Noelle E Carlozzi1, Michael A Kallen2, Phillip A Ianni3, Angelle M Sander4, Elizabeth A Hahn2, Rael T Lange5, Tracey A Brickell6, Louis M French6, Jennifer A Miner3, Robin Hanks7. 1. Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI. Electronic address: carlozzi@med.umich.edu. 2. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL. 3. Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI. 4. H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine & Harris Health System, Houston, TX; Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX. 5. Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD; National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD; University of British Columbia, Vancouver, British Columbia, Canada. 6. Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD; National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD; Uniformed Services University of the Health Sciences, Bethesda, MD. 7. Department of Psychology and Neuropsychology, Rehabilitation Institute of Michigan, Detroit, MI; Department of Physical Medicine and Rehabilitation, Wayne State University, Detroit, MI.
Abstract
OBJECTIVE: To develop new patient-reported outcome (PRO) measures to better understand feelings of loss in caregivers of individuals with traumatic brain injury (TBI). DESIGN: Cross-sectional survey study. SETTING: Three TBI Model Systems rehabilitation hospitals, an academic medical center, and a military medical treatment facility. PARTICIPANTS: Caregivers (N=560) of civilians with TBI (n=344) or service members/veterans (SMVs) with TBI (n=216). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Traumatic Brain Injury Caregiver Quality of Life (TBI-CareQOL) Feelings of Loss-Self and TBI-CareQOL Feelings of Loss-Person with Traumatic Brain Injury item banks. RESULTS: While the initial exploratory and confirmatory factor analyses of the feelings of loss item pool (98 items) potentially supported a unidimensional set of items, further analysis indicated 2 different factors: Feelings of Loss-Self (43 items) and Feelings of Loss-Person with TBI (20 items). For Feelings of Loss-Self, an additional 13 items were deleted due to item-response theory-based item misfit; the remaining 30 items had good overall model fit (comparative fit index [CFI]=0.96, Tucker-Lewis index [TLI]=.96, root mean squared error of approximation [RMSEA]=.10). For Feelings of Loss-Other, 1 additional item was deleted due to an associated high correlated error modification index value; the final 19 items evidenced good overall model fit (CFI=0.97, TLI=.97, RMSEA=.095). The final item banks were developed to be administered as either a Computer Adaptive Test (CAT) or a short-form (SF). Clinical experts approved the content of the 6-item SFs of the 2 measures (3-week test-retest was r=.87 for Feelings of Loss-Self and r=.85 for Feelings of Loss-Person with TBI). CONCLUSIONS: The findings from this study resulted in the development of 2 new PROs to assess feelings of loss in caregivers of individuals with TBI; TBI-CareQOL Feelings of Loss-Self and TBI-CareQOL Feelings of Loss-Person with TBI. Good psychometric properties were established and an SF was developed for ease of use in clinical situations. Additional research is needed to determine concurrent and predictive validity of these measures in the psychological treatment of those caring for persons with TBI.
OBJECTIVE: To develop new patient-reported outcome (PRO) measures to better understand feelings of loss in caregivers of individuals with traumatic brain injury (TBI). DESIGN: Cross-sectional survey study. SETTING: Three TBI Model Systems rehabilitation hospitals, an academic medical center, and a military medical treatment facility. PARTICIPANTS: Caregivers (N=560) of civilians with TBI (n=344) or service members/veterans (SMVs) with TBI (n=216). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Traumatic Brain Injury Caregiver Quality of Life (TBI-CareQOL) Feelings of Loss-Self and TBI-CareQOL Feelings of Loss-Person with Traumatic Brain Injury item banks. RESULTS: While the initial exploratory and confirmatory factor analyses of the feelings of loss item pool (98 items) potentially supported a unidimensional set of items, further analysis indicated 2 different factors: Feelings of Loss-Self (43 items) and Feelings of Loss-Person with TBI (20 items). For Feelings of Loss-Self, an additional 13 items were deleted due to item-response theory-based item misfit; the remaining 30 items had good overall model fit (comparative fit index [CFI]=0.96, Tucker-Lewis index [TLI]=.96, root mean squared error of approximation [RMSEA]=.10). For Feelings of Loss-Other, 1 additional item was deleted due to an associated high correlated error modification index value; the final 19 items evidenced good overall model fit (CFI=0.97, TLI=.97, RMSEA=.095). The final item banks were developed to be administered as either a Computer Adaptive Test (CAT) or a short-form (SF). Clinical experts approved the content of the 6-item SFs of the 2 measures (3-week test-retest was r=.87 for Feelings of Loss-Self and r=.85 for Feelings of Loss-Person with TBI). CONCLUSIONS: The findings from this study resulted in the development of 2 new PROs to assess feelings of loss in caregivers of individuals with TBI; TBI-CareQOLFeelings of Loss-Self and TBI-CareQOLFeelings of Loss-Person with TBI. Good psychometric properties were established and an SF was developed for ease of use in clinical situations. Additional research is needed to determine concurrent and predictive validity of these measures in the psychological treatment of those caring for persons with TBI.
Authors: Jean A Langlois; Scott R Kegler; Jacqui A Butler; Karen E Gotsch; Renee L Johnson; Audrey A Reichard; Kevin W Webb; Victor G Coronado; Anbesaw W Selassie; David J Thurman Journal: MMWR Surveill Summ Date: 2003-06-27
Authors: Angelle M Sander; Jerome S Caroselli; Walter M High; Cory Becker; Leah Neese; Randy Scheibel Journal: Brain Inj Date: 2002-08 Impact factor: 2.311
Authors: Noelle E Carlozzi; Michael A Kallen; Robin Hanks; Elizabeth A Hahn; Tracey A Brickell; Rael T Lange; Louis M French; Anna L Kratz; David S Tulsky; David Cella; Jennifer A Miner; Phillip A Ianni; Angelle M Sander Journal: Arch Phys Med Rehabil Date: 2018-09-07 Impact factor: 3.966
Authors: Noelle E Carlozzi; Rael T Lange; Louis M French; Michael A Kallen; Nicholas R Boileau; Robin A Hanks; Risa Nakase-Richardson; Jill P Massengale; Angelle M Sander; Elizabeth A Hahn; Jennifer A Miner; Tracey A Brickell Journal: Rehabil Psychol Date: 2020-01-09
Authors: Robin A Hanks; Nicholas R Boileau; Andria L Norman; Risa Nakase-Richardson; Kyr Hudson Mariouw; Noelle E Carlozzi Journal: Rehabil Psychol Date: 2020-01-09
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: Noelle E Carlozzi; Phillip A Ianni; Rael T Lange; Tracey A Brickell; Michael A Kallen; Elizabeth A Hahn; Louis M French; David Cella; Jennifer A Miner; David S Tulsky Journal: Arch Phys Med Rehabil Date: 2018-07-31 Impact factor: 3.966
Authors: Noelle E Carlozzi; Nicholas R Boileau; Michael A Kallen; Risa Nakase-Richardson; Elizabeth A Hahn; David S Tulsky; Jennifer A Miner; Robin A Hanks; Jill P Massengale; Rael T Lange; Tracey A Brickell; Louis M French; Phillip A Ianni; Angelle M Sander Journal: Rehabil Psychol Date: 2019-12-12
Authors: Noelle E Carlozzi; Rael T Lange; Louis M French; Angelle M Sander; Phillip A Ianni; David S Tulsky; Jennifer A Miner; Michael A Kallen; Tracey A Brickell Journal: Arch Phys Med Rehabil Date: 2018-06-30 Impact factor: 3.966
Authors: Noelle E Carlozzi; Nicholas R Boileau; Robin A Hanks; Angelle M Sander; Risa Nakase-Richardson; Jill P Massengale Journal: Rehabil Psychol Date: 2020-08-10