Measuring community integration after spinal cord injury: validation of the Sydney psychosocial reintegration scale and community integration measure.
OBJECTIVE
To evaluate the reliability, validity, sensitivity to change, and clinical usefulness of the Sydney Psychosocial Reintegration Scale (SPRS) and Community Integration Measure (CIM) for people with spinal cord injury (SCI).


METHODS
A sample of 58 people with recent traumatic SCI was followed up at 12 months post-discharge from inpatient rehabilitation. The SPRS, CIM, Craig Handicap Assessment and Reporting Technique (CHART) and SF-6D Health Utility Scale (SF-6D) were administered.


RESULTS
The SPRS and CIM were internally consistent (α = .80 and .78, respectively). The SPRS showed greatest sensitivity to change as measured by percentage of participants meeting minimum difference in score change over time (21%). CIM and CHART had comparable sensitivity to change (14% minimum difference). SPRS correlated significantly with CHART (r = .72, P < .001), unlike CIM. Neither SPRS nor CIM discriminated between high and low impairment, unlike CHART. Correlations with CHART and SF-6D domains supported convergent and divergent validity of the SPRS domains.


CONCLUSIONS
Research should continue to develop conceptually and psychometrically valid instruments to capture the multidimensionality of community integration. The SPRS and CIM show potential to extend measurement of community reintegration following SCI.
De Wolf
Annelies
A
Rehabilitation Studies Unit, University of Sydney and Royal Rehabilitation Centre Sydney, 59 Charles Street, Ryde, NSW 2112, Australia. anneliesd@med.usyd.edu.au
Lane-Brown
Amanda
A
Tate
Robyn L
RL
Middleton
James
J
Cameron
Ian D
ID
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011594:Psychometrics / Q000295:instrumentation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D011795:Surveys and Questionnaires