title: The development and validation of the readiness to engage in self-management after acute traumatic injury questionnaire.
abstract: OBJECTIVE
  Although the management of acute traumatic injury has improved, long-term functional outcomes remain poor. Data suggest major improvements in outcome will require comprehensive, self-management (SM) interventions. However, little is known about trauma survivors' willingness to participate in such interventions. The goal of this study was to create and validate an instrument based on the stages of change (SOC) framework to assess readiness to engage in SM programs following acute traumatic injury.
  
  
  METHODS
  The Readiness to Engage in Self-Management after Acute Traumatic Injury (RESMATI) was developed based on SOC theory. Participants (N = 150) were admitted to a Level I trauma center for treatment of severe trauma and completed the RESMATI 3 to 12 months postinjury. A random sample (n = 60) completed a reassessment 1 month later to determine item stability. A principal components analysis and an exploratory factor analysis were conducted.
  
  
  RESULTS
  The analyses of the 34 RESMATI items yielded a 5-factor model, collapsed into 3 domains based on SOC theory. Two factors were classified as "precontemplation," 2 factors were classified as "contemplation," and 1 factor was classified as "action/maintenance." All 3 domains had good internal consistency reliability (.71 to .92) and moderate test-retest reliability (.56 and .73).
  
  
  CONCLUSIONS
  The exploratory factor analysis yielded 3 domains that were consistent with the SOC model. Two notable exceptions were the lack of a "preparation" domain and lack of distinction between the action and maintenance stages. The RESMATI is a reliable instrument that requires further testing to establish validity and utility in identifying individuals' readiness to engage in SM following acute traumatic injury.
authors.affiliation: Johns Hopkins University School of Medicine.
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Wegener
authors.affiliation: Johns Hopkins Bloomberg School of Public Health.
authors.forename: Renan C
authors.initials: RC
authors.lastname: Castillo
authors.affiliation: Johns Hopkins Bloomberg School of Public Health.
authors.forename: Sara E
authors.initials: SE
authors.lastname: Heins
authors.affiliation: Johns Hopkins Bloomberg School of Public Health.
authors.forename: Anna N
authors.initials: AN
authors.lastname: Bradford
authors.affiliation: Johns Hopkins Bloomberg School of Public Health.
authors.forename: Mary Zadnik
authors.initials: MZ
authors.lastname: Newell
authors.affiliation: University of Maryland School of Medicine.
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Pollak
authors.affiliation: Johns Hopkins Bloomberg School of Public Health.
authors.forename: Ellen J
authors.initials: EJ
authors.lastname: MacKenzie
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006233:Persons with Disabilities / Q000523:psychology* / Q000534:rehabilitation* / Q000706:statistics & numerical data; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D025341:Principal Component Analysis; D015203:Reproducibility of Results; D012648:Self Care / Q000379:methods / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires / Q000592:standards*; D014947:Wounds and Injuries / Q000523:psychology* / Q000534:rehabilitation; D055815:Young Adult