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Establishing the Factor Structure of a Health-Related Quality of Life Measurement System for Caregivers of Persons Living with Traumatic Brain Injury
Archives of Physical Medicine and Rehabilitation ( IF 4.3 ) Pub Date : 2020-07-01 , DOI: 10.1016/j.apmr.2020.03.014
Jason H Raad 1 , David S Tulsky 2 , Rael T Lange 3 , Tracey A Brickell 4 , Angelle M Sander 5 , Robin A Hanks 6 , Louis French 7 , Jennifer A Miner 1 , Pamela A Kisala 2 , Noelle E Carlozzi 1
Affiliation  

OBJECTIVE To understand the factor structure of Health-Related Quality of Life (HRQOL) specific to caregivers of people living with Traumatic Brain Injury (TBI). DESIGN Prospective, cross-sectional data collection. SETTING Three TBI Model Systems rehabilitation hospitals, an academic medical center, and a military medical treatment facility. PARTICIPANTS 558 caregivers of people who have sustained a TBI (344 caregivers of civilians and 214 caregivers of service member/veterans; 85% female; 58% spouses; mean age = 46.12, SD =14.07 years) who have provided care for an average of 5.82 (SD = 5.40) years. INTERVENTIONS Not Applicable. MAIN OUTCOMES MEASURE The Traumatic Brain Injury Caregiver Quality of Life (TBI-CareQOL) measurement system including 10 Patient-Reported Outcomes Measurement Information System (PROMIS) item banks (Anger, Anxiety, Depression, Social Isolation, Sleep Disturbance, Fatigue, Ability to Participate in Social Roles and Activities, Satisfaction with Social Roles and Activities, Emotional Support, Informational Support) and five TBI-CareQOL banks (Feelings of Loss-Self, Feelings of Loss-Person with TBI, Feeling Trapped, Caregiver-Specific Anxiety and Caregiver Strain). RESULTS Confirmatory Factor Analysis (CFA) model fit indices were compared for 14 empirically and five theoretically derived models. CFA results indicated that the best model fit was for a six-factor model with dimensions that included: Mental Health, Social Support, Social Participation, Social Isolation, Physical Health, and Caregiver Emotion. CONCLUSION Results indicated a six-factor model provided the best model fit for HRQOL in caregivers of individuals with TBI. These results have utility for both research and clinical applications. Establishing the TBI-CareQOL's factor structure provides preliminary evidence of the measurement system's construct validity, helps inform the selection of measures for specific research or clinical interventions, and informs the development of composite scores.

中文翻译:

为脑外伤患者的护理人员建立与健康相关的生活质量测量系统的因素结构

目的 了解针对创伤性脑损伤 (TBI) 患者的护理人员的健康相关生活质量 (HRQOL) 的因素结构。设计前瞻性、横截面数据收集。设置 三个 TBI 模型系统康复医院、一个学术医疗中心和一个军事医疗设施。参与者 558 名 TBI 患者的护理人员(344 名平民护理人员和 214 名军人/退伍军人护理人员;85% 为女性;58% 为配偶;平均年龄 = 46.12,SD = 14.07 岁),他们平均提供护理时间为5.82 (SD = 5.40) 年。干预措施 不适用。主要结果测量 创伤性脑损伤护理人员生活质量 (TBI-CareQOL) 测量系统,包括 10 个患者报告结果测量信息系统 (PROMIS) 项目库(愤怒、焦虑、抑郁、社交孤立、睡眠障碍、疲劳、参与能力)社会角色和活动、对社会角色和活动的满意度、情感支持、信息支持)和五个 TBI-CareQOL 库(自我丧失感、TBI 患者的失落感、被困感、看护者特定焦虑和看护者紧张) )。结果 对 14 个经验模型和 5 个理论模型的验证性因素分析 (CFA) 模型拟合指数进行了比较。CFA 结果表明,最佳模型拟合是六因素模型,其维度包括:心理健康、社会支持、社会参与、社会孤立、身体健康和护理人员情绪。结论 结果表明,六因素模型为 TBI 患者的护理人员提供了最适合 HRQOL 的模型。这些结果对于研究和临床应用都有用处。建立 TBI-CareQOL 的因子结构为测量系统的构建有效性提供了初步证据,有助于为特定研究或临床干预措施的选择提供信息,并为综合评分的开发提供信息。
更新日期:2020-07-01
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