4.5 Article

The development of a Trauma Resiliency Scale (tRS-18)

Journal

JOURNAL OF ORTHOPAEDIC RESEARCH
Volume 41, Issue 9, Pages 2040-2045

Publisher

WILEY
DOI: 10.1002/jor.25550

Keywords

clinical; rehabilitation; trauma; treatment

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Resiliency is composed of three core components: the presence of adversity, protective factors to overcome adversity, and positive outcomes or growth. This paper describes the development of the Trauma Resiliency Scale (tRS) to measure the resiliency of trauma patients. The tRS-18 is a brief, self-administered measure that demonstrates sound psychometric properties including face validity, construct validity, and reliability. It may be used to quantify resiliency at any time point and potentially predict progress during recovery.
Resiliency consists of three core components, which include presence of adversity, protective factors to overcome adversity, and positive outcomes or growth. Therefore, resiliency aligns with the trauma recovery process. This paper describes development of the Trauma Resiliency Scale (tRS) to quantify the resiliency of trauma patients upon presentation and during recovery. Scale items were proposed and reviewed by an expert panel. Group construct validity testing was performed using both individual and focus group feedback with item analysis. Reliability was measured with test-retest administered 14 days apart and evaluated with intraclass correlation coefficient. One hundred and twenty-three items were initially proposed. Following item categorizing, a preliminary 17-item questionnaire was created. The questionnaire was administered to 40 individual participants and a trauma survivor focus group to evaluate construct validity. Following group construct testing, an 18-item Trauma Resiliency Scale (tRS-18) was proposed. Twenty-four participants were given the tRS-18 twice, 14 days apart to establish test-retest. Sixteen of the 18 questions had an intraclass correlation >0.7 (0.793-0.949). The remaining two questions underperformed based on the ICC (0.592 and 0.493) and were manually evaluated for inclusion. The final tRS-18 is a brief, self-administered measure of resiliency designed specifically for trauma patients. Sound psychometric properties including face validity, construct validity, and reliability of the instrument have been demonstrated. The tRS-18 may quantify resiliency at any time point with potential to be predictive of progress during recovery. Level of Evidence III, prognostic.

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