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das Nair R, Bradshaw LE, Carpenter H, Clarke S, Day F, Drummond A, Fitzsimmons D, Harris S, Montgomery AA, Newby G, Sackley C, Lincoln NB. A group memory rehabilitation programme for people with traumatic brain injuries: the ReMemBrIn RCT. Health Technol Assess 2020; 23:1-194. [PMID: 31032782 DOI: 10.3310/hta23160] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND People with traumatic brain injuries (TBIs) commonly report memory impairments. These are persistent, debilitating and reduce quality of life, but patients do not routinely receive memory rehabilitation after discharge from hospital. OBJECTIVE To assess the clinical effectiveness and cost-effectiveness of a group memory rehabilitation programme for people with TBI. DESIGN Multicentre, pragmatic, cluster randomised controlled trial. Qualitative and health economic evaluations were also undertaken. SETTING Community settings in nine sites in England. PARTICIPANTS Participants were aged 18-69 years, had undergone a TBI > 3 months prior to recruitment, reported memory problems, were able to travel to a site to attend group sessions, could communicate in English and gave informed consent. RANDOMISATION AND BLINDING Clusters of four to six participants were randomised to the memory rehabilitation arm or the usual-care arm on a 1 : 1 ratio. Randomisation was based on a computer-generated pseudo-random code using random permuted blocks of randomly varying size, stratified by study site. Participants and therapists were aware of the treatment allocation whereas outcome assessors were blinded. INTERVENTIONS In the memory rehabilitation arm 10 weekly sessions of a manualised memory rehabilitation programme were provided in addition to usual care. Participants were taught restitution strategies to retrain impaired memory functions and compensation strategies to enable them to cope with memory problems. The usual-care arm received usual care only. MAIN OUTCOME MEASURES Outcomes were assessed at 6 and 12 months after randomisation. Primary outcome: patient-completed Everyday Memory Questionnaire - patient version (EMQ-p) at 6 months' follow-up. Secondary outcomes: Rivermead Behavioural Memory Test - third edition (RBMT-3), General Health Questionnaire 30-item version, European Brain Injury Questionnaire, Everyday Memory Questionnaire - relative version and individual goal attainment. Costs (based on a UK NHS and Personal Social Services perspective) were collected using a service use questionnaire, with the EuroQol-5 Dimensions, five-level version, used to derive quality-adjusted life-years (QALYs). A Markov model was developed to explore cost-effectiveness at 5 and 10 years, with a 3.5% discount applied. RESULTS We randomised 328 participants (memory rehabilitation, n = 171; usual care, n = 157), with 129 in the memory rehabilitation arm and 122 in the usual-care arm included in the primary analysis. We found no clinically important difference on the EMQ-p between the two arms at 6 months' follow-up (adjusted difference in mean scores -2.1, 95% confidence interval -6.7 to 2.5; p = 0.37). For secondary outcomes, differences favouring the memory rehabilitation arm were observed at 6 months' follow-up for the RBMT-3 and goal attainment, but remained only for goal attainment at 12 months' follow-up. There were no differences between arms in mood or quality of life. The qualitative results suggested positive experiences of participating in the trial and of attending the groups. Participants reported that memory rehabilitation was not routinely accessible in usual care. The primary health economics outcome at 12 months found memory rehabilitation to be £26.89 cheaper than usual care but less effective, with an incremental QALY loss of 0.007. Differences in costs and effects were not statistically significant and non-parametric bootstrapping demonstrated considerable uncertainty in these findings. No safety concerns were raised and no deaths were reported. LIMITATIONS As a pragmatic trial, we had broad inclusion criteria and, therefore, there was considerable heterogeneity within the sample. The study was not powered to perform further subgroup analyses. Participants and therapists could not be blinded to treatment allocation. CONCLUSIONS The group memory rehabilitation delivered in this trial is very unlikely to lead to clinical benefits or to be a cost-effective treatment for people with TBI in the community. Future studies should examine the selection of participants who may benefit most from memory rehabilitation. TRIAL REGISTRATION Current Controlled Trials ISRCTN65792154. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 16. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Roshan das Nair
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK.,Institute of Mental Health, Nottingham, UK.,Department of Clinical Psychology and Neuropsychology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Lucy E Bradshaw
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - Hannah Carpenter
- Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK
| | - Sara Clarke
- Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK
| | - Florence Day
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - Avril Drummond
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | | | - Shaun Harris
- Swansea Centre for Health Economics, Swansea University, Swansea, UK
| | - Alan A Montgomery
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - Gavin Newby
- Newby Psychological Services Ltd, Northwich, UK
| | - Catherine Sackley
- Division of Health and Social Care, King's College London, London, UK
| | - Nadina B Lincoln
- Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK
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Houben F, Ghysels R, Mennen D, Bosmans R, Nuyts E, Spooren A. A tool for measuring burden in activities and participation of clients with acquired brain injury: the FINAH-instrument. Brain Inj 2020; 34:1245-1252. [PMID: 32755421 DOI: 10.1080/02699052.2020.1802658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PRIMARY OBJECTIVE The objective of this study was to design an instrument to screen for burden in the daily life of both the client with acquired brain injury (ABI) and their nonprofessional caregiver. RESEARCH DESIGN Exploratory research Methods and Procedures: Based on a survey amongst stakeholder organizations, the FINAH-instrument is designed as a digital self-assessment questionnaire, based on ICF-framework. A test survey of the FINAH instrument is conducted on both clients, nonprofessional caregivers and healthcare professionals. MAIN OUTCOMES AND RESULTS The relative burden per item for clients and nonprofessional caregivers is most prominent in the domains of fatigue, cognitive and emotional consequences, self-care and mobility. The estimation of burden for clients and nonprofessional caregiver by healthcare professionals showed an overall 65% correct estimation by the healthcare professional. 19% of the items showed underestimation of burden, while 16% showed overestimation. CONCLUSIONS These results show that FINAH can ameliorate the estimation of the health care professional on the self-assessed burden of clients and nonprofessional caregivers, thus substantiating a more client-centred approach.
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Affiliation(s)
- Frederik Houben
- Department of Healthcare, PXL University College , Hasselt, Belgium
| | - Rudi Ghysels
- Department of Healthcare, PXL University College , Hasselt, Belgium
| | - Danny Mennen
- Department of Neurology, Adelante Centre of Expertise in Rehabilitation and Audiology , Hoensbroek, The Netherlands
| | - Roel Bosmans
- Department of Technology, PXL University College , Hasselt, Belgium
| | - Erik Nuyts
- Department of Healthcare, PXL University College , Hasselt, Belgium.,Faculty of Architecture and Arts, Hasselt University , Hasselt, Belgium
| | - Annemie Spooren
- Department of Healthcare, PXL University College , Hasselt, Belgium.,Faculty of Rehabilitation Sciences, Hasselt University , Hasselt, Belgium
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McCarron RH, Gracey F, Bateman A. Detecting mental health problems after paediatric acquired brain injury: A pilot Rasch analysis of the strengths and difficulties questionnaire. Neuropsychol Rehabil 2020; 31:1048-1068. [PMID: 32401169 DOI: 10.1080/09602011.2020.1760111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The parent-reported Strengths and Difficulties Questionnaire (SDQ-P) is commonly used to assess for mental health problems, but its psychometric properties have not been studied in the paediatric Acquired Brain Injury (ABI) population. This study investigated the properties of the SDQ-P and its subscales in this population using Rasch analysis. One hundred and forty-three SDQ-Ps and 123 Impact Supplements were analyzed. Sixty-nine percent of SDQ-Ps were completed by female carers, 59% of young people were male, and 58% had Traumatic Brain Injury (TBI). In this population the SDQ-P Total Difficulties Scale and the Conduct Problems subscale showed questionable construct validity. The individual subscales and Impact Supplement did not meet the criteria for reliability. Two items had disordered thresholds. The individual subscales showed mistargeting and 13-24% person misfit. Two items were significantly underdiscriminating. There was differential item functioning with age and time post-injury, and local dependence between subscale items. The Total Difficulties scale was multidimensional. The most easily endorsed items were in keeping with common symptoms of brain injury. These findings suggest the SDQ-P in its current form may not be a reliable and valid assessment measure for mental health difficulties in the paediatric ABI population and requires further investigation.
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Affiliation(s)
- Robyn Henrietta McCarron
- The Cambridge Centre for Paediatric Neuropsychological Rehabilitation, Cambridgeshire and Peterborough NHS Foundation Trust (CPFT), Cambridge, UK.,Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Fergus Gracey
- The Cambridge Centre for Paediatric Neuropsychological Rehabilitation, Cambridgeshire and Peterborough NHS Foundation Trust (CPFT), Cambridge, UK.,Collaborations for Leadership in Applied Health Research and Care (CLAHRC) East of England Programme, National Institute of Health Research (NIHR), Cambridge, UK.,Department of Clinical Psychology, University of East Anglia, Norwich, UK
| | - Andrew Bateman
- Department of Psychiatry, University of Cambridge, Cambridge, UK.,School of Health and Social Care, University of Essex, Colchester, UK
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Cariello AN, Perrin PB, Agudelo YR, Olivera Plaza SL, Quijano-Martínez MC, Trujillo MA, Arango-Lasprilla JC. Predictors of longitudinal depression trajectories after traumatic brain injury in Latin America: A multi-site study. NeuroRehabilitation 2020; 46:205-212. [PMID: 32083603 DOI: 10.3233/nre-192972] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND Latin America has exceptionally high rates of traumatic brain injury (TBI), but very little research has been conducted on longitudinal TBI outcomes in this global region. OBJECTIVE This study examined whether cognitive dysfunction and social disadaptation in individuals with TBI in Latin America at hospital discharge predict longitudinal trajectories of depression at baseline, 2 months, and 4 months. METHODS A sample of 109 people with a new TBI was recruited from three hospitals: Mexico City, Mexico, Cali, Colombia and Neiva, Colombia. Participants completed measures of cognitive dysfunction and social disadaptation before hospital discharge and measures of depression at baseline, 2 months, and 4 months. RESULTS Results suggested that depression scores were found to decrease over time in a quadratic (or U-shaped) fashion, and more significant cognitive dysfunction at hospital discharge was associated with higher longitudinal depression trajectories. Social disadaptation did not exert a unique effect on depression trajectories after controlling for cognitive dysfunction. Depression trajectories changed differentially over time as a function of baseline cognitive dysfunction, such that for those with high cognitive impairment, depression scores started high and then dropped to a moderated range and plateaued, but for individuals with low cognitive dysfunction, depression scores started lower and decreased linearly but moderately. CONCLUSIONS The results suggest a strong need for neuropsychological assessments and evidence-based cognitive rehabilitation strategies to be implemented immediately after TBI in Latin America, which could exert salubrious effects on depression trajectories over time.
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Affiliation(s)
| | | | - Yaneth Rodriguez Agudelo
- Department of Neuropsychology, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | | | | | | | - Juan Carlos Arango-Lasprilla
- BioCruces Bizkaia Health Research Institute, Cruces University Hospital Barakaldo, Barakaldo, Spain.,IKERBASQUE, Basque Foundation for Science, Bilbao, Spain.,Department of Cell Biology and Histology, University of the Basque Country (UPV/EHU), Leioa, Spain
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das Nair R, Bradshaw LE, Day FEC, Drummond A, Harris SRS, Fitzsimmons D, Montgomery AA, Newby G, Sackley C, Lincoln NB. Clinical and cost effectiveness of memory rehabilitation following traumatic brain injury: a pragmatic cluster randomized controlled trial. Clin Rehabil 2019; 33:1171-1184. [PMID: 30977398 PMCID: PMC6585159 DOI: 10.1177/0269215519840069] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 02/28/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the clinical and cost effectiveness of a group-based memory rehabilitation programme for people with traumatic brain injury. DESIGN Multicentre, pragmatic, observer-blinded, randomized controlled trial in England. SETTING Community. PARTICIPANTS People with memory problems following traumatic brain injury, aged 18-69 years, able to travel to group sessions, communicate in English, and give consent. INTERVENTIONS A total of 10 weekly group sessions of manualized memory rehabilitation plus usual care (intervention) vs. usual care alone (control). MAIN MEASURES The primary outcome was the patient-reported Everyday Memory Questionnaire (EMQ-p) at six months post randomization. Secondary outcomes were assessed at 6 and 12 months post randomization. RESULTS We randomized 328 participants. There were no clinically important differences in the primary outcome between arms at six-month follow-up (mean EMQ-p score: 38.8 (SD 26.1) in intervention and 44.1 (SD 24.6) in control arms, adjusted difference in means: -2.1, 95% confidence interval (CI): -6.7 to 2.5, p = 0.37) or 12-month follow-up. Objectively assessed memory ability favoured the memory rehabilitation arm at the 6-month, but not at the 12-month outcome. There were no between-arm differences in mood, experience of brain injury, or relative/friend assessment of patient's everyday memory outcomes, but goal attainment scores favoured the memory rehabilitation arm at both outcome time points. Health economic analyses suggested that the intervention was unlikely to be cost effective. No safety concerns were raised. CONCLUSION This memory rehabilitation programme did not lead to reduced forgetting in daily life for a heterogeneous sample of people with traumatic brain injury. Further research will need to examine who benefits most from such interventions.
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Affiliation(s)
- Roshan das Nair
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Lucy E Bradshaw
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - Florence EC Day
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - Avril Drummond
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Shaun RS Harris
- Swansea Centre for Health Economics, Swansea University, Swansea, UK
| | | | - Alan A Montgomery
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - Gavin Newby
- Newby Psychological Services Ltd, Northwich, UK
| | - Catherine Sackley
- School of Population Health & Environmental Sciences, King’s College London, London, UK
| | - Nadina B Lincoln
- Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK
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Perrin PB, Norup A, Caracuel A, Bateman A, Tjørnlund M, Arango-Lasprilla JC. An Actor-Partner Interdependence Model of Acquired Brain Injury Patient Impairments and Caregiver Psychosocial Functioning: A Dyadic-Report, Multinational Study. J Clin Psychol 2016; 73:279-293. [PMID: 27362465 DOI: 10.1002/jclp.22324] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 04/12/2016] [Accepted: 04/18/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The purpose of this study was to use actor-partner interdependence modeling (APIM) to examine the simultaneous effects of both acquired brain injury (ABI) patient and caregiver ratings of patient impairments on both patient and caregiver ratings of caregiver psychosocial dysfunction. METHOD A sample of 968 individuals with ABI and their caregivers (n = 1,936) from 4 countries completed the European Brain Injury Questionnaire, a measure of ABI impairments and caregiver psychosocial functioning in the context of providing care for the person with ABI. RESULTS An APIM with all adequate or good fit indices found that patient ratings of their own impairments in the domains of social disadaptation and depression were uniquely and positively associated with patient ratings of caregiver psychosocial dysfunction, yet none of the patient ratings of their own impairments were uniquely associated with caregiver ratings of caregiver psychosocial dysfunction. Caregiver ratings of patient impairments across all 3 domains (cognition, social disadaptation, and depression) were uniquely and positively associated with caregiver ratings of caregiver psychosocial dysfunction. Yet only caregiver ratings of patient social disadaptation were uniquely and positively associated with patient ratings of caregiver psychosocial dysfunction. CONCLUSIONS These findings suggest that caregivers' views of ABI patients' impairments are likely much more associated with caregiver psychosocial functioning than are patients' views of their own impairments, pointing to caregivers' interpretations of their patients' impairments as a primary target for cognitive behavioral interventions.
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Affiliation(s)
| | - Anne Norup
- A national study on young brain injury survivors, Department of Neurology, Rigshospitalet, Copenhagen University Hospital
| | | | - Andrew Bateman
- Collaboration for Leadership in Applied Health Research & Care (CLAHRC) East of England.,Department of Psychiatry, University of Cambridge.,Oliver Zangwill Centre for Neuropsychological Rehabilitation-Cambridgeshire Community Services NHS Trust
| | - Morten Tjørnlund
- Center for Rehabilitation of Brain Injury-University of Copenhagen
| | - Juan Carlos Arango-Lasprilla
- BioCruces Health Research Institute, Cruces University Hospital, Barakaldo, Bizkaia, Spain.,IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
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Ford CEL, Malley D, Bateman A, Clare IC, Wagner AP, Gracey F. Selection and visualisation of outcome measures for complex post-acute acquired brain injury rehabilitation interventions. NeuroRehabilitation 2016; 39:65-79. [PMID: 27341362 PMCID: PMC5268089 DOI: 10.3233/nre-161339] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Outcome measurement challenges rehabilitation services to select tools that promote stakeholder engagement in measuring complex interventions. OBJECTIVES To examine the suitability of outcome measures for complex post-acute acquired brain injury (ABI) rehabilitation interventions, report outcomes of a holistic, neuropsychological ABI rehabilitation program and propose a simple way of visualizing complex outcomes. METHODS Patient/carer reported outcome measures (PROMS), experience measures (PREMS) and staff-rated measures were collected for consecutive admissions over 1 year to an 18-week holistic, neuropsychological rehabilitation programme at baseline, 18 weeks and 3- and 6-month follow-up. RESULTS Engagement with outcome measurement was poorest for carers and at follow-up for all stakeholders. Dependence, abilities, adjustment, unmet needs, symptomatology including executive dysfunction, and self-reassurance showed improvements at 18 weeks. Adjustment, social participation, perceived health, symptomatology including dysexecutive difficulties, and anxiety were worse at baseline for those who did not complete rehabilitation, than those who did. A radar plot facilitated outcome visualization. CONCLUSIONS Engagement with outcome measurement was best when time and support were provided. Supplementing patient- with staff-rated and attendance measures may explain missing data and help quantify healthcare needs. The MPAI4, EBIQ and DEX-R appeared suitable measures to evaluate outcomes and distinguish those completing and not completing neuropsychological rehabilitation.
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Affiliation(s)
- Catherine Elaine Longworth Ford
- The Oliver Zangwill Centre for Neuropsychological Rehabilitation, Cambridgeshire Community Services NHS Trust, Princess of Wales Hospital, Ely, UK
| | - Donna Malley
- The Oliver Zangwill Centre for Neuropsychological Rehabilitation, Cambridgeshire Community Services NHS Trust, Princess of Wales Hospital, Ely, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care East of England at Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
| | - Andrew Bateman
- The Oliver Zangwill Centre for Neuropsychological Rehabilitation, Cambridgeshire Community Services NHS Trust, Princess of Wales Hospital, Ely, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care East of England at Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
| | - Isabel C.H. Clare
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care East of England at Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
- Cambridgeshire & Peterborough NHS Foundation Trust, Fulbourn Hospital, Cambridge, UK
- Cambridge Intellectual & Developmental Disabilities Research Group, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Adam P. Wagner
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care East of England at Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
- Cambridge Intellectual & Developmental Disabilities Research Group, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Fergus Gracey
- The Oliver Zangwill Centre for Neuropsychological Rehabilitation, Cambridgeshire Community Services NHS Trust, Princess of Wales Hospital, Ely, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care East of England at Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
- Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, UK
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Donna M, Wheatcroft J, Gracey F. Fatigue after Acquired Brain Injury: a model to guide clinical management. ADVANCES IN CLINICAL NEUROSCIENCE & REHABILITATION 2014. [DOI: 10.47795/jver9544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Biszak AM, Babbage DR. Facial affect recognition difficulties in traumatic brain injury rehabilitation services. Brain Inj 2013; 28:97-104. [DOI: 10.3109/02699052.2013.856475] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Spanish, French, and British cross-cultural validation of the European Brain Injury Questionnaire. J Head Trauma Rehabil 2012; 26:478-88. [PMID: 21169861 DOI: 10.1097/htr.0b013e3181fc042c] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To explore the factor structure of the European Brain Injury Questionnaire and to assess the cross-cultural and construct validity of this questionnaire by using Rasch analysis. PARTICIPANTS A total of 366 individuals with traumatic brain injury or stroke were recruited from 3 different countries: Spain (116 participants), the United Kingdom (110 participants), and France (140 participants). ANALYSES We first performed a factor analysis and then applied Rasch analysis to the resulting factors to examine construct and cross-cultural validity. RESULTS Three subscales labeled Depressive Mood, Cognitive Dysfunction, and Poor Social and Emotional Self-regulation were extracted using the factor analysis. In the Rasch analyses, 8 items were removed because of misfit and 7 items showed differential item functioning by country. CONCLUSION Rasch analyses showed good fit to the model, unidimensionality, construct validity, and good reliability of the 3 European Brain Injury Questionnaire subscales. However, only the Depressive and Cognitive subscales showed cross-cultural validity.
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Measuring functional and quality of life outcomes following major head injury: common scales and checklists. Injury 2011; 42:281-7. [PMID: 21145059 DOI: 10.1016/j.injury.2010.11.047] [Citation(s) in RCA: 120] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2010] [Accepted: 11/12/2010] [Indexed: 02/02/2023]
Abstract
Traumatic brain injury (TBI) is a major public health issue, which results in significant mortality and long term disability. The profound impact of TBI is not only felt by the individuals who suffer the injury but also their care-givers and society as a whole. Clinicians and researchers require reliable and valid measures of long term outcome not only to truly quantify the burden of TBI and the scale of functional impairment in survivors, but also to allow early appropriate allocation of rehabilitation supports. In addition, clinical trials which aim to improve outcomes in this devastating condition require high quality measures to accurately assess the impact of the interventions being studied. In this article, we review the properties of an ideal measure of outcome in the TBI population. Then, we describe the key components and performance of the measurement tools most commonly used to quantify outcome in clinical studies in TBI. These measurement tools include: the Glasgow Outcome Scale (GOS) and extended Glasgow Outcome Scale (GOSe); Disability Rating Scale (DRS); Functional Independence Measure (FIM); Functional Assessment Measure (FAM); Functional Status Examination (FSE) and the TBI-specific and generic quality of life measures used in TBI patients (SF-36 and SF-12, WHOQOL-BREF, SIP, EQ-5D, EBIQ, and QOLIBRI).
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Simblett SK, Bateman A. Dimensions of the Dysexecutive Questionnaire (DEX) examined using Rasch analysis. Neuropsychol Rehabil 2011; 21:1-25. [DOI: 10.1080/09602011.2010.531216] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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