Mark Sherer1, Julia M P Poritz2, David Tulsky3, Pamela Kisala4, Luis Leon-Novelo5, Esther Ngan5. 1. TIRR Memorial Hermann, Houston, TX; Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX. Electronic address: Mark.Sherer@memorialhermann.org. 2. TIRR Memorial Hermann, Houston, TX; Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX. 3. Department of Physical Therapy, University of Delaware College of Health Sciences, Newark, DE; Kessler Foundation, West Orange, NJ. 4. Department of Physical Therapy, University of Delaware College of Health Sciences, Newark, DE. 5. University of Texas Health Science Center at Houston-School of Public Health, Houston, TX.
Abstract
OBJECTIVE: To determine the factor structure of the Traumatic Brain Injury-Quality of Life (TBI-QOL) measurement system. DESIGN: Observational. SETTING: 3 TBI Model Systems rehabilitation centers. PARTICIPANTS: Twenty TBI-QOL item banks were administered to a sample of community-dwelling adults with TBI (N=504) as part of a study of TBI classification. A subsample of participants (n=200) was randomly selected for exploratory factor analyses, while data from the remaining participants (n=304) were used for the confirmatory factor analysis. To examine a wide range of conceptual models, confirmatory factor analyses were conducted on a total of 16 models, ranging from 1 to 7 factors. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Not applicable. RESULTS: Initial exploratory factor analysis yielded support for a 5-factor model (negative emotion, cognitive impairment, functioning and participation, positive emotion, pain). Confirmatory factor analysis results, however, indicated a 7-factor model including physical function, physical symptoms, cognition, negative emotion, positive emotion, sense of self, and social participation (model 16; robust fit statistics root mean square error of approximation =.063, standardized root mean square residual =.035, comparative fit index =.955, Tucker-Lewis Index =.943, Bayes Information Criterion =40059.44). CONCLUSIONS: The complex 7-factor model of the TBI-QOL provides a more nuanced framework for understanding health-related quality of life for persons with TBI than the commonly used 3-factor model including physical health, mental health, and social health.
OBJECTIVE: To determine the factor structure of the Traumatic Brain Injury-Quality of Life (TBI-QOL) measurement system. DESIGN: Observational. SETTING: 3 TBI Model Systems rehabilitation centers. PARTICIPANTS: Twenty TBI-QOL item banks were administered to a sample of community-dwelling adults with TBI (N=504) as part of a study of TBI classification. A subsample of participants (n=200) was randomly selected for exploratory factor analyses, while data from the remaining participants (n=304) were used for the confirmatory factor analysis. To examine a wide range of conceptual models, confirmatory factor analyses were conducted on a total of 16 models, ranging from 1 to 7 factors. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Not applicable. RESULTS: Initial exploratory factor analysis yielded support for a 5-factor model (negative emotion, cognitive impairment, functioning and participation, positive emotion, pain). Confirmatory factor analysis results, however, indicated a 7-factor model including physical function, physical symptoms, cognition, negative emotion, positive emotion, sense of self, and social participation (model 16; robust fit statistics root mean square error of approximation =.063, standardized root mean square residual =.035, comparative fit index =.955, Tucker-Lewis Index =.943, Bayes Information Criterion =40059.44). CONCLUSIONS: The complex 7-factor model of the TBI-QOL provides a more nuanced framework for understanding health-related quality of life for persons with TBI than the commonly used 3-factor model including physical health, mental health, and social health.
Authors: Jason H Raad; David S Tulsky; Rael T Lange; Tracey A Brickell; Angelle M Sander; Robin A Hanks; Louis French; Jennifer A Miner; Pamela A Kisala; Noelle E Carlozzi Journal: Arch Phys Med Rehabil Date: 2020-04-18 Impact factor: 3.966
Authors: Callie E Tyner; Pamela A Kisala; Aaron J Boulton; Mark Sherer; Nancy D Chiaravalloti; Angelle M Sander; Tamara Bushnik; David S Tulsky Journal: Front Hum Neurosci Date: 2022-03-04 Impact factor: 3.169