Table 2.

Person factor constructs (scales) and operational definitions for the safety assessment measure

Proposed Construct	Stakeholder / Expert Feedback and Research Team Decisions	Field Testing Scale Name	Operational Definition of Scale Construct
Cognitive Capacity	Agreement on core construct and that operational definition has unidimensionality	Cognitive Capacity	Cognitive impairments lead to a “lack of behavior” that creates specific safety risks Forgetfulness, inattention, slowed processing speed, lack of initiation, and difficulty understanding information drives risk Difficulty responding in an emergency situation
Physical Capacity	Determined that physical capacity related to upper and lower extremity functioning was not unidimensional Agreed on visuomotor capacity as a unidimensional core construct Agreed to measure presence of upper extremity impairments (e.g. spasticity, hemiparesis) in a physical and history questionnaire	Visuomotor Capacity	Visuomotor impairments lead to “unsuccessful behavior” that creates specific safety risks Visuomotor safety risks are secondary to vision, strength, coordination, balance, and dexterity
	Determined that a subset of persons with TBI used a wheelchair and that this posed risk Agreed that a range of behavior related to wheelchair use would be a unidimensional core construct	Wheelchair Use	Impaired attention, processing speed, judgment, balance, and/or impulsivity lead to wheelchair use behaviors that place self and/or others at risk Does not follow wheelchair safety precautions
Perceived Susceptibility to Harm	Agreed on core construct of perceiving risk; changed the construct name due to concerns that patients and families would not understand “perceived susceptibility” Created separate construct, “Compliance Failures with Safety Recommendations” to capture not following medical recommendations or activity restrictions	Risk Perception	Impaired judgment of risk due to naiveté or limited awareness of impairments Difficulty anticipating potentially harmful situations or consequences Does not follow common safety precautions
		Compliance Failures with Safety Recommendations	Does not seek medical treatment when needed Does not comply with recommended treatments, activity restrictions, or situational supervision Does not use needed assistive equipment
Self-Regulation	Agreement on core construct and that operational definition has unidimensionality	Self-Regulation	Impulsivity-acts directly on drives/emotions Disinhibition-inability to control impulsive responses to situations Aggression, sexual disinhibition, and wandering

Note. Following field testing, patients and families in focus groups to develop a translational report recommended renaming the scales; the final scale names reflect their feedback and research team decisions.