Latent Factors in Measures of Rehabilitation Outcomes After Traumatic Brain Injury

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Abstract

Objectives

To determine whether there is a latent structure among measures used to evaluate rehabilitation outcomes for persons with traumatic brain injury and if the construct of participation is discernible within this structure.

Design

Exploratory factor analyses of 2 cross-sectional cohorts of rehabilitation patients who sustained a traumatic brain injury up to 5 years prior to assessment.

Primary Measures

Community Integration Questionnaire (CIQ), Craig Handicap Assessment and Reporting Technique (CHART), Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and the Satisfaction With Life Scale (SWLS).

Results

Both factor analyses suggested a latent structure composed of 3 factors that were interpreted as representing the Activities and Participation dimensions of the World Health Organization's International Classification of Functioning, Disability and Health (ICF), and a third representing Subjective Well-Being. Low to moderate correlations were found between factors.

Conclusions

The World Health Organization's ICF excludes subjective well-being; however the factor analyses indicate that it is a distinct domain not incorporated into Activities and Participation. The SF-36, CIQ, and CHART can, in combination, evaluate all 3 domains, but not alone. The SF-36 appears to be sensitive to the affective, but not the cognitive, aspect of Subjective Well-Being. A measure of life satisfaction would be a useful supplement to traditional measures of rehabilitation outcome.

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