Validation of the French-Canadian adaptation of the Mayo-Portland Adaptability Inventory in an adult traumatic brain injury (TBI) rehabilitation setting

The Mayo-Portland Adaptability Inventory-4 (MPAI-4) (Malec, 2005) assesses functional abilities, global outcome and community integration of individuals with brain injuries by covering a wide range of physical, cognitive, emotional and social problems that may arise after the injury. The original version of the MPAI-4 has undergone rigorous psychometric testing (Kean et al., 2011; Malec et al., 2003), and given its clinical usefulness, the questionnaire was translated and adapted to other languages, such as French (McKerral et al., 2014). However, the psychometric properties of the French-Canadian version of the MPAI-4 have not yet been reported. Therefore, our objective was to establish the psychometric properties of the French-Canadian MPAI-4, using a Canadian sample of adults with TBI receiving post-acute rehabilitation services. Method: The MPAI-4, a 30-item questionnaire divided into three subscales (Abilities, Adjustment, Participation), gives rise to specific indexes and a total score reflecting the general level of adaptation/social participation. The French-Canadian MPAI-4 was implemented in four rehabilitation centres in the greater Montreal region and MPAI-4 data are systematically obtained for all individuals participating in interdisciplinary rehabilitation at the start and end of the programs. Participants (N = 513) were adults having sustained a mild, moderate or severe TBI who received rehabilitation interventions at one of the four rehabilitation centres, and for whom a first MPAI-4 measure was completed between 2013 and 2018. Results: To evaluate the construct validity of the French-Canadian MPAI-4, an exploratory factor analysis (EFA) using a varimax rotation method was performed on z-scores for the 30 items. The final and best solution was a three-factor solution, which accounted for 42.77% of the variance. Three of the 30 items failed to have a loading value u2265 .30 on any factor. Since failure of these items to load reflects the homogeneity of participantsu2019 responses, the three items were theoretically assigned to a factor. The internal consistency of the French-Canadian MPAI-4 was determined using Cronbachu2019s alpha, and all three subscales showed good internal consistency (all a u2265 .73). Conclusions: The three factors extracted using data from the French-Canadian MPAI-4 and a Canadian TBI sample are similar, but not entirely identical to the three subscales found in the original version of the MPAI-4. This may be explained by cultural and clinical differences between the studied samples, which can affect the distribution of items across factors. The factor labels suggested by Malec (2005) also suited the extracted factors and were thus retained for the French-Canadian MPAI-4 (Abilities, Adjustment, Participation). Overall, the French-Canadian MPAI-4 factor structure is validated, and the questionnaire shows good psychometric properties. The French-Canadian MPAI-4 thus represents a suitable tool to measure functional evolution, outcomes and social integration of individuals with TBI receiving rehabilitation services in a French-Canadian context.

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