TBI-CareQOL military health care frustration in caregivers of service members/veterans with traumatic brain injury.

Noelle E. Carlozzi*, Rael T. Lange, Louis M. French, Michael A. Kallen, Nicholas R. Boileau, Robin A. Hanks, Risa Nakase-Richardson, Jill P. Massengale, Angelle M. Sander, Elizabeth A. Hahn, Jennifer A. Miner, Tracey A. Brickell

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Caregivers of service members/veterans (SMVs) encounter a number of barriers when navigating the military health care system. The purpose of this study was to develop a new measure to assess potential caregiver frustration with the systems of care and benefits in the United States Departments of Defense and Veterans Affairs. Method: The TBI-CareQOL Military Health Care Frustration measure was developed using data from 317 caregivers of SMVs with TBI who completed an item pool comprised of 64 questions pertaining to anger or frustration with accessing military health care services. Results: Exploratory and confirmatory factor analyses supported the retention of 58 items. Constrained graded response model (GRM) overall fit and item fit analyses and differential item functioning investigations of age and education factors supported the retention of 43 items in the final measure. Expert review and GRM item calibration products were used to inform the selection of two 6-item static short forms (TBI-CareQOL Military Health Care Frustration-Self; TBI-CareQOL Military Health Care Frustration-Person with TBI) and to program the TBI-CareQOL Military Health Care Frustration computer adaptive test (CAT). Preliminary data supported the reliability (i.e., internal consistency and test–retest reliability) as well as the validity (i.e., convergent, discriminant, and known-groups) of the new measure. Conclusions: The new TBI-CareQOL Military Health Care Frustration measure can be used to examine caregiver perceptions of and experience with the military health care system, to target improvements. (PsycInfo Database Record (c) 2020 APA, all rights reserved)Impact and Implications: There is a need for a measure of caregiver-reported concerns with navigating the military health care system. Given that caregivers are an important part of the recovery process for persons with TBI, it is important to evaluate their perception of services that their loved ones may or may not receive. A new measure, the TBI-CareQOL Military Health Care Frustration item bank, was developed for this purpose. It includes a long form (43 items), two six-item short forms (a version focused on services for the caregiver and a version focused on services for the person with TBI in the military), and a computer-adaptive test. This measure can assist the military health care system to focus on targeting unmet needs of the caregivers of those with TBI. (PsycInfo Database Record (c) 2020 APA, all rights reserved)

Original languageEnglish (US)
Pages (from-to)360-376
Number of pages17
JournalRehabilitation Psychology
Volume65
Issue number4
DOIs
StatePublished - 2020

Keywords

  • caregivers
  • frustration
  • health care
  • patient-reported outcomes
  • traumatic brain injury

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Psychology
  • Psychiatry and Mental health

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