The development of the St Andrew's-Swansea Neurobehavioural Outcome Scale: validity and reliability of a new measure of neurobehavioural disability and social handicap.
OBJECTIVE
Neurobehavioural disability (NBD) has a major impact on long-term psychosocial outcome following acquired brain injury (ABI). A recent review highlighted that a reliable and valid measure that can adequately capture the subtle and varied characteristics of NBD has yet to be developed. In this paper, the work underpinning the 'St Andrews-Swansea Neurobehavioural Outcome Scale' (SASNOS) is described using a conceptual framework underpinned by the WHO ICF. The intention is that SASNOS will provide a reliable and valid means of measuring NBD.


METHODS
Three hundred and thirty-six sets of ratings were made regarding ABI and neurologically healthy samples. The initial pool of 117 items was subjected to exploratory factor analysis and Rasch analysis. Reliability and validity of the new measure were determined using a range of appropriate statistical methods.


RESULTS
Forty-nine items were retained, falling into five principal factors. Content and construct validity are calculated. SASNOS has excellent discriminant/diagnostic validity. Inter-rater and test-re-test reliability are good.


CONCLUSIONS
SASNOS has a range of clinical and research applications and can be employed when measuring outcome. This new measure will enable neurorehabilitation services to directly compare the clinical populations they serve using the same frame of reference for NBD.
National Brain Injury Centre, Kemsley Unit, St Andrew's Healthcare, Northampton, UK. nalderman@standrew.co.uk
Nick
N
Alderman
Rodger Li
RL
Wood
Claire
C
Williams
D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000145:classification / Q000523:psychology* / Q000534:rehabilitation; D004185:Disability Evaluation; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000145:classification / Q000523:psychology* / Q000534:rehabilitation; D008875:Middle Aged; D019964:Mood Disorders / Q000145:classification / Q000175:diagnosis / Q000523:psychology*; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D011594:Psychometrics / Q000145:classification; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014852:Wales; D055815:Young Adult