PURPOSE Caregivers of service members/veterans (SMVs) encounter a number of barriers when navigating the military health care system. The purpose of this study was to develop a new measure to assess potential caregiver frustration with the systems of care and benefits in the United States Departments of Defense and Veterans Affairs. METHOD The TBI-CareQOL Military Health Care Frustration measure was developed using data from 317 caregivers of SMVs with TBI who completed an item pool comprised of 64 questions pertaining to anger or frustration with accessing military health care services. RESULTS Exploratory and confirmatory factor analyses supported the retention of 58 items. Constrained graded response model (GRM) overall fit and item fit analyses and differential item functioning investigations of age and education factors supported the retention of 43 items in the final measure. Expert review and GRM item calibration products were used to inform the selection of two 6-item static short forms (TBI-CareQOL Military Health Care Frustration-Self; TBI-CareQOL Military Health Care Frustration-Person with TBI) and to program the TBI-CareQOL Military Health Care Frustration computer adaptive test (CAT). Preliminary data supported the reliability (i.e., internal consistency and test-retest reliability) as well as the validity (i.e., convergent, discriminant, and known-groups) of the new measure. CONCLUSIONS The new TBI-CareQOL Military Health Care Frustration measure can be used to examine caregiver perceptions of and experience with the military health care system, to target improvements. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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TBI-CareQOL 军事医疗保健对患有脑外伤的服役人员/退伍军人的护理人员造成的挫败感。

目的 军人/退伍军人 (SMV) 的护理人员在使用军队医疗保健系统时会遇到许多障碍。本研究的目的是制定一种新措施来评估护理人员对美国国防部和退伍军人事务部的护理和福利系统的潜在不满。方法 TBI-CareQOL 军事医疗保健挫败感测量是根据 317 名患有 TBI 的 SMV 护理人员的数据制定的，他们完成了一个项目池，该项目库包含 64 个与获得军事医疗保健服务时感到愤怒或沮丧有关的问题。结果 探索性和验证性因素分析支持保留 58 个项目。约束分级反应模型 (GRM) 整体拟合和项目拟合分析以及年龄和教育因素的差异项目功能调查支持在最终测量中保留 43 个项目。使用专家评审和 GRM 项目校准产品来通知选择两个 6 项目静态简表（TBI-CareQOL 军事医疗保健挫败感 - 自我；TBI-CareQOL 军事医疗保健挫败感 - 患有 TBI 的人），并对 TBI- 进行编程CareQOL 军事医疗保健挫败感计算机自适应测试 (CAT)。初步数据支持新测量的可靠性（即内部一致性和重测可靠性）以及有效性（即收敛性、判别性和已知组）。结论 新的 TBI-CareQOL 军事医疗保健挫败感测量可用于检查护理人员对军事医疗保健系统的看法和经验，以制定改进目标。（PsycINFO 数据库记录 (c) 2020 APA，保留所有权利）。