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Ataman R, Alhasani R, Auneau-Enjalbert L, Quigley A, Michael HU, Ahmed S. The psychometric properties of the Quality of Life in Neurological Disorders (Neuro-QoL) measurement system in neurorehabilitation populations: a systematic review. J Patient Rep Outcomes 2024; 8:106. [PMID: 39292414 PMCID: PMC11410750 DOI: 10.1186/s41687-024-00743-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 05/17/2024] [Indexed: 09/19/2024] Open
Abstract
OBJECTIVE To systematically review the literature of existing evidence on the measurement properties of the Quality of Life in Neurological Disorders (Neuro-QoL) measurement system among neurorehabilitation populations. DATA SOURCES The Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) guided this systematic review in which we searched nine electronic databases and registries, and hand-searched reference lists of included articles. STUDY SELECTION Two independent reviewers screened selected articles and extracted data from 28 included studies. DATA EXTRACTION COSMIN's approach guided extraction and synthesizing measurement properties evidence (insufficient, sufficient), and the modified GRADE approach guided synthesizing evidence quality (very-low, low, moderate, high) by diagnosis. DATA SYNTHESIS Neuro-QoL has sufficient measurement properties when used by individuals with Huntington's disease, Multiple Sclerosis, Parkinson's disease, stroke, lupus, cognitive decline, and amyotrophic lateral sclerosis. The strongest evidence is for the first four conditions, where test-retest reliability, construct validity, and responsiveness are nearly always sufficient (GRADE: moderate-high). Structural validity is assessed only in multiple sclerosis and stroke but is often insufficient (GRADE: moderate-high). Criterion validity is sufficient in some stroke and Huntington's disease domains (GRADE: high). Item response theory analyses were reported for some stroke domains only. There is limited, mixed evidence for responsiveness and measurement error (GRADE: moderate-high), and no cross-cultural validity evidence CONCLUSIONS: Neuro-QoL domains can describe and evaluate patients with Huntington's disease, multiple sclerosis, Parkinson's disease, and stroke, but predictive validity evidence would be beneficial. In the other conditions captured in this review, a limited number of Neuro-QoL domains have evidence for descriptive use only. For these conditions, further evidence of structural validity, measurement error, cross-cultural validity and predictive validity would enhance the use and interpretation of Neuro-QoL.
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Affiliation(s)
- Rebecca Ataman
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, Québec, Canada
- Clinical Institutes and Quality Programs, Ontario Health, Toronto, Ontario, Canada
| | - Rehab Alhasani
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Line Auneau-Enjalbert
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, Québec, Canada
- Constance Lethbridge Rehabilitation Center, CIUSSS Centre-Ouest de l'Île de Montreal, Montreal, Quebec, Canada
| | - Adria Quigley
- School of Physiotherapy, Dalhousie University, Forrest Building, 5869 University Avenue, PO Box 15000, Halifax, Nova Scotia, B3H 4R2, Canada
- Nova Scotia Health Authority, Nova Scotia Rehabilitation and Arthritis Centre, 1341 Summer St, Halifax, Nova Scotia, B3H 4K4, Canada
| | - Henry Ukachukwu Michael
- Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
- Center for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Center, Montreal, Quebec, Canada
| | - Sara Ahmed
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada.
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, Québec, Canada.
- Constance Lethbridge Rehabilitation Center, CIUSSS Centre-Ouest de l'Île de Montreal, Montreal, Quebec, Canada.
- Clinical Epidemiology, Center for Outcome Research and Evaluation (CORE), McGill University Health Center Research Institute, Montreal, Quebec, Canada.
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Jung W, Vogel M, Figuracion KCF, Byun E, Thompson H. The Perceived Meaning of Traumatic Brain Injury for Older Adults: A Longitudinal-Multiple Case Study. Rehabil Nurs 2024; 49:14-23. [PMID: 38156950 DOI: 10.1097/rnj.0000000000000445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
PURPOSE The aim of this study was to explore the perceived meaning of traumatic brain injury (TBI) over the first-year postinjury among older adults and to explore if and how meaning changes. DESIGN A longitudinal multiple-case study design was used. METHODS Semistructured face-to-face interviews were completed at 1 week and 1, 3, 6, and 12 months postinjury. Transcripts were analyzed using inductive thematic analysis. RESULTS Fifty-five interviews were conducted with 12 participants. Four themes were identified: gratitude, vulnerability and dependence, slowing down and being more careful, and a chance for reflecting on life. Most participants' perceptions of their TBI remained either consistently positive or negative over the first-year postinjury. CLINICAL RELEVANCE Nurses should elicit and support patients' positive illness perceptions regarding their brain injury, which can contribute to a higher quality of life. For those patients with negative illness perceptions, nurses should provide resources in order to support coping and resilience following brain injury. CONCLUSIONS This study is the first study to explore individual perceptions over time of the meaning made from experiencing TBI among older adults. Findings can serve as a foundation for tailored supportive interventions among older adults following TBI to maximize quality of life.
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Affiliation(s)
- Wonkyung Jung
- RESILIENCE Center, School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Mia Vogel
- Center for Public Health Systems Science, Institute for Clinical and Translational Science, Brown School, Washington University in St. Louis, St Louis, MO, USA
| | - Karl Cristie F Figuracion
- School of Nursing, Alvord Brain Tumor Center, Department of Radiation Oncology, University of Washington, Seattle, WA, USA
| | - Eeeseung Byun
- Department of Biobehavioral Nursing & Health Informatics, School of Nursing, University of Washington, Seattle, WA, USA
| | - Hilaire Thompson
- Department of Biobehavioral Nursing & Health Informatics, School of Nursing, Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA, USA
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Gavrila Laic RA, Vander Sloten J, Depreitere B. In-depth assessment of quality of life and real life impact of mild traumatic brain injury in elderly by means of a focus group study. BRAIN & SPINE 2023; 3:101722. [PMID: 37383461 PMCID: PMC10293298 DOI: 10.1016/j.bas.2023.101722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/06/2023] [Accepted: 02/22/2023] [Indexed: 06/30/2023]
Abstract
Traumatic Brain Injury (TBI) in the elderly population leads to more severe consequences than in young patients. However, the impact that TBI has on elderly patients' Quality of Life (QoL) has not been thoroughly investigated and is still unclear. Therefore, the main objective of this study is to qualitatively investigate changes in QoL after mild TBI in elderly patients. A focus group interview was conducted with 6 mild TBI patients, with a median age of 74 years old, admitted to the University Hospitals Leuven (UZ Leuven) between 2016 and 2022. The data analysis was performed following the guide provided by Dierckx de Casterlé et al. in 2012, using Nvivo software. Three themes emerged from the analysis: functional disturbances and symptoms, daily life after TBI, and life quality, feelings and satisfaction. The most reported factors that deteriorated QoL 1-5 years post-TBI in our cohort were the lack of support from partners and families, changes in self-perception and social life, tiredness, balance disturbances, headache, cognitive deterioration, changes in physical health, senses' disturbances, changes in sexual life, sleep problems, speech disturbances and dependence for daily life activities. No symptoms of depression or feelings of shame were reported. The acceptance of the situation and hope for improvement were shown to be the most important coping mechanisms for these patients. In conclusion, mild TBI in elderly patients frequently leads to changes in self-perception, daily life activities and social life 1-5 years after the injury, which could contribute to a loss of independence and QoL deterioration. The acceptance of the situation and a good support network seem to be protective factors for these patients' well-being after TBI.
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Chang CW, Tzeng HY, Ma CY, Li ST, Chen KJ, Chiang HH. Effectiveness of exercise in improving quality of life in patients with traumatic brain injury: A systematic review and meta-analysis. Brain Inj 2023; 37:140-146. [PMID: 36625006 DOI: 10.1080/02699052.2023.2165155] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Traumatic brain injury (TBI) is a major cause of disability and mortality worldwide. People with TBI exhibit poor quality of life (QOL). Exercise is considered a possible intervention for improving cognitive function and mood, helping improve QOL in patients with TBI. According to our review of the relevant literature, meta-analyses have yet to explore the effect of exercise on QOL in patients with TBI. OBJECTIVES To determine by meta-analysis of relevant studies whether physical exercise could promote QOL in patients with TBI. METHODS A systematic review and meta-analysis of intervention studies involving physical exercise for improving QOL outcomes in TBI populations were conducted according to the PRISMA guideline. Our inclusion criteria were as follows: being randomized or nonrandomized controlled trials with quantitative designs that included patients diagnosed with TBI. RESULTS Thus, six studies met the inclusion criteria. The interventions in four of the six studies had statistically significant effects on QOL improvement. Our meta-analysis revealed a moderate effect size of physical exercise on QOL promotion in patients with TBI. CONCLUSION For TBI, exercise seems to improve QOL. More research with long-term follow-up should be conducted to assess the effect of exercise on patients with TBI.
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Affiliation(s)
- Chia-Wen Chang
- Department of Nursing, Taoyuan Armed Forces, Taoyuan General Hospital, Taoyuan, Taiwan
| | - Hsin-Ya Tzeng
- School of Nursing, National Defense Medical Center, Taipei, Taiwan.,Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan
| | - Ching-Yuan Ma
- School of Nursing, National Defense Medical Center, Taipei, Taiwan.,Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan
| | - Shih-Ting Li
- School of Nursing, National Defense Medical Center, Taipei, Taiwan.,Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan
| | - Kuan-Jung Chen
- Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan
| | - Hui-Hsun Chiang
- School of Nursing, National Defense Medical Center, Taipei, Taiwan
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van der Vlegel M, Mikolić A, Lee Hee Q, Kaplan ZLR, Retel Helmrich IRA, van Veen E, Andelic N, Steinbuechel NV, Plass AM, Zeldovich M, Wilson L, Maas AIR, Haagsma JA, Polinder S. Health care utilization and outcomes in older adults after Traumatic Brain Injury: A CENTER-TBI study. Injury 2022; 53:2774-2782. [PMID: 35725508 DOI: 10.1016/j.injury.2022.05.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/11/2022] [Accepted: 05/08/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The incidence of Traumatic Brain Injury (TBI) is increasingly common in older adults aged ≥65 years, forming a growing public health problem. However, older adults are underrepresented in TBI research. Therefore, we aimed to provide an overview of health-care utilization, and of six-month outcomes after TBI and their determinants in older adults who sustained a TBI. METHODS We used data from the prospective multi-center Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. In-hospital and post-hospital health care utilization and outcomes were described for patients aged ≥65 years. Ordinal and linear regression analyses were performed to identify determinants of the Glasgow Outcome Scale Extended (GOSE), health-related quality of life (HRQoL), and mental health symptoms six-months post-injury. RESULTS Of 1254 older patients, 45% were admitted to an ICU with a mean length of stay of 9 days. Nearly 30% of the patients received inpatient rehabilitation. In total, 554/1254 older patients completed the six-month follow-up questionnaires. The mortality rate was 9% after mild and 60% after moderate/severe TBI, and full recovery based on GOSE was reported for 44% of patients after mild and 6% after moderate/severe TBI. Higher age and increased injury severity were primarily associated with functional impairment, while pre-injury systemic disease, psychiatric conditions and lower educational level were associated with functional impairment, lower generic and disease-specific HRQoL and mental health symptoms. CONCLUSION The rate of impairment and disability following TBI in older adults is substantial, and poorer outcomes across domains are associated with worse preinjury health. Nonetheless, a considerable number of patients fully or partially returns to their preinjury functioning. There should not be pessimism about outcomes in older adults who survive.
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Affiliation(s)
- Marjolein van der Vlegel
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands.
| | - Ana Mikolić
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands
| | - Quentin Lee Hee
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands
| | - Z L Rana Kaplan
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands
| | - Isabel R A Retel Helmrich
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands
| | - Ernest van Veen
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands; Department of Intensive Care Adults, Rotterdam, the Netherlands
| | - Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital and University of Oslo, 0424 Oslo, Norway
| | - Nicole V Steinbuechel
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen (UMG)/ Georg-August-University, Göttingen, Germany
| | - Anne Marie Plass
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen (UMG)/ Georg-August-University, Göttingen, Germany
| | - Marina Zeldovich
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen (UMG)/ Georg-August-University, Göttingen, Germany
| | - Lindsay Wilson
- Division of Psychology, University of Stirling, Stirling, UK
| | - Andrew I R Maas
- Department of Neurosurgery, Antwerp University Hospital and University of Antwerp, Edegem, Belgium
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands
| | - Suzanne Polinder
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands
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Perseguino MG, Okuno MFP, Horta ALDM. Vulnerability and quality of life of older persons in the community in different situations of family care. Rev Bras Enferm 2021; 75Suppl. 4:e20210034. [PMID: 34852042 DOI: 10.1590/0034-7167-2021-0034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/10/2021] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE to correlate socio-contextual aspects, physical vulnerability and quality of life of older persons in the community in different situations of family care. METHODS epidemiological, a cross-sectional and analytical study, with elderly people in the community (n=769), with application of the instruments: Vulnerable Elders Survey-13 (VES-13), World Health Organization Quality of Life for Older Persons (WHOQOL-OLD) and the World Health Organization Quality of Life (WHOQOL-BREF); and socio-contextual data questionnaire. RESULTS the population assessed presented an average of regular quality of life in both the WHOQOL-BREF and the WHOQOL-OLD. Older non-vulnerable persons (62.2%) and those with close family contact (82.6%) have a better quality of life than the vulnerable (p<0.0001). CONCLUSION lower quality of life scores and more distant families are related to vulnerable elderly people; thus, the assessment of family proximity and physical vulnerability of older persons is shown to be an important factor in improving quality of life.
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Falkowska Z, Heider N, Resch K, Royko J, Büttner-Kunert J. Die Erhebung von kommunikativ-pragmatischen Fähigkeiten und Lebensqualität nach Schädel-Hirn-Trauma. ZEITSCHRIFT FÜR NEUROPSYCHOLOGIE 2021. [DOI: 10.1024/1016-264x/a000336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung. Hintergrund: Kommunikationsstörungen nach Schädel-Hirn-Trauma (SHT) können die Betroffenen langfristig in der sozialen Teilhabe und damit in der Lebensqualität (LQ) beeinträchtigen. Der Erfassung dieser Störungen liegt aktuell kein einheitliches Vorgehen zugrunde. Ziele: Ziel des vorliegenden Scoping Reviews war die Erfassung von Diagnostikverfahren, welche die kommunikativ-pragmatischen Kompetenzen und die Auswirkung möglicher kommunikativer Defizite auf soziale Teilhabe und LQ bei Menschen mit SHT überprüfen. Ergebnisse: Eine systematische Datenbankrecherche für den Veröffentlichungszeitraum 2010 bis 2020 identifizierte 14 relevante Testverfahren (6 auf Deutsch verfügbar). Eine inhaltliche und methodische Analyse stellte Verfahren zur Überprüfung der Kommunikationsfähigkeit (z. B. La Trobe Communication Questionnaire [LCQ]) und Verfahren zur Erfassung von Partizipation und LQ (z. B. Quality of Life after Brain Injury [QOLIBRI]) heraus. Zusammenfassung: Trotz der hohen Auftretenshäufigkeit und Persistenz kommunikativer Störungen nach SHT stehen im deutschsprachigen Raum bislang wenige geeignete Diagnostikverfahren zur Ermittlung von Kommunikationsfähigkeiten und LQ zur Verfügung. Eine weiterführende Entwicklung erscheint unerlässlich.
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Affiliation(s)
- Zofia Falkowska
- Masterstudiengang Sprachtherapie, Schwerpunkt „Neurogene Sprach- und Sprechstörungen“, LMU München
| | - Nathalie Heider
- Masterstudiengang Sprachtherapie, Schwerpunkt „Neurogene Sprach- und Sprechstörungen“, LMU München
| | - Katharina Resch
- Masterstudiengang Sprachtherapie, Schwerpunkt „Neurogene Sprach- und Sprechstörungen“, LMU München
| | - Julia Royko
- Masterstudiengang Sprachtherapie, Schwerpunkt „Neurogene Sprach- und Sprechstörungen“, LMU München
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Sokas C, Herrera-Escobar JP, Klepp T, Stanek E, Kaafarani H, Salim A, Nehra D, Cooper Z. Impact of chronic illness on functional outcomes and quality of life among injured older adults. Injury 2021; 52:2638-2644. [PMID: 33823987 DOI: 10.1016/j.injury.2021.03.052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/17/2021] [Accepted: 03/23/2021] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Trauma care for injured older adults is complicated by pre-existing chronic illness. We examined the association between chronic illness and post-injury function, healthcare utilization and quality of life. METHODS Trauma patients ≥65 years with an Injury Severity Score (ISS) ≥9 discharged from one of three level-1 trauma centers were interviewed 6-12 months post-discharge. Patients were asked about new functional limitations, injury-related emergency department (ED) visits or readmission, and health-related quality of life (HRQoL). Trauma registry data was used to determine presence of seven chronic illnesses. Adjusted regression models examined associations between increasing number of chronic illness (0, 1, ≥2) and outcomes. RESULTS Of 1,379 patients, 46.5% had at least one chronic illness. In adjusted analysis, any chronic illness was associated with higher odds of new functional limitation (1 chronic illness, OR1.54, CI: 1.20-1.97; ≥2, OR1.69, CI: 1.16-2.48) and worse physical health-related QoL (1 chronic illness adj. mean diff= -4.0, CI: -5.6 to -2.5; ≥2 adj. mean diff.= -4.4, CI: -7.3 to -1.4, p<0.01). Mental health post-injury was consistent with population norms across all groups. CONCLUSION Presence of any chronic illness in older adults is associated with new functional limitations and worse physical HRQoL post-injury, but unchanged mental health. Focused interventions are needed to support long-term recovery.
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Affiliation(s)
- Claire Sokas
- Brigham and Woman's Hospital, Center for Surgery and Public Health, Boston, MA USA.
| | | | - Timothy Klepp
- Boston University, School of Medicine, Boston, MA USA
| | - Ewelina Stanek
- Brigham and Woman's Hospital, Center for Surgery and Public Health, Boston, MA USA
| | - Haytham Kaafarani
- Harvard Medical School, Boston, MA, USA; Massachusetts General Hospital, Boston, MA, USA
| | - Ali Salim
- Brigham and Woman's Hospital, Center for Surgery and Public Health, Boston, MA USA; Harvard Medical School, Boston, MA, USA
| | | | - Zara Cooper
- Brigham and Woman's Hospital, Center for Surgery and Public Health, Boston, MA USA; Harvard Medical School, Boston, MA, USA
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Carter B, Hayes C, Smith A, Pennington A, Price M, Pearson O, Vitoratou S, Hewitt J. A single patient reported outcome measure for acquired brain injury, multiple sclerosis & Parkinson's disease. PLoS One 2021; 16:e0251484. [PMID: 34086698 PMCID: PMC8177510 DOI: 10.1371/journal.pone.0251484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 04/28/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To determine psychometric properties of the PROMIS-10 and Standard Stroke Question Set (by International Consortium for Health Outcome Measures) presented as a new 15-item Patient Related Outcome (PRO), for patients with: acquired Brain Injury (ABI), Multiple sclerosis (MS) and Parkinson's disease (PD). METHODS In an eight centre, UK wide, cross-sectional study we approached patients during their routine follow-up to complete: a disease-specific instrument (European Brain Injury Questionnaire, Multiple Sclerosis Impact Scale, and Parkinson's disease questionnaire); General Health questionnaire with a Quality of life measure (EQ-5D); and PRO. We validated the PRO using factor analysis to define the latent construct domains, then calculated the internal consistency (Cronbach's-α), and construct validity (correlation). RESULTS There were 340 patients with ABI (N = 91, median age = 55.1, 41% female), MS (N = 99, age = 58.9, 69%) and PD (N = 150, age = 74.5, 40%). Factor analysis suggested the PRO offered three domains of: physical health; functionality-capacity and mental health. All factors correlated strongly with the three disease-specific instruments, and the overall PRO had a large correlation with the EQ-5D (correlation>0.8) offering good construct validity and excellent internal consistency (∝>0.89). INTERPRETATION The PRO offered promising psychometric properties and could be used in place of disease specific questionnaires for patients with ABI, MS, and PD. The PRO has three construct domains, describing patients': mental health; physical health; and functional-capacity, and may be used in routine clinical practice. The PRO offered both relevance to each of the three separate neurological conditions and generalisability across all the conditions, increasing its utility.
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Affiliation(s)
- Ben Carter
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Chloe Hayes
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, United Kingdom
| | - Alexander Smith
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Anna Pennington
- Aneurin Bevan University Health Board, South Wales, United Kingdom
| | | | - Owen Pearson
- Swansea Bay University Health Board, Port Talbot, United Kingdom
| | - Silia Vitoratou
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Jonathan Hewitt
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
- Aneurin Bevan University Health Board, South Wales, United Kingdom
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Zhou Y, Ye H, Lu W. Serum Substance P Concentration in Children With Traumatic Brain Injury: A First Report. World Neurosurg 2020; 147:e200-e205. [PMID: 33307260 DOI: 10.1016/j.wneu.2020.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 12/01/2020] [Accepted: 12/01/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To review the clinic value and severity assessment of serum substance P (SP) concentration in children with different degrees of traumatic brain injury (TBI) through analyzing correlations with outcomes. METHODS One hundred thirty-nine children with TBI who were diagnosed and treated at Nanjing Medical University for longer than 72 hours between June 2017 and 2019 were analyzed. Blood samples were obtained within 24 hours after TBI to measure SP concentration. The endpoint was discharge mortality. Thirty healthy children composed the control group. Comparative analyses of differences in SP concentration were conducted for the different groups. Both the Sequential Organ Failure Assessment (SOFA) scores and Pediatric Clinical Illness Score (PCIS) were measured on admission and used in univariate and multivariate analyses. RESULTS The serum SP (89.10 ± 64.32) pmol/L) level in the case group was significantly higher than that in the control group (21.84 ± 2.09) pmol/L (t = 5.71, P < 0.05). The serum SP (182.81 ± 58.39) pmol/L) level in the deceased group was significantly higher than that in the survival group (59.93 ± 27.90) pmol/L (t = 16.52, P < 0.05). A negative correlation existed between serum SP concentration and Glasgow Coma Scale score in the severe, moderate, and mild groups (r = -0.72, P < 0.05). Serum SP concentration was identified as an independent risk factor for mortality (odds ratio >1, 95% confidence interval = 1.04-1.28, P < 0.01). Receiver operating characteristic curve analysis suggested that serum SP concentration had the same calibrating power as SOFA and PCIS in discriminating the risk of death of children. CONCLUSIONS Serum SP concentration was associated with severity in children with TBI, and extremely high levels indicated a poor prognosis.
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Affiliation(s)
- Ying Zhou
- Department of Surgical Intensive Care Unit, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Hui Ye
- Department of Surgical Intensive Care Unit, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Weifeng Lu
- Department of Surgical Intensive Care Unit, Children's Hospital of Nanjing Medical University, Nanjing, China.
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