Validation of the Mayo-Portland Adaptability Inventory-4 (MPAI-4) and reference norms in a French-Canadian population with traumatic brain injury receiving rehabilitation

Abstract

Purpose

Validate the factor structure and establish internal consistency reliability of the French-Canadian version of the Mayo-Portland Adaptability Inventory (MPAI-4), using a Canadian sample of adults with traumatic brain injury (TBI) receiving post-acute rehabilitation services.

Materials and methods

Psychometric analysis of French-Canadian MPAI-4 data from TBI adults (N = 1012) who received rehabilitation interventions and for whom a first French-Canadian MPAI-4 measure was completed between 2016 and 2020.

Results

Exploratory factor analysis was used to evaluate the factor structure of the French-Canadian MPAI-4. The final and best solution revealed three factors, which accounted for 48.68% of the variance. Using Cronbach’s alpha, all subscales showed good internal consistency (all 0.70 ≤ α ≤ 0.89). Reference norms for the TBI sample are provided, as well as descriptive raw data according to sex, age, TBI severity and rehabilitation setting.

Conclusions

The French-Canadian MPAI-4 factor structure is validated. The three factors extracted are similar to the three subscales of the original MPAI-4. The questionnaire shows good psychometric properties and represents a suitable tool for TBI adults receiving rehabilitation services in a French-Canadian context. The provided reference norms will also help guide the clinical use of the MPAI-4 in French-Canadian TBI populations.

Implications for rehabilitation

• The MPAI-4 questionnaire measures functional abilities, global outcome and community integration following traumatic brain injury (TBI).

• The questionnaire can be used in inpatient, outpatient and vocational rehabilitation settings to assess TBI patients’ progress and outcomes, plan interventions and evaluate the effect of rehabilitation.

• The French-Canadian version of the MPAI-4 is validated and suitable to be used in French-Canadian post-acute TBI rehabilitation settings.

Keywords:

• Traumatic brain injury
• rehabilitation
• outcome assessment
• social participation
• psychometrics
• validation study

Acknowledgments

The authors wish to thank the clinicians and program managers from the TBI rehabilitation programs at the two Integrated University Health and Social Services Centres (CIUSSS) and the Integrated Health and Social Services Centre (CISSS) that participated in the study: the CIUSSS du Centre-Sud-de-l'Île-de-Montréal, the CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, and the CISSS de Laval.

Declaration of interest

The authors report no conflicts of interest.

Additional information

Funding

This research was supported by a graduate scholarship from the Fonds de recherche du Québec – Santé (FRQS) to Marie-Claude Guerrette and by a research grant from the Fonds de recherche du Québec – Santé (FRQS) to Michelle McKerral [grant number 254599].