The Safety Assessment Measure for persons with traumatic brain injury: Item pool development and content validity

Issue title: Special Section: Unintentional Injury Following Traumatic Brain Injury

Guest editors: Juliet Haarbauer-Krupa

Article type: Research Article

Authors: Seel, Ronald T.^{a; *} | Macciocchi, Stephen^{a; b} | Velozo, Craig A.^{c; d} | Shari, Kimether^a | Thompson, Nicole^a | Heinemann, Allen W.^f | Sander, Angelle M.^{g; h; i} | Sleet, David^e

Affiliations: [a] Shepherd Center, Atlanta, GA, USA | [b] University of Georgia, Athens, GA, USA | [c] University of Florida, Gainesville, FL, USA | [d] Medical University of South Carolina, Charleston, South Carolina, USA | [e] Centers for Disease Control and Injury Prevention, Atlanta, GA, USA | [f] Northwestern University and Rehabilitation Institute of Chicago, Chicago, IL, USA | [g] Baylor College of Medicine, Houston, TX, USA | [h] Harris Health System, Houston, TX, USA | [i] TIRR Memorial Hermann, Houston, TX, USA

Correspondence: [*] Address for correspondence: Ronald T. Seel, Shepherd Center, Crawford Research Institute, 6th Floor; 2020 Peachtree Road, Atlanta, GA 30309, USA. Tel.: +1 404 387 5625; E-mail: ron_seel@shepherd.org.

Abstract: BACKGROUND: Persons with moderate to severe TBI are at increased risk for unintentional injury or harm in the home and community; however, there is currently no standard measure of safety risk they face now and in the future. OBJECTIVE: To develop comprehensive and content valid scales and item pools for assessing safety and risk for persons with moderate to severe traumatic brain injuries. METHOD: Qualitative psychometric methods for developing scales and items were used including literature review, item development and revision, focus groups with interdisciplinary rehabilitation staff (n = 26) for rating content validity, and cognitive interviewing of TBI family members (n = 9) for assuring item clarity. RESULTS: The Safety Assessment Measure is comprised of 6 primary scales – Cognitive Capacity, Visuomotor Capacity, Wheelchair Use, Risk Perception, Self-Regulation, and Compliance Failures with Safety Recommendations – in which family caregivers or clinicians rate the risk for unintentional injury or harm in adults who have sustained moderate or severe TBI. The scale item pools encompass a broad spectrum of everyday activities that pose risk in the home and community and were rated as having excellent levels of content validity. CONCLUSIONS: The Safety Assessment Measure scales and items cover a broad range of instrumental activities of daily living that can increase the risk of unintentional injuries or harm. Empirical evidence suggests that the Safety Assessment Measure items have excellent content validity. Future research should use modern psychometric methods to examine each scale unidimensionality, model fit, and precision.

Keywords: Unintentional injuries, brain injuries, cognition, diagnosis, rehabilitation

DOI: 10.3233/NRE-161369

Journal: NeuroRehabilitation, vol. 39, no. 3, pp. 371-387, 2016