.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
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
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11136-010-9685-6