Measuring progress and outcome in community rehabilitation after brain injury with a new assessment instrument--the BICRO-39 scales. Brain Injury Community Rehabilitation Outcome.
OBJECTIVE
Construction and validation of a new instrument, the Brain Injury Community Rehabilitation Outcome scales, to assess problems experienced by brain-injured patients living in the community.


METHODS
Seventy-six items describing aspects of personal and social functioning were generated. Two hundred thirty-five patients and/or their carers (separately) rated the items on 6-point scales, and patients retrospectively rated their functioning before injury. Seven scales were derived from factor analysis; one was included a priori. Thirty-nine items with high factor loadings were retained. Test-retest reliability, interrater reliability, and construct validity were examined in subsamples.


METHODS
Patients were recruited from four centers: two community-based teams, a day-patient clinic, and an outpatient clinic.


METHODS
Of the patients, 127 had traumatic brain injury, 72 had cerebrovascular accidents, 15 had multiple sclerosis, and 21 had acquired brain injury of other origins. Mean time since brain injury was 2.6 years; mean age was 43 years; 164 were men and 71 were women.


RESULTS
All scales showed good test-retest reliability, and agreement between patient and carer ratings was moderate to high. They showed predicted moderate correlations with other relevant scales. Postinjury scores differed significantly from preinjury scores, and 6 of the 8 scales showed change over a period of recovery/rehabilitation.


CONCLUSIONS
The scales appear reliable and easy to complete. They may have utility as quantitative measures of outcome for clinical and treatment evaluations.
Powell
J H
JH
Homerton Hospital, Department of Psychology, Goldsmiths College, London, UK.
Beckers
K
K
Greenwood
R J
RJ
D000203:Activities of Daily Living; D000328:Adult; D000554:Ambulatory Care Facilities; D001930:Brain Injuries / Q000503:physiopathology* / Q000534:rehabilitation*; D003153:Community Health Services; D003631:Day Care, Medical; D016002:Discriminant Analysis; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards*; D016896:Treatment Outcome