Defense and Veterans Brain Injury Center.
Rehabil Psychol. 2019 Aug;64(3):366-376. doi: 10.1037/rep0000270. Epub 2019 Mar 21.
PURPOSE/OBJECTIVE: To (a) examine the factor structure of the original 47-item Caregiver Appraisal Scale (CAS) in caregivers of service members/veterans (SMVs) following traumatic brain injury (TBI) and (b) assess whether the CAS yields a similar factor structure in this population compared to caregivers of civilian adults following TBI. Research Method/Design: Participants were 287 caregivers (female = 96.2%; spouse = 87.8%; mean age = 38.6 years) of SMVs who sustained a mild, moderate, severe, or penetrating TBI, recruited from Walter Reed National Military Medical Center and via caregiver community outreach. Caregivers completed the CAS, Caregiver Questionnaire, and Mayo-Portland Adaptability Inventory-4 upon enrollment in the study.
Principal component analysis (PCA) revealed four factors that explained 43.2% of the variance in CAS scores: Perceived Burden, Caregiving Relationship Satisfaction, Caregiving Ideology, and Caregiving Mastery. Thirty-seven of the 47 CAS items loaded significantly onto only one of the four factors (≥ .40). A secondary PCA was performed on these 37 items, resulting in a four-factor solution very similar to that of the 47-item solution, which explained 46.8% of the variance in the 37-item measure. All but one item loaded significantly on a factor corresponding to a conceptually similar construct.
CONCLUSIONS/IMPLICATIONS: Military and civilian caregivers have overlapping and differing concerns. The findings support a 37-item four-factor model of caregiving stress appraisal that has the potential for use as an outcome measure for developing caregiver interventions. It may be as useful to administer a reduced 37-item measure of the CAS to caregivers as the original 47-item measure, but further development is required. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
（a）检验创伤性脑损伤（TBI）后服务成员/退伍军人（SMV）照顾者原始 47 项照顾者评估量表（CAS）的因素结构；（b）评估 CAS 在该人群中的因素结构是否与 TBI 后照顾平民成年人的因素结构相似。
研究方法/设计：参与者为 287 名照顾者（女性=96.2%；配偶=87.8%；平均年龄=38.6 岁），他们的 SMV 患有轻度、中度、重度或穿透性 TBI，招募自沃尔特·里德国家军事医疗中心和照顾者社区外联。照顾者在参加研究时完成了 CAS、照顾者问卷和梅奥-波特兰适应量表-4。
主成分分析（PCA）显示，CAS 评分的 43.2%可由四个因素解释：感知负担、照顾关系满意度、照顾意识形态和照顾掌握程度。47 项 CAS 条目中有 37 项显著加载到仅一个因素上（≥.40）。对这 37 个项目进行了二次 PCA，得到了一个与 47 项解决方案非常相似的四因素解决方案，该方案解释了 37 项测量中 46.8%的方差。除一项外，所有项目都显著加载到与概念上相似结构相对应的因素上。
结论/意义：军人和平民照顾者有重叠和不同的关注点。这些发现支持了一个 37 项四因素的照顾者压力评估模型，该模型有可能作为开发照顾者干预措施的结果测量工具。与原始的 47 项测量相比，使用简化的 37 项 CAS 测量可能同样有用，但需要进一步开发。（PsycINFO 数据库记录（c）2019 APA，保留所有权利）。
