A Network Analysis of the PART-O at 1 and 2 Years After TBI: A Veterans Affairs Model Systems Study

Abstract

Objective: The construct of participation after traumatic brain injury (TBI) can be difficult to operationalize. Psychometric network analysis offers an empirical approach to visualizing and quantifying the associations between activities that comprise participation, elucidating the relations among the construct's components without assuming the presence of a latent common cause and generating a model to inform future measurement methods. The current research applied psychometric network analysis to the Participation Assessment with Recombined Tools-Objective (PART-O) within a sample of Service Members and Veterans (SM/Vs) with a history of TBI at 1-and 2-years (T1 and T2) post-injury. Participants: Participants (N = 663) were SM/Vs with a history of TBI who completed comprehensive inpatient rehabilitation services at a VA Polytrauma Rehabilitation Center (PRC). Setting: Five VA PRCs. Design: Cross-sectional, retrospective analysis of data from the Veterans Affairs (VA) TBI Model Systems study. Main Measures: Participation Assessment with Recombined Tools-Objective (PART-O)Results: Network analysis demonstrated that the PART-O structure was generally consistent over time, but some differences emerged. The greatest difference observed was the association between "spending time with friends" and "giving emotional support" to others. This association was more than twice as strong at T2 as at T1. The "out of the house" item was most central, as demonstrated by dense connections within its own subscale (Out and About) and items in other subscales (i.e., Social Relations and Productivity). When examining items connecting the three subscales, the items related to giving emotional support, Internet use, and getting out of the house emerged as the strongest connectors at T1, and Internet was the strongest connector at T2.

Participation in the Chronic Phase after Traumatic Brain Injury: Variations and Key Predictors

“…The influence of being married or cohabitating on overall and social participation is expected as partner status is included in PART-O [36]. Our findings of the positive relationship between living with a partner and social participation may also be attributed to the psychosocial influence of cohabitating with a partner.…”