Sydney Psychosocial Reintegration Scale

Traumatic Brain Injury: (Tate et al., 2011; n=105, mean age=39.7 (16.68), healthy adults; n=510, mean age=35 (sample A) and 33 (sample B), TBI)

Traumatic Brain Injury: (Tate et al., 1999; subacute group n=20 assessed for responsiveness of measure (admission and 3 months later or at discharge, whichever came first; long term group n=40 assessed for reliability and validity of measure (close relative was interviewed with the measure, SPRS readministered one month later)

• Excellent reliability for total score (ICC=0.90)
• Excellent reliability for occupational activities (ICC=0.93)
• Excellent reliability for interpersonal relationships (ICC=0.0.77)
• Excellent reliability for living skills (ICC=0.88)

Brain Injury: (Tate et al., 2004; n=66; mean age=35.2 (14.22); 47 males and 19 females. Assessed Form B) 

Traumatic Brain Injury: (Tate et al., 2011; n=105, mean age=39.7 (16.68), healthy adults; n=510, mean age=35 (sample A) and 33 (sample B), TBI)

Traumatic Brain Injury: (Tate et al., 1999; subacute group n=20 assessed for responsiveness of measure (admission and 3 months later or at discharge, whichever came first; long term group n=40 assessed for reliability and validity of measure (close relative was interviewed with the measure, SPRS readministered one month later)

• Excellent reliability for total score (ICC=0.95) 
• Excellent reliability for occupational activities (ICC=0.92)
• Excellent reliability for interpersonal relationships (ICC=0.86)
• Excellent reliability for living skills (ICC=0.94) 

Brain Injury: (Tate et al., 2004; n=66; mean age=35.2 (14.22); 47 males and 19 females. Assessed Form B) 

Traumatic Brain Injury: (Tate et al, 2011; n=105, mean age=39.7 (16.68), healthy adults; n=510, mean age=35 (sample A) and 33 (sample B), TBI) 

Traumatic Brain Injury: (Tate et al., 1999; subacutesub acute group n=20 assessed for responsiveness of measure (admission and 3 months later or at discharge, whichever came first; mean age at injury=32.80 (14.07); long term group n=40 assessed for reliability and validity of measure (close relative was interviewed with the measure, SPRS re-administered one month later); mean age at injury= 34.95 (15.49) 

• Intercorrelations among domains were adequate: occupational activities with interpersonal relationships (r=.56), occupational activities with living skills (r=.77) , and interpersonal relationships with living skills (r=.64); each P < .001 

Brain Injury: (Tate et al., 2004; n=66; mean age=35.2 (14.22); 47 males and 19 females. Assessed Form B)

• Excellent internal consistency (Cronbach’s alpha=0.93)
• Excellent item-total correlation coefficients (greater than 0.7) for 9 of the 12 items, with the exceptions being item 1 (work, Cronbach’s alpha=.39), item 2 (work skills, Cronbach’s alpha=.67), and item 6 (family, Cronbach’s alpha=.51)

Traumatic Brain Injury: (Tate et al., 2011; n=105, mean age=39.7 (16.68), healthy adults; n=510, mean age=35 (sample A) and 33 (sample B), TBI) 

Neurological diagnoses: Primary Brain Tumor (PBT), Spinal Cord Injury (SCI), Traumatic Brain Injury (TBI) (Tate et al., 2012; PBT n=54; SCI n=50; TBI n=130)

• PBT population: Excellent internal consistency (Cronbach’s alpha=0.87)

Concurrent Validity:

Acquired Brain Injury: (Kuipers et al., 2004; n=521; diagnoses: TBI, stroke, tumor, infection, others)

• Adequate: Community Integration Questionnaire (CIQ) total scores correlated with SPRS total scores: r=0.56
• Adequate: CIQ home competency with SPRS living skills: r=0.42
• Adequate: CIQ social interaction with SPRS interpersonal relationships: r=0.45
• Adequate: CIQ productive activity with SPRS occupational activity: r=0.42 

Traumatic Brain Injury: (Draper et al., 2007; n=53)

• Significant correlations (P < .001) were found between the GOSE and the SPRS subscales
• Adequate to excellent validity (r = 0.72, 0.78, 0.54, and 0.58) between Glasgow Outcome Scale-Extended (GOSE) and TBI participants’ SPRS total, Occupational Activities (OA), Interpersonal Relationships (IR), and Living Skills (LS) ratings, respectively
• Excellent validity (r = 0.68, 0.68, 0.62, and 0.61) between GOSE and relatives’ SPRS total, OA, IR, and LS ratings, respectively

Traumatic Brain Injury: (Tate et al., 2011; n=105, mean age=39.7 (16.68), healthy adults; n=510, mean age=35 (sample A) and 33 (sample B), TBI) 

Construct Validity:

Acquired Brain Injury: (Kuipers et al., 2004; n= 521; diagnoses: TBI, stroke, tumor, infection, others)

• 2-factor solution on multidimensional scaling analysis supported a continuum of productivity vs personal life and independent activity vs dependent involvement. 

Discriminant Validity: 

Traumatic Brain Injury:

• SPRS demonstrated significant differences between groups defined by high vs low community integration (Winkler et al, 2006) 

Convergent validity and discriminant validity:

Traumatic Brain Injury: (Tate et al., 1999; subacute group n=20 assessed for responsiveness of measure (admission and 3 months later or at discharge, whichever came first; long term group n=40 assessed for reliability and validity of measure (close relative was interviewed with the measure, SPRS readministered one month later)

• SPRS total score showed excellent correlation coefficients with all four scales administered: r=-.76 with both Sickness Impact Profile (SIP) and Katz Adjustment Scale (Form R2); r=-0.77 with Glasgow Outcome Scale-Extended (GOSE); and r=-.85 with London Handicap Scale. 
• No significant correlation was found between the total score and age (r=-.25), although those for PTA and chronicity were statistically significant (r=-.41 and r=-.36, respectively, each P < .05). 
• SIP physical domain showed the highest correlation with SPRS living skills subscale (r=-0.58; P < .001) and a low and non-significant correlation with interpersonal relationships subscale (r=-0.23; P >.05). 
• SIP-psychosocial domain showed the highest correlation with SPRS interpersonal relationships (r=-0.76;P < .001), and adequate correlation living skills (r=-0.59). 
• SIP combined score for work and recreation/pastimes correlated most highly with the SPRS occupational activities domain (r=-0.72; P < .001). 
• Construct validity with respect to group differences on the GOS: significant subgroup differences between good recovery versus moderate disability and moderate disability versus severe disability were found for each of the domains. 
• No differences were found between the moderate and severe disability subgroups for the interpersonal relationship domain. 
• Variability was evident among each of the three SPRS domains, but for every GOS disability level, the greatest amount of change was found for the occupational activities domain.

Traumatic Brain Injury: (Draper et al., 2007; n=53)

• Gender, age, and the GCS score were not significantly correlated with either patients’ or relatives’ SPRS total score. 
• The correlation between PTA and SPRS total according to ratings of the person with TBI was not significant (r = −0.26, P = .057). 
• PTA duration (r=−0.39, P = .004) and age (r = −0.33, P =.019) were significantly correlated with the OA subscale.

Convergent and Divergent Validity:

Traumatic Brain Injury: (Tate et al., 2011; n=105, mean age=39.7 (16.68), healthy adults; n=510, mean age=35 (sample A) and 33 (sample B), TBI) 

Discriminant Validity: 

Traumatic Brain Injury: (Tate et al., 2011; n=105, mean age=39.7 (16.68), healthy adults; n=510, mean age=35 (sample A) and 33 (sample B), TBI)

• Those with duration of PTA less than 30 days: higher SPRS-2 scores (mean=32.98 ( 11.22) and mean = 33.27 (9.62) on Forms A and B, respectively) than those with PTA duration between 1 and 3 months (mean= 25.48 (10.55) and mean= 27.05 (11.28), respectively), who in turn had higher SPRS-2 scores than those with PTA greater than 3 months (mean= 14.70 (9.47) and mean= 13.97 (8.80), respectively). 

Neurological diagnoses - Primary Brain Tumor (PBT), Spinal Cord Injury (SCI), Traumatic Brain Injury (TBI): (Tate et al., 2012; PBT n=54; SCI n=50; TBI n=130)

• Participants with the more severe TBI demonstrated poorer SPRS total and domain scores than those with PTA less than 30 days. 
• Within the PBT sample, there were no significant differences in participation related to severity. 
• A significant difference was observed between high and low impairment SCI participants on living skills with the high impairment group performing more poorly, but no differences were found for the total or other domain scores.

Traumatic Brain Injury: (Tate et al., 1999; subacute group n=20 assessed for responsiveness of measure (admission and 3 months later or at discharge, whichever came first; long term group n=40 assessed for reliability and validity of measure (close relative was interviewed with the measure, SPRS readministered one month later)

• At discharge from rehabilitation, percentage of participants scoring at the scale minimum ranged 3.0% (interpersonal relationships ) to 18.2% (occupational activities) while patients scoring at the scale maximum ranged from 1.5% (living skills) to 7.6% (interpersonal relationships 
• Initial floor effects noted, however, data indicated that SPRS was sensitive to detect changes over time. 

Traumatic Brain Injury: (Tate et al., 2011; n=105, mean age=39.7 (16.68), healthy adults; n=510, mean age=35 (sample A) and 33 (sample B), TBI)

• No significant floor or ceiling effects were present for the total score for either Form A (0% and 2.5%, respectively) or Form B (1.3% for both floor and ceiling). 
• For each of the domains, both floor and ceiling effects were less than the stringent criterion of 15% 

Neurological diagnoses - Primary Brain Tumor (PBT), Spinal Cord Injury (SCI), Traumatic Brain Injury (TBI): (Tate et al., 2012; PBT n=54; SCI n=50; TBI n=130)

• PBT population: There was a ceiling effect on the living skills domain with 28% achieving the highest score on this subscale. 
• At the item level, analysis of the frequencies found that there was a spread of responses on all items; however, six items (items 5–10) showed ceiling effects with more than 50% of the sample achieving the highest score.

Traumatic Brain Injury: (Tate et al., 1999; subacute group n=20 assessed for responsiveness of measure (admission and 3 months later or at discharge, whichever came first; long term group n=40 assessed for reliability and validity of measure (close relative was interviewed with the measure, SPRS readministered one month later)

• Significant change (p<.001) was reported for total SPRS scores and all sub-scales between admission to and discharge from in-patient rehabilitation.