Participant-proxy agreement on objective and subjective aspects of societal participation following traumatic brain injury.

Objective: To examine congruence between participant (P) and significant other (SO) reports on societal participation in 3 objective domains (economic, community, and social activities) and subjective satisfaction with participation at 1 year after traumatic brain injury (TBI).
Participants: Ninety-seven persons with moderate to severe TBI and their SOs (27 spouses/partners, 47 parents, 23 other relatives/friends).
Main Outcome Measure: Community Participation Indicators questionnaire, divided into Objective (Economic, Community, Social) and Subjective (Satisfaction) subscales.
Design: Prospective correlational study.
Results: P-SO congruence differed by domain of participation, with Economic and Community indicators showing higher agreement than Social and Satisfaction items. Congruence was not affected by P-SO relationship or whether the pair lived together. However, pairs who spent at least daily time together had significantly higher agreement on Satisfaction items than pairs who were together less often. Congruence was not predicted by SOs' self-reported degree of awareness of Ps' concerns. Severity of TBI, within the range represented in this sample, had no effect on P-SO congruence in any domain.
Conclusion: In research on participation after TBI, proxy report may be an acceptable substitute for missing participant report on productivity and community activity outcomes. However, proxy responses should be used with caution for questions about social activities and degree of satisfaction with participation.