Article 2: Comparability of mayo-portland adaptability inventory ratings by staff, significant others, and people with acquired brain injury

Abstract

Objective: To determine the internal consistency, reliability, and comparability of the Mayo-Portland Adaptability Inventory (MPAI-4) and subscales completed independently by people with acquired brain injury, family and significant others, and rehabilitation staff. Design: Rater agreement for MPAI-4 protocols was evaluated and data were submitted to Rasch facets analysis to determine the internal consistency for each rater group and for a composite measure based on all rater groups. Setting: Outpatient rehabilitation. Participants: 134 people with acquired brain injury consecutively seen for outpatient rehabilitation evaluation, significant others, and staff. Interventions: Not applicable. Main Outcome Measure: MPAI-4 and subscales (ability, adjustment, and participation indices). Results: Rasch indicators of internal consistency were entirely within acceptable limits for 3-rater composite full scale and subscale measures, and generally within acceptable limits for measures for single rater groups. Item agreement was generally acceptable; disagreements suggested varying perspectives and sources of bias for specific rater groups. Conclusions: The MPAI-4 possesses satisfactory internal consistency regardless of rating source. For research and program evaluation, the composite measure provides a method to synthesize multiple perspectives on current status. In clinical settings, assessment of varying these perspectives during initial evaluation is helpful in developing effective rehabilitation plans.