Validation of an Eight-item Resilience Scale for Inpatients with Spinal Cord Injuries in a Rehabilitation Hospital: Exploratory Factor Analyses and Item Response Theory 1133

Abstract

Objectives

To validate the factor validity and discrimination ability of a resilience scale, CD-RISC-10, for clinical usage in adults with SCI during hospitalization.

Design

Nighty-three adults with spinal cord injury responded to the self-reported survey, including CD-RISC-10, the Patient Health Questionnaire-9 Scale, the Satisfaction with Life Scale, and the Intrinsic Spirituality Scale. We conducted descriptive statistics, exploratory factor analysis, and item response theory. Item response theory analysis was completed in R software (ie, “ltm” package).

Setting

A medical center including rehabilitation care.

Participants

Nighty-three people with spinal cord injury undergoing inpatient rehabilitation in a medical center in the Southern US inclusion criteria were: diagnosis of SCI with either traumatic or acquired, complete or incomplete, or multitrauma injuries; ≥18 years old, and able to respond to an assessment in English. Consistent with the IRB advice, we welcomed any gender, sex, and race/ethnicity as long as individuals met the inclusion criteria. A convenience and volunteer sampling approach was applied.

Interventions

Not applicable.

Main Outcome Measures

(1) The CD-RISC-10 assesses one latent factor of resilience. The measure consists of 10 items, using a 5-point Likert scale ranging from 0 (not true at all) to 4 (true nearly all of the time). (2) The Patient Health Questionnaire-9 Depression Scale is a brief 9-item self-report measure of depressive symptoms. Each item is rated on a 4-point Likert-type scale ranging from 0 (not at all) to 3 (nearly every day). (3) The Satisfaction with Life Scale has been one of the most widely used life satisfaction measures, largely because of its brevity of only 5 items. Participants indicate their degree of agreement with each item using a 7-point Likert-type scale, with scores ranging from 1 (strongly disagree) to 7 (strongly agree). (4) The Intrinsic Spirituality Scale measures intrinsic spirituality. The Intrinsic Spirituality Scale is a 6-item measure that uses a sentence completion format where an incomplete sentence fragment is provided, followed by 2 phrases anchoring each end of the scale.

Results

Two items were deleted from CD-RISC-10 after exploratory factor analysis, forming CD-RISC-8. The item discriminations of the remaining 8 items from the unconstrained item response theory model ranged from a high of 3.071 to a relatively low 1.433. CD-RISC-8 is significantly related to Patient Health Questionnaire-9 Scale and Satisfaction with Life Scale.

Conclusions

The factor validity of the CD-RISC-8 was improved. Significantly, the CD-RISC-8 has excellent potential for clinical usage due to its discriminant ability between low and intermediate resilience.

Disclosures

none.