Kersey Jessica, Baum Carolyn M, Hammel Joy, Terhorst Lauren, McCue Michael, Skidmore Elizabeth R
OTR/L, Department of Occupational Therapy, University of Pittsburgh, School of Health and Rehabilitation Science, Pittsburgh, Pennsylvania, USA.
OTR/L, Program in Occupational Therapy, Washington University in St. Louis, St. Louis, Missouri, USA.
PM R. 2023 Feb;15(2):176-183. doi: 10.1002/pmrj.12743. Epub 2022 Jan 24.
Community participation is an important outcome of rehabilitation following traumatic brain injury. Yet, few measures assess inclusion and belonging (enfranchisement) as a dimension of community participation. The Enfranchisement scale of the Community Participation Indicators addresses this need. However, research on its psychometric properties is lacking.
To examine cut points and sensitivity to change of the Enfranchisement scale of the Community Participation Indicators in adults with traumatic brain injury.
This was a repeated measures study with assessments administered twice (3 months apart).
Assessments were administered either over the phone, virtually (Zoom), or in person at the participant's home.
A total of 44 participants from community settings who had either experienced a traumatic brain injury within the previous year or were receiving rehabilitation interventions were recruited.
The Enfranchisement scale has two subscales: the Control subscale (range: 13-65) and the Importance subscale (range: 14-70). On both subscales, lower scores indicate better enfranchisement.
The software SAS PROC Logistic and the macro %ROCPlot were used to examine cut points at varying levels of sensitivity and specificity. The area under the receiver operating characteristics curve was calculated to determine overall classification accuracy. Minimum detectable change and minimal clinically important difference were also calculated.
For the Control subscale, a cut point of 44 (area under the curve = .75), a minimum detectable change of 8, and a minimal clinically important difference of 5 were found. For the Importance subscale, a cut point of 39 (area under the curve = .81), a minimum detectable change of 8, and a minimal clinically important difference of 5 were found.
The cut points resulted in good classification accuracy, providing support for their reliability. The results provided evidence that both subscales are sensitive to change in adults with brain injury.
社区参与是创伤性脑损伤康复的一项重要成果。然而，很少有措施将融入感和归属感（赋权）作为社区参与的一个维度进行评估。社区参与指标的赋权量表满足了这一需求。然而，缺乏对其心理测量特性的研究。
研究创伤性脑损伤成人社区参与指标赋权量表的切点及对变化的敏感性。
这是一项重复测量研究，评估进行两次（间隔3个月）。
评估通过电话、虚拟方式（Zoom）或在参与者家中亲自进行。
共招募了44名来自社区环境的参与者，他们要么在过去一年中经历过创伤性脑损伤，要么正在接受康复干预。
赋权量表有两个子量表：控制子量表（范围：13 - 65）和重要性子量表（范围：14 - 70）。在两个子量表上，得分越低表明赋权越好。
使用软件SAS PROC Logistic和宏%ROCPlot来检查不同敏感性和特异性水平下的切点。计算受试者工作特征曲线下的面积以确定总体分类准确性。还计算了最小可检测变化和最小临床重要差异。
对于控制子量表，发现切点为44（曲线下面积 = 0.75），最小可检测变化为8，最小临床重要差异为5。对于重要性子量表，发现切点为39（曲线下面积 = 0.81），最小可检测变化为8，最小临床重要差异为5。
切点具有良好的分类准确性，为其可靠性提供了支持。结果提供了证据，表明两个子量表对脑损伤成人的变化都敏感。
