Long-term disabilities associated with combat casualties: measuring disability and reintegration in combat veterans

Many physical and mental health problems associated with combat casualties affect the reintegration of service members into home and community life. Quantifying and measuring reintegration is important to answer questions about clinical, research, economic, and policy issues that directly affect combat veterans. Although the construct of participation presented in the International Statistical Classification of Diseases and Related Health Problems and in the International Classification of Functioning, Disability and Health provides a theoretical framework with which to understand and measure community reintegration in general, a measure was needed that specifically addressed the reintegration of combat veterans. To address this need, the Community Reintegration for Service Members global outcomes measure was developed. It consists of three scales, which measure extent of participation, perceived limitations, and satisfaction. The measure was validated in a general sample of veterans and in a sample of severely wounded service members. The computer-adapted test version shows good precision, reliability, construct validity, and predictive validity.