Validation of an eight-item resilience scale for inpatients with spinal cord injuries in a rehabilitation hospital: exploratory factor analyses and item response theory

PurposePeople with spinal cord injury (PwSCI) can experience life changes, including impacts on their physical and mental health. PwSCI often report less life satisfaction and lower subjective well-being than peers without SCI. These challenges and adversities increase the demand on them to be more resilient. Healthcare providers need quick and valid instruments to assess adult patients' resilience in clinical settings. We aimed to validate the factor validity and discrimination ability of a resilience scale, CD-RISC-10, for clinical usage in adults with SCI during hospitalization.Materials and Methods93 adults with SCI responded to the self-reported survey, including CD-RISC-10, the Patient Health Questionnaire-9 Scale (PHQ-9), the Satisfaction with Life Scale (SWLS), and the Intrinsic Spirituality Scale. We conducted descriptive statistics, exploratory factor analysis (EFA), and item response theory (IRT).ResultsTwo items were deleted from CD-RISC-10 after EFA, forming CD-RISC-8. The item discriminations of the remaining eight items from the unconstrained IRT model ranged from a high of 3.071 to a relatively low 1.433. CD-RISC-8 is significantly related to PHQ-9 and SWLS.ConclusionsThe factor validity of the CD-RISC-8 was improved. Significantly, the CD-RISC-8 has excellent potential for clinical usage due to its discriminant ability between low and intermediate resilience. Spinal Cord InjuryPeople with spinal cord injury (PwSCI) experience unique challenges and adversities that can negatively affect physical, mental, social, and financial health and life satisfaction.PwSCI with higher resilience adapt to challenges quicker, and have better mental health outcomes and improved quality of life.The CD-RISC-8 is useful for screening PwSCI who need resilience intervention and it is sensitive enough to evaluate resilience improvement within two minutes.