Psychometric validation of the reintegration to normal living index in people living with spinal cord injuries

Abstract

The evaluation of rehabilitation outcomes requires measurement instruments that are valid and reliable, and have been psychometrically tested in the context of a particular population. The purpose of this study was to psychometrically test the validity and reliability of the Reintegration to Normal Living Index (RNLI) as a measure of community reintegration in a population of community-dwelling people living with spinal cord injury (PLWSCI) in South Africa. The study was a cross-sectional, involving community dwelling people living with SCI (PLWSCI), who had been discharged from inpatient rehabilitation at for at least two years. RNLI data collected from 160 PLWSCI were subjected to factor analysis and tested for reliability using chronbach’s alpha. Cronbach’s alpha for the RNLI instrument was 0.97 (ICC 95% CI: 0.97 – 0.98), indicating an excellent reliability coefficient. A single -factor structure emerged from principal components analysis, indicating that there is only one factor structure for the RNLI in this population of PLWSCI. The content, construct, convergent and discriminate validity of the instrument were established. The results of this study support the reliability and factorial validity of the RNLI as a measure of community reintegration for PLWSCI. The RNLI is therefore a valuable outcome measure and should be extended to other SCI rehabilitation studies in South Africa.