The Injury Distress Index: Development and Validation

David E. Victorson, Craig K. Enders, Kent F. Burnett, Elizabeth A. Ouellette

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Victorson DE, Enders CK, Burnett KF, Ouellette EA. The Injury Distress Index: development and validation. Objective: To develop and validate a new measurement tool designed to assess self-reported distress responses after traumatic physical injury. Design: A mixed-methods study design was used. Development of the Injury Distress Index (IDI) included input from patients and experts and a comprehensive literature review. The IDI and validity measures were administered by a trained research assistant at bedside within 1 week of admission. The internal structure (exploratory factor analyses [EFAs]), reliability (internal consistency), and associations with other variables (construct and criterion validity) were examined. Setting: Hand, multiple trauma, and burn services at a large southeastern level-1 trauma center. Participants: Multicultural cohort of 169 traumatically injured adults (31% hand, 21% burn, 48% multiple trauma). Interventions: Not applicable. Main Outcome Measures: IDI, Trauma Symptom Checklist-40, Short-Form McGill Pain Questionnaire, Perceived Stress Scale-10, Life Orientation Test-Revised, General Perceived Self-Efficacy Scale, Drug Abuse Screening Test-10, Brief Michigan Alcoholism Screening Test, Abbreviated Injury Scale, hospital length of stay (LOS), postdischarge emergency department visits, and days readmitted to hospital postdischarge. Results: An item pool was developed from patient, expert, and literature review data. EFAs extracted 3 separate factors for posttraumatic stress (avoidance and numbing, re-experience, and hyperarousal: coefficient range, .31-.98), which is consistent with conceptual and diagnostic criteria. EFAs also produced single factors of depression (coefficient range, .44-.72), anxiety (coefficient range, .50-.75), and pain (coefficient range, .57-.79). Most IDI scales (except anxiety) could be differentiated between different levels of injury severity. IDI scales and subscales correlated highly and in a convergent pattern with validity measures of posttraumatic stress (r range, .18-.50), depression (r range, .24-.52), anxiety (r range, .30-.57), and pain (r range, .10-.42), as well as theoretically related variables, such as general distress (r range, .32-.56), self-efficacy (r range, -.15 to -.39), and optimism (r range, -.21 to -.45). IDI scales correlated in a discriminant pattern with measures of drug and alcohol abuse (r range, .02-.07; r range, .09-.21, respectfully). Concurrent and predictive validity evidence was also supported with small associations with injury severity (r range, .16-.30), hospital LOS (r range, .05-.21), number of emergency department visits postdischarge (r range, -.05 to .27), and number of days readmitted to the hospital postdischarge (r range, .05-.21). Cronbach α coefficients were within the acceptable range (α range, .75-.92). Conclusions: A new tool to examine injury-related distress after traumatic physical injury has been developed. Results suggest that IDI scores showed acceptable reliability and validity coefficients with this multicultural sample. Additional validation studies are recommended with larger sample sizes using similar populations to confirm these findings.

Original languageEnglish
Pages (from-to)1893-1902
Number of pages10
JournalArchives of Physical Medicine and Rehabilitation
Volume89
Issue number10
DOIs
StatePublished - Oct 1 2008

Fingerprint

Wounds and Injuries
Length of Stay
Statistical Factor Analysis
Anxiety
Multiple Trauma
Self Efficacy
Alcoholism
Hospital Emergency Service
Substance Abuse Detection
Hand
Abbreviated Injury Scale
Depression
Pain
Trauma Centers
Validation Studies
Pain Measurement
Checklist
Reproducibility of Results
Sample Size
Substance-Related Disorders

Keywords

  • Burns
  • Hand injuries
  • Multiple trauma
  • Rehabilitation
  • Stress, psychological
  • Validation study [publication type]

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Victorson, D. E., Enders, C. K., Burnett, K. F., & Ouellette, E. A. (2008). The Injury Distress Index: Development and Validation. Archives of Physical Medicine and Rehabilitation, 89(10), 1893-1902. https://doi.org/10.1016/j.apmr.2008.02.032

The Injury Distress Index : Development and Validation. / Victorson, David E.; Enders, Craig K.; Burnett, Kent F.; Ouellette, Elizabeth A.

In: Archives of Physical Medicine and Rehabilitation, Vol. 89, No. 10, 01.10.2008, p. 1893-1902.

Research output: Contribution to journalArticle

Victorson, DE, Enders, CK, Burnett, KF & Ouellette, EA 2008, 'The Injury Distress Index: Development and Validation', Archives of Physical Medicine and Rehabilitation, vol. 89, no. 10, pp. 1893-1902. https://doi.org/10.1016/j.apmr.2008.02.032
Victorson, David E. ; Enders, Craig K. ; Burnett, Kent F. ; Ouellette, Elizabeth A. / The Injury Distress Index : Development and Validation. In: Archives of Physical Medicine and Rehabilitation. 2008 ; Vol. 89, No. 10. pp. 1893-1902.
@article{793f568a1a914c5baccc4a98d9247a62,
title = "The Injury Distress Index: Development and Validation",
abstract = "Victorson DE, Enders CK, Burnett KF, Ouellette EA. The Injury Distress Index: development and validation. Objective: To develop and validate a new measurement tool designed to assess self-reported distress responses after traumatic physical injury. Design: A mixed-methods study design was used. Development of the Injury Distress Index (IDI) included input from patients and experts and a comprehensive literature review. The IDI and validity measures were administered by a trained research assistant at bedside within 1 week of admission. The internal structure (exploratory factor analyses [EFAs]), reliability (internal consistency), and associations with other variables (construct and criterion validity) were examined. Setting: Hand, multiple trauma, and burn services at a large southeastern level-1 trauma center. Participants: Multicultural cohort of 169 traumatically injured adults (31{\%} hand, 21{\%} burn, 48{\%} multiple trauma). Interventions: Not applicable. Main Outcome Measures: IDI, Trauma Symptom Checklist-40, Short-Form McGill Pain Questionnaire, Perceived Stress Scale-10, Life Orientation Test-Revised, General Perceived Self-Efficacy Scale, Drug Abuse Screening Test-10, Brief Michigan Alcoholism Screening Test, Abbreviated Injury Scale, hospital length of stay (LOS), postdischarge emergency department visits, and days readmitted to hospital postdischarge. Results: An item pool was developed from patient, expert, and literature review data. EFAs extracted 3 separate factors for posttraumatic stress (avoidance and numbing, re-experience, and hyperarousal: coefficient range, .31-.98), which is consistent with conceptual and diagnostic criteria. EFAs also produced single factors of depression (coefficient range, .44-.72), anxiety (coefficient range, .50-.75), and pain (coefficient range, .57-.79). Most IDI scales (except anxiety) could be differentiated between different levels of injury severity. IDI scales and subscales correlated highly and in a convergent pattern with validity measures of posttraumatic stress (r range, .18-.50), depression (r range, .24-.52), anxiety (r range, .30-.57), and pain (r range, .10-.42), as well as theoretically related variables, such as general distress (r range, .32-.56), self-efficacy (r range, -.15 to -.39), and optimism (r range, -.21 to -.45). IDI scales correlated in a discriminant pattern with measures of drug and alcohol abuse (r range, .02-.07; r range, .09-.21, respectfully). Concurrent and predictive validity evidence was also supported with small associations with injury severity (r range, .16-.30), hospital LOS (r range, .05-.21), number of emergency department visits postdischarge (r range, -.05 to .27), and number of days readmitted to the hospital postdischarge (r range, .05-.21). Cronbach α coefficients were within the acceptable range (α range, .75-.92). Conclusions: A new tool to examine injury-related distress after traumatic physical injury has been developed. Results suggest that IDI scores showed acceptable reliability and validity coefficients with this multicultural sample. Additional validation studies are recommended with larger sample sizes using similar populations to confirm these findings.",
keywords = "Burns, Hand injuries, Multiple trauma, Rehabilitation, Stress, psychological, Validation study [publication type]",
author = "Victorson, {David E.} and Enders, {Craig K.} and Burnett, {Kent F.} and Ouellette, {Elizabeth A.}",
year = "2008",
month = "10",
day = "1",
doi = "10.1016/j.apmr.2008.02.032",
language = "English",
volume = "89",
pages = "1893--1902",
journal = "Archives of Physical Medicine and Rehabilitation",
issn = "0003-9993",
publisher = "W.B. Saunders Ltd",
number = "10",

}

TY - JOUR

T1 - The Injury Distress Index

T2 - Development and Validation

AU - Victorson, David E.

AU - Enders, Craig K.

AU - Burnett, Kent F.

AU - Ouellette, Elizabeth A.

PY - 2008/10/1

Y1 - 2008/10/1

N2 - Victorson DE, Enders CK, Burnett KF, Ouellette EA. The Injury Distress Index: development and validation. Objective: To develop and validate a new measurement tool designed to assess self-reported distress responses after traumatic physical injury. Design: A mixed-methods study design was used. Development of the Injury Distress Index (IDI) included input from patients and experts and a comprehensive literature review. The IDI and validity measures were administered by a trained research assistant at bedside within 1 week of admission. The internal structure (exploratory factor analyses [EFAs]), reliability (internal consistency), and associations with other variables (construct and criterion validity) were examined. Setting: Hand, multiple trauma, and burn services at a large southeastern level-1 trauma center. Participants: Multicultural cohort of 169 traumatically injured adults (31% hand, 21% burn, 48% multiple trauma). Interventions: Not applicable. Main Outcome Measures: IDI, Trauma Symptom Checklist-40, Short-Form McGill Pain Questionnaire, Perceived Stress Scale-10, Life Orientation Test-Revised, General Perceived Self-Efficacy Scale, Drug Abuse Screening Test-10, Brief Michigan Alcoholism Screening Test, Abbreviated Injury Scale, hospital length of stay (LOS), postdischarge emergency department visits, and days readmitted to hospital postdischarge. Results: An item pool was developed from patient, expert, and literature review data. EFAs extracted 3 separate factors for posttraumatic stress (avoidance and numbing, re-experience, and hyperarousal: coefficient range, .31-.98), which is consistent with conceptual and diagnostic criteria. EFAs also produced single factors of depression (coefficient range, .44-.72), anxiety (coefficient range, .50-.75), and pain (coefficient range, .57-.79). Most IDI scales (except anxiety) could be differentiated between different levels of injury severity. IDI scales and subscales correlated highly and in a convergent pattern with validity measures of posttraumatic stress (r range, .18-.50), depression (r range, .24-.52), anxiety (r range, .30-.57), and pain (r range, .10-.42), as well as theoretically related variables, such as general distress (r range, .32-.56), self-efficacy (r range, -.15 to -.39), and optimism (r range, -.21 to -.45). IDI scales correlated in a discriminant pattern with measures of drug and alcohol abuse (r range, .02-.07; r range, .09-.21, respectfully). Concurrent and predictive validity evidence was also supported with small associations with injury severity (r range, .16-.30), hospital LOS (r range, .05-.21), number of emergency department visits postdischarge (r range, -.05 to .27), and number of days readmitted to the hospital postdischarge (r range, .05-.21). Cronbach α coefficients were within the acceptable range (α range, .75-.92). Conclusions: A new tool to examine injury-related distress after traumatic physical injury has been developed. Results suggest that IDI scores showed acceptable reliability and validity coefficients with this multicultural sample. Additional validation studies are recommended with larger sample sizes using similar populations to confirm these findings.

AB - Victorson DE, Enders CK, Burnett KF, Ouellette EA. The Injury Distress Index: development and validation. Objective: To develop and validate a new measurement tool designed to assess self-reported distress responses after traumatic physical injury. Design: A mixed-methods study design was used. Development of the Injury Distress Index (IDI) included input from patients and experts and a comprehensive literature review. The IDI and validity measures were administered by a trained research assistant at bedside within 1 week of admission. The internal structure (exploratory factor analyses [EFAs]), reliability (internal consistency), and associations with other variables (construct and criterion validity) were examined. Setting: Hand, multiple trauma, and burn services at a large southeastern level-1 trauma center. Participants: Multicultural cohort of 169 traumatically injured adults (31% hand, 21% burn, 48% multiple trauma). Interventions: Not applicable. Main Outcome Measures: IDI, Trauma Symptom Checklist-40, Short-Form McGill Pain Questionnaire, Perceived Stress Scale-10, Life Orientation Test-Revised, General Perceived Self-Efficacy Scale, Drug Abuse Screening Test-10, Brief Michigan Alcoholism Screening Test, Abbreviated Injury Scale, hospital length of stay (LOS), postdischarge emergency department visits, and days readmitted to hospital postdischarge. Results: An item pool was developed from patient, expert, and literature review data. EFAs extracted 3 separate factors for posttraumatic stress (avoidance and numbing, re-experience, and hyperarousal: coefficient range, .31-.98), which is consistent with conceptual and diagnostic criteria. EFAs also produced single factors of depression (coefficient range, .44-.72), anxiety (coefficient range, .50-.75), and pain (coefficient range, .57-.79). Most IDI scales (except anxiety) could be differentiated between different levels of injury severity. IDI scales and subscales correlated highly and in a convergent pattern with validity measures of posttraumatic stress (r range, .18-.50), depression (r range, .24-.52), anxiety (r range, .30-.57), and pain (r range, .10-.42), as well as theoretically related variables, such as general distress (r range, .32-.56), self-efficacy (r range, -.15 to -.39), and optimism (r range, -.21 to -.45). IDI scales correlated in a discriminant pattern with measures of drug and alcohol abuse (r range, .02-.07; r range, .09-.21, respectfully). Concurrent and predictive validity evidence was also supported with small associations with injury severity (r range, .16-.30), hospital LOS (r range, .05-.21), number of emergency department visits postdischarge (r range, -.05 to .27), and number of days readmitted to the hospital postdischarge (r range, .05-.21). Cronbach α coefficients were within the acceptable range (α range, .75-.92). Conclusions: A new tool to examine injury-related distress after traumatic physical injury has been developed. Results suggest that IDI scores showed acceptable reliability and validity coefficients with this multicultural sample. Additional validation studies are recommended with larger sample sizes using similar populations to confirm these findings.

KW - Burns

KW - Hand injuries

KW - Multiple trauma

KW - Rehabilitation

KW - Stress, psychological

KW - Validation study [publication type]

UR - http://www.scopus.com/inward/record.url?scp=55649096183&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=55649096183&partnerID=8YFLogxK

U2 - 10.1016/j.apmr.2008.02.032

DO - 10.1016/j.apmr.2008.02.032

M3 - Article

C2 - 18929018

AN - SCOPUS:55649096183

VL - 89

SP - 1893

EP - 1902

JO - Archives of Physical Medicine and Rehabilitation

JF - Archives of Physical Medicine and Rehabilitation

SN - 0003-9993

IS - 10

ER -