Self-reported competency – validation of the Norwegian version of the patient competency rating scale for traumatic brain injury

Abstract

Purpose: To evaluate the psychometric properties of the Norwegian version of the Patient Competency Rating Scale (PCRS) in patients with traumatic brain injury (TBI) at 12 months post-injury. Methods: Demographic and injury-related data were registered upon admission to the hospital in 148 TBI patients with mild, moderate, or severe TBI. At 12 months post-injury, competency in activities and global functioning were measured using the PCRS patient version and the Glasgow Outcome Scale-Extended (GOSE). Descriptive reliability statistics, factor analysis and Rasch modeling were applied to explore the psychometric properties of the PCRS. External validity was evaluated using the GOSE. Results: The PCRS can be divided into three subscales that reflect interpersonal/emotional, cognitive, and activities of daily living competency. The three-factor solution explained 56.6% of the variance in functioning. The internal consistency was very good, with a Cronbach’s α of 0.95. Item 30, “controlling my laughter”, did not load above 0.40 on any factors and did not fit the Rasch model. The external validity of the subscales was acceptable, with correlations between 0.50 and 0.52 with the GOSE. Conclusion: The Norwegian version of the PCRS is reliable, has an acceptable construct and external validity, and can be recommended for use during the later phases of TBI.Implications for RehabilitationThe Patient Competency Rating Scale appears appropriate for measuring functional outcome across TBI severity groups.The instrument captures self-reported functional impairments, activity limitations and participation restrictions.The PCRS may be applied as a measurement tool at a late phase post-injury and may thus be suited for long-term follow-up after TBI.