
Arch Phys Med Rehabil 2003 Feb;84(2):277-284
Kolitz BP, Vanderploeg RD, Curtiss G.
Departments of Psychology (Kolitz, Vanderploeg) and Psychiatry (Vanderploeg,
Curtiss), University of South Florida, Tampa, FL; the James A. Haley Veterans
Affairs Medical Center (Vanderploeg, Curtiss), Tampa, FL; and the Defense
and Veterans Head Injury Program (Vanderploeg, Curtiss), Tampa, FL.
OBJECTIVE:
To describe the development and initial validation of a neurobehavioral outcome measure, the Key Behaviors Change Inventory (KBCI), for individuals with traumatic brain injury (TBI).
DESIGN:
Scale construction and development, and validity study.
SETTING:
Large state university and postal survey.
PARTICIPANTS:
Seventy-five volunteer undergraduate students and 25 volunteer collateral informants of individuals with TBI participated in the item-analysis phase.
Thirty members of the Brain Injury Association and 20 members of the National Multiple Sclerosis Society rated both an identified patient and an age- and gender-equated control in the validation phase.
INTERVENTIONS:
Not applicable.
MAIN OUTCOME MEASURES:
Content validity was examined through expert panel item sorts.
Scale internal consistencies were examined with the Cronbach alpha.
Construct validity was examined by comparing scale elevations between controls and 2 neurologic groups.
RESULTS:
Item-analysis procedures resulted in 8 scales of 8 items each: inattention, impulsivity, unawareness of problems, apathy, interpersonal difficulties, communication problems, somatic difficulties, and emotional adjustment.
Internal consistency reliability coefficients ranged from.82 to.91.
Multivariate analysis of variance revealed significant (P</=.001) differences in scale elevations among TBI, multiple sclerosis (MS), and control groups.
The TBI and MS groups scored significantly higher than the control group on all scales; a subset of KBCI scales discriminated between the 2 neurologic groups.
CONCLUSION:
The KBCI was both sensitive and specific to typical behavioral changes after TBI, thus supporting its usefulness in rehabilitation settings.
Cross-validation and development of a normative database are future steps necessary in its development.