Psychometric properties of the psychosocial screening instrument for physical trauma patients (PSIT)

Maria Karabatzakis, Brenda den Oudsten, Taco Gosens, Jolanda de Vries*

*Corresponding author for this work

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Abstract

Background
Early detection of psychosocial problems post-injury may prevent them from becoming chronic. Currently, there is no psychosocial screening instrument that can be used in patients surviving a physical trauma or injury. Therefore, we recently developed a psychosocial screening instrument for adult physical trauma patients, the PSIT. The aim of this study was to finalize and psychometrically examine the PSIT.

Methods
All adult (≥ 18 years) trauma patients admitted to a Dutch level I trauma center from October 2016 through September 2017 without severe cognitive disorders (n = 1448) received the PSIT, Impact of Events Scale-Revised (IES-R), Patient Health Questionnaire-9 (PHQ-9), Rosenberg Self-Esteem Scale (RSES), State-Trait Anxiety Inventory-State (STAI-S), and the World Health Organization Quality of Life-Abbreviated version (WHOQOL-Bref). After 2 weeks, a subgroup of responding participants received the PSIT a second time. The internal structure (principal components analysis, PCA; and confirmatory factor analysis, CFA), internal consistency (Cronbach’s alpha, α), test-retest reliability (Intraclass Correlation Coefficient, ICC), construct validity (Spearman’s rho correlations), diagnostic accuracy (Area Under the Curve, AUC), and potential cut-off values (sensitivity and specificity) were examined.

Results
A total of 364 (25.1%) patients participated, of whom 128 completed the PSIT again after 19.5 ± 6.8 days. Test-retest reliability was good (ICC = 0.86). Based on PCA, five items were removed because of cross-loadings ≥ 0.3. Three subscales were identified: (1) Negative affect (7 items; α = 0.91; AUC = 0.92); (2) Anxiety and Post-Traumatic Stress Symptoms (4 items; α = 0.77; AUC = 0.88); and (3) Social and self-image (4 items; α = 0.79; AUC = 0.92). CFA supported this structure (comparative fit index = 0.96; root mean square error of approximation = 0.06; standardized rood mean square residual = 0.04). Four of the five a priori formulated hypotheses regarding construct validity were confirmed. The following cut-off values represent maximum sensitivity and specificity: 7 on subscale 1 (89.6% and 83.4%), 3 on subscale 2 (94.4% and 90.3%), and 4 on subscale 3 (85.7% and 90.7%).

Conclusion
The final PSIT has good psychometric properties in adult trauma patients.
Original languageEnglish
Article number172
Number of pages13
JournalHealth and Quality of Life Outcomes
Volume17
DOIs
Publication statusPublished - 2019

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Keywords

  • CLINICAL UTILITY
  • DEPRESSIVE SYMPTOMS
  • EVENT SCALE
  • HEALTH-ORGANIZATION QUALITY
  • HIP FRACTURE
  • Injury
  • ORTHOPEDIC TRAUMA
  • PSYCHOLOGICAL DISTRESS
  • Physical trauma
  • Psychosocial problems
  • QUALITY-OF-LIFE
  • QUESTIONNAIRE
  • Reliability
  • STRESS-DISORDER
  • Screening instrument
  • Validity

Cite this

@article{276b7e68c83f4f36b8ed3caefe51b9ed,
title = "Psychometric properties of the psychosocial screening instrument for physical trauma patients (PSIT)",
abstract = "BackgroundEarly detection of psychosocial problems post-injury may prevent them from becoming chronic. Currently, there is no psychosocial screening instrument that can be used in patients surviving a physical trauma or injury. Therefore, we recently developed a psychosocial screening instrument for adult physical trauma patients, the PSIT. The aim of this study was to finalize and psychometrically examine the PSIT.MethodsAll adult (≥ 18 years) trauma patients admitted to a Dutch level I trauma center from October 2016 through September 2017 without severe cognitive disorders (n = 1448) received the PSIT, Impact of Events Scale-Revised (IES-R), Patient Health Questionnaire-9 (PHQ-9), Rosenberg Self-Esteem Scale (RSES), State-Trait Anxiety Inventory-State (STAI-S), and the World Health Organization Quality of Life-Abbreviated version (WHOQOL-Bref). After 2 weeks, a subgroup of responding participants received the PSIT a second time. The internal structure (principal components analysis, PCA; and confirmatory factor analysis, CFA), internal consistency (Cronbach’s alpha, α), test-retest reliability (Intraclass Correlation Coefficient, ICC), construct validity (Spearman’s rho correlations), diagnostic accuracy (Area Under the Curve, AUC), and potential cut-off values (sensitivity and specificity) were examined.ResultsA total of 364 (25.1{\%}) patients participated, of whom 128 completed the PSIT again after 19.5 ± 6.8 days. Test-retest reliability was good (ICC = 0.86). Based on PCA, five items were removed because of cross-loadings ≥ 0.3. Three subscales were identified: (1) Negative affect (7 items; α = 0.91; AUC = 0.92); (2) Anxiety and Post-Traumatic Stress Symptoms (4 items; α = 0.77; AUC = 0.88); and (3) Social and self-image (4 items; α = 0.79; AUC = 0.92). CFA supported this structure (comparative fit index = 0.96; root mean square error of approximation = 0.06; standardized rood mean square residual = 0.04). Four of the five a priori formulated hypotheses regarding construct validity were confirmed. The following cut-off values represent maximum sensitivity and specificity: 7 on subscale 1 (89.6{\%} and 83.4{\%}), 3 on subscale 2 (94.4{\%} and 90.3{\%}), and 4 on subscale 3 (85.7{\%} and 90.7{\%}).ConclusionThe final PSIT has good psychometric properties in adult trauma patients.",
keywords = "CLINICAL UTILITY, DEPRESSIVE SYMPTOMS, EVENT SCALE, HEALTH-ORGANIZATION QUALITY, HIP FRACTURE, Injury, ORTHOPEDIC TRAUMA, PSYCHOLOGICAL DISTRESS, Physical trauma, Psychosocial problems, QUALITY-OF-LIFE, QUESTIONNAIRE, Reliability, STRESS-DISORDER, Screening instrument, Validity",
author = "Maria Karabatzakis and {den Oudsten}, Brenda and Taco Gosens and {de Vries}, Jolanda",
note = "Funding was provided by The Netherlands Organisation for Health Research and Development (ZonMw), grant number 842004010. The funding source played no role in the design of the study, data collection, analysis or interpretation, or in writing the manuscript.",
year = "2019",
doi = "10.1186/s12955-019-1234-6",
language = "English",
volume = "17",
journal = "Health and Quality of Life Outcomes",
issn = "1477-7525",
publisher = "BioMed Central Ltd.",

}

TY - JOUR

T1 - Psychometric properties of the psychosocial screening instrument for physical trauma patients (PSIT)

AU - Karabatzakis, Maria

AU - den Oudsten, Brenda

AU - Gosens, Taco

AU - de Vries, Jolanda

N1 - Funding was provided by The Netherlands Organisation for Health Research and Development (ZonMw), grant number 842004010. The funding source played no role in the design of the study, data collection, analysis or interpretation, or in writing the manuscript.

PY - 2019

Y1 - 2019

N2 - BackgroundEarly detection of psychosocial problems post-injury may prevent them from becoming chronic. Currently, there is no psychosocial screening instrument that can be used in patients surviving a physical trauma or injury. Therefore, we recently developed a psychosocial screening instrument for adult physical trauma patients, the PSIT. The aim of this study was to finalize and psychometrically examine the PSIT.MethodsAll adult (≥ 18 years) trauma patients admitted to a Dutch level I trauma center from October 2016 through September 2017 without severe cognitive disorders (n = 1448) received the PSIT, Impact of Events Scale-Revised (IES-R), Patient Health Questionnaire-9 (PHQ-9), Rosenberg Self-Esteem Scale (RSES), State-Trait Anxiety Inventory-State (STAI-S), and the World Health Organization Quality of Life-Abbreviated version (WHOQOL-Bref). After 2 weeks, a subgroup of responding participants received the PSIT a second time. The internal structure (principal components analysis, PCA; and confirmatory factor analysis, CFA), internal consistency (Cronbach’s alpha, α), test-retest reliability (Intraclass Correlation Coefficient, ICC), construct validity (Spearman’s rho correlations), diagnostic accuracy (Area Under the Curve, AUC), and potential cut-off values (sensitivity and specificity) were examined.ResultsA total of 364 (25.1%) patients participated, of whom 128 completed the PSIT again after 19.5 ± 6.8 days. Test-retest reliability was good (ICC = 0.86). Based on PCA, five items were removed because of cross-loadings ≥ 0.3. Three subscales were identified: (1) Negative affect (7 items; α = 0.91; AUC = 0.92); (2) Anxiety and Post-Traumatic Stress Symptoms (4 items; α = 0.77; AUC = 0.88); and (3) Social and self-image (4 items; α = 0.79; AUC = 0.92). CFA supported this structure (comparative fit index = 0.96; root mean square error of approximation = 0.06; standardized rood mean square residual = 0.04). Four of the five a priori formulated hypotheses regarding construct validity were confirmed. The following cut-off values represent maximum sensitivity and specificity: 7 on subscale 1 (89.6% and 83.4%), 3 on subscale 2 (94.4% and 90.3%), and 4 on subscale 3 (85.7% and 90.7%).ConclusionThe final PSIT has good psychometric properties in adult trauma patients.

AB - BackgroundEarly detection of psychosocial problems post-injury may prevent them from becoming chronic. Currently, there is no psychosocial screening instrument that can be used in patients surviving a physical trauma or injury. Therefore, we recently developed a psychosocial screening instrument for adult physical trauma patients, the PSIT. The aim of this study was to finalize and psychometrically examine the PSIT.MethodsAll adult (≥ 18 years) trauma patients admitted to a Dutch level I trauma center from October 2016 through September 2017 without severe cognitive disorders (n = 1448) received the PSIT, Impact of Events Scale-Revised (IES-R), Patient Health Questionnaire-9 (PHQ-9), Rosenberg Self-Esteem Scale (RSES), State-Trait Anxiety Inventory-State (STAI-S), and the World Health Organization Quality of Life-Abbreviated version (WHOQOL-Bref). After 2 weeks, a subgroup of responding participants received the PSIT a second time. The internal structure (principal components analysis, PCA; and confirmatory factor analysis, CFA), internal consistency (Cronbach’s alpha, α), test-retest reliability (Intraclass Correlation Coefficient, ICC), construct validity (Spearman’s rho correlations), diagnostic accuracy (Area Under the Curve, AUC), and potential cut-off values (sensitivity and specificity) were examined.ResultsA total of 364 (25.1%) patients participated, of whom 128 completed the PSIT again after 19.5 ± 6.8 days. Test-retest reliability was good (ICC = 0.86). Based on PCA, five items were removed because of cross-loadings ≥ 0.3. Three subscales were identified: (1) Negative affect (7 items; α = 0.91; AUC = 0.92); (2) Anxiety and Post-Traumatic Stress Symptoms (4 items; α = 0.77; AUC = 0.88); and (3) Social and self-image (4 items; α = 0.79; AUC = 0.92). CFA supported this structure (comparative fit index = 0.96; root mean square error of approximation = 0.06; standardized rood mean square residual = 0.04). Four of the five a priori formulated hypotheses regarding construct validity were confirmed. The following cut-off values represent maximum sensitivity and specificity: 7 on subscale 1 (89.6% and 83.4%), 3 on subscale 2 (94.4% and 90.3%), and 4 on subscale 3 (85.7% and 90.7%).ConclusionThe final PSIT has good psychometric properties in adult trauma patients.

KW - CLINICAL UTILITY

KW - DEPRESSIVE SYMPTOMS

KW - EVENT SCALE

KW - HEALTH-ORGANIZATION QUALITY

KW - HIP FRACTURE

KW - Injury

KW - ORTHOPEDIC TRAUMA

KW - PSYCHOLOGICAL DISTRESS

KW - Physical trauma

KW - Psychosocial problems

KW - QUALITY-OF-LIFE

KW - QUESTIONNAIRE

KW - Reliability

KW - STRESS-DISORDER

KW - Screening instrument

KW - Validity

U2 - 10.1186/s12955-019-1234-6

DO - 10.1186/s12955-019-1234-6

M3 - Article

C2 - 31718663

VL - 17

JO - Health and Quality of Life Outcomes

JF - Health and Quality of Life Outcomes

SN - 1477-7525

M1 - 172

ER -