Multisite randomized feasibility study of Problem-Solving Training for care partners of adults with traumatic brain injury during inpatient rehabilitation.

BACKGROUND: Problem-Solving Training (PST) during inpatient rehabilitation could provide care partners the skills needed to manage their life roles after discharge. OBJECTIVE: Determine the feasibility of PST+ Education versus Education for care partners of adults with traumatic brain injury (TBI) during inpatient rehabilitation. METHODS: We conducted a multisite randomized feasibility trial across three sites. We present recruitment rates, reasons for refusal to participate, and reasons for non-completion of interventions. We measured client satisfaction, participant engagement, and fidelity for both interventions. We compared change in depressive symptoms and caregiver burden between PST and Education groups. RESULTS: Though the interventions were generally feasible, recruitment and retention rates were lower than anticipated largely due to the COVID-19 pandemic. Participants who completed >3 sessions were less likely to be employed full-time and more often spouses and co-residing. Length of inpatient rehabilitation stay was correlated with number of sessions completed. We observed potential benefits of PST over Education, specifically for reducing depression symptoms and caregiver burden. CONCLUSION: High satisfaction, engagement, and fidelity, overall recruitment and retention, and positive change in outcomes suggest that PST is generally feasible and beneficial for care partners of persons with TBI. Adaptations, such as developing a 3-session version of PST, could improve feasibility.

Psychometric Properties of a COVID-19 Impact Scale Among a Sample of Individuals with Disabilities

Research Objectives To examine psychometric properties of a COVID-19 Impact Scale among individuals with disabilities. Design Cross-sectional analysis. Setting Web-based survey. Participants A sample of 418 individuals with multiple sclerosis (62.68%), traumatic brain injury (n=15.07%), and spinal cord injury (22.25%) completed a survey about experiences during the COVID-19 pandemic. The sample was 71.01% female. Ages ranged from 21-84 (M=52.00, SD=11.56). Interventions Not Applicable. Main Outcome Measures COVID-19: Impact of the Pandemic and Health Related Quality of Life (Penedo, Cohen, Bower, & Antoni, 2020). Analysis was restricted to the Psychosocial and Practical Experiences portion of the questionnaire, which yields a Total Measure Score representing overall impact of the pandemic and has three subscales (Distress, Disruption, and Resiliency). Results Principal components analysis of Rasch residuals demonstrated lack of unidimensionality for the overall Total Measure Score. Therefore, subscales were analyzed separately, each showing satisfactory internal consistency (Cronbach's alpha>0.80). The person separation index was 2.48 for Distress, 2.00 for Disruption, and 1.88 for Resiliency. Infit mean square values and corrected item-total correlations were satisfactory for all items on the Distress subscale. However, two items on Disruption and two on Resiliency had corrected item-total correlations < 0.30 and/or infit mean square values>1.30. Conclusions The three subscales on the COVID-19 impact scale had good internal consistency reliability and could differentiate the sample into at least two levels on their respective constructs. Two items referring to pandemic-related practices of health care providers showed poor fit on the Disruption subscale, and items referring to acceptance and the ability to provide others with instrumental social support showed poor fit on the Resiliency subscale. Overall, the study suggests that the instrument provides a reliable indicator of various levels of COVID impact in clinical samples with neurological disabilities. Author(s) Disclosures All authors have no conflicts of interest to declare.