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Krol L, Hagmayer Y, von Steinbuechel N, Cunitz K, Buchheim A, Koerte IK, Zeldovich M. Reference Values for the German Version of the Quality of Life after Brain Injury in Children and Adolescents (QOLIBRI-KID/ADO) from a General Population Sample. J Pers Med 2024; 14:336. [PMID: 38672963 PMCID: PMC11051333 DOI: 10.3390/jpm14040336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 03/07/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024] Open
Abstract
Assessment of health-related quality of life (HRQoL) after pediatric traumatic brain injury (TBI) has been limited in children and adolescents due to a lack of disease-specific instruments. To fill this gap, the Quality of Life after Traumatic Brain Injury for Children and Adolescents (QOLIBRI-KID/ADO) Questionnaire was developed for the German-speaking population. Reference values from a comparable general population are essential for comprehending the impact of TBI on health and well-being. This study examines the validity of the German QOLIBRI-KID/ADO in a general pediatric population in Germany and provides reference values for use in clinical practice. Overall, 1997 children and adolescents aged 8-17 years from the general population and 300 from the TBI population participated in this study. The questionnaire was tested for reliability and validity. A measurement invariance (MI) approach was used to assess the comparability of the HRQoL construct between both samples. Reference values were determined by percentile-based stratification according to factors that significantly influenced HRQoL in regression analyses. The QOLIBRI-KID/ADO demonstrated strong psychometric properties. The HRQoL construct was measured largely equivalently in both samples, and reference values could be provided. The QOLIBRI-KID/ADO was considered reliable and valid for assessing HRQoL in a general German-speaking pediatric population, allowing for clinically meaningful comparisons between general and TBI populations.
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Affiliation(s)
- Leonie Krol
- Department of Psychology, Clinical Psychology, Experimental Psychopathology, and Psychotherapy, University of Marburg, 35037 Marburg, Germany
| | - York Hagmayer
- Georg-Elias-Müller Institute for Psychology, Georg-August-University, 37073 Goettingen, Germany;
| | - Nicole von Steinbuechel
- Institute of Psychology, University of Innsbruck, 6020 Innsbruck, Austria; (N.v.S.); (K.C.); (A.B.)
| | - Katrin Cunitz
- Institute of Psychology, University of Innsbruck, 6020 Innsbruck, Austria; (N.v.S.); (K.C.); (A.B.)
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, 37075 Goettingen, Germany
| | - Anna Buchheim
- Institute of Psychology, University of Innsbruck, 6020 Innsbruck, Austria; (N.v.S.); (K.C.); (A.B.)
| | - Inga K. Koerte
- cBRAIN/Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, LMU University Hospital, Ludwig-Maximilian University, 80337 Munich, Germany;
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Mass General Brigham, Harvard Medical School, Boston, MA 02115, USA
| | - Marina Zeldovich
- Institute of Psychology, University of Innsbruck, 6020 Innsbruck, Austria; (N.v.S.); (K.C.); (A.B.)
- Faculty of Psychotherapy Science, Sigmund Freud University Vienna, Freudplatz 1, 1020 Vienna, Austria
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Kuok CI, Chan WKY, Kwok AWL. What and who should we focus in pediatric injury prevention - An analysis of critical pediatric trauma in a major trauma center in Hong Kong. Pediatr Neonatol 2021; 62:620-627. [PMID: 34330685 DOI: 10.1016/j.pedneo.2021.05.027] [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: 01/25/2021] [Revised: 04/18/2021] [Accepted: 05/20/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Understanding trauma epidemiology is essential in formulating region-specific strategies for injury prevention. Our study aimed to evaluate the characteristics and clinical outcomes of critical pediatric trauma requiring intensive care in Hong Kong. METHODS A retrospective analysis was performed on pediatric patients who were injured and admitted to the pediatric intensive care unit (PICU), Queen Elizabeth Hospital, Hong Kong between 2014 and 2018. Clinical features of patients who sustained injuries before and after 2 years old were compared. RESULTS 141 patients were admitted to the PICU due to trauma during the study period. Most patients sustained injuries due to fall (48.2%) or road traffic injuries (34.0%), with the latter more common in older patients. Two (1.4%) patients died due to the trauma. The majority (95.0%) of the survivors had good recovery assessed by Glasgow Outcome Scale. Patients younger than 2 years old were mostly injured at home due to fall while left unattended. Children in this age group were more likely to receive interventions, including mechanical ventilation (OR 2.61; 95% CI 1.15-5.95), anti-epileptic medications (OR 2.61; 95% CI 1.17-5.83), blood transfusion (OR 5.37; 95% CI 2.29-12.60) and inotropic support (OR 4.08; 95% CI 1.31-12.70), and require longer hospitalization (PICU stay 2.5 vs. 1.5 days, p = 0.011; hospital stay 10.9 vs. 6.9 days, p = 0.012). CONCLUSION Fall injuries and road traffic injuries were common etiologies of critical pediatric trauma in Hong Kong. Patients younger than 2 years old had worse clinical outcomes. Parental education on home safety and importance of close supervision should be emphasized in this age group.
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Affiliation(s)
- Chon In Kuok
- Department of Paediatrics, Queen Elizabeth Hospital, Hong Kong.
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Rahman RAA, Hanapiah FA, Nikmat AW, Ismail NA, Manaf H. Effects of Concurrent Tasks on Gait Performance in Children With Traumatic Brain Injury Versus Children With Typical Development. Ann Rehabil Med 2021; 45:186-196. [PMID: 34126668 PMCID: PMC8273728 DOI: 10.5535/arm.21004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 04/12/2021] [Indexed: 11/17/2022] Open
Abstract
Objective To investigate how gait parameters in children with traumatic brain injury (TBI) versus typically developing (TD) children are influenced by secondary concurrent tasks and examine the correlations between gait parameters and attention and balance in children with TBI. Methods Sixteen children with TBI (mean age, 11.63±1.89 years) and 22 TD controls (mean age, 11.41±2.24 years) participated in this case-control study. Attention and functional balance were measured using the Children’s Color Trail Test (CCTT) and Pediatric Balance Scale (PBS). All participants first walked without concurrent tasks and then with concurrent motor and cognitive tasks. The APDM Mobility Lab was used to measure gait parameters, including gait velocity, stride length, stride duration, cadence, and double support time. Repeated-measures analysis of variance and Spearman correlation coefficient were used for the analysis. Results Children with TBI showed significantly more deterioration in gait performance than TD children (p<0.05). Concurrent tasks (motor and cognitive) significantly decreased gait velocity and cadence and increased stride time; the differences were more obvious during the concurrent cognitive task. A moderate correlation was found between gait parameters (gait velocity and stride length) and CCTT-2 and PBS scores in children with TBI. Conclusion Gait performance may be affected by task complexity following TBI. Attention and balance deficits caused deterioration in gait performance under the concurrent task condition in children with TBI. This study illustrates the crucial role of task demand and complexity in dual-task interference.
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Affiliation(s)
- Rabiatul Adawiah Abdul Rahman
- Physiotherapy Programme, Faculty of Health Sciences, Universiti Teknologi MARA - Bertam Campus, Pulau Pinang, Malaysia
| | - Fazah Akhtar Hanapiah
- Department of Rehabilitation Medicine, Faculty of Medicine, Universiti Teknologi MARA - Sungai Buloh Campus, Selangor, Malaysia.,Daehan Rehabilitation Hospital Putrajaya, Putrajaya, Malaysia
| | - Azlina Wati Nikmat
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA - Sungai Buloh Campus, Selangor, Malaysia
| | | | - Haidzir Manaf
- Clinical and Rehabilitation Exercise Research Group, Faculty of Health Sciences, Universiti Teknologi MARA - Puncak Alam Campus, Selangor, Malaysia
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Krenz U, Timmermann D, Gorbunova A, Lendt M, Schmidt S, von Steinbuechel N. Health-related quality of life after pediatric traumatic brain injury: A qualitative comparison between children's and parents' perspectives. PLoS One 2021; 16:e0246514. [PMID: 33566806 PMCID: PMC7875394 DOI: 10.1371/journal.pone.0246514] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 01/20/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Pediatric traumatic brain injury (TBI) may cause a wide range of symptoms, which can negatively affect the quality of life of patients and their entire families. No internationally and simultaneously developed disease-specific instrument exists for assessing pediatric health-related quality of life (HRQoL) after TBI. The aim of the current project is to provide original material from small group interviews with individuals after TBI concerning what they state is relevant for their HRQoL. This material is required for a further study to generate items for age-adapted questionnaires assessing the TBI-specific HRQoL of children and adolescents (C&A): the QOLIBRI-Kiddy/Kid/Ado and proxy versions (Quality of Life after Brain Injury-Kiddy/Kids/Adolescents/Proxy) for individuals aged 6-17 and their parents. METHODS The semi-structured interviews were conducted with separate small groups of C&A (n = 19), divided into three age groups (5-7y, 8-12y, 13-17y), after mild, moderate, and severe TBI, and with groups of the corresponding parents (n = 26). All interviews lasted for about 60 minutes, were recorded and transcribed verbatim. The statements were investigated by qualitative analyses and sorted into categories relevant to the HRQoL of C&A after TBI. Only descriptive group comparisons but no pairwise comparisons between children and corresponding parents were performed. RESULTS The analyses led to 32 subcategories, which were assigned to six main theoretically based HRQoL categories. Many agreements exist between the C&A's and parents' perspectives within the main categories, however their focus on HRQoL differs, especially concerning age-related contents. Parents of the youngest participant group already focus on topics such as autonomy, whereas this only becomes relevant for C&A from the age of eight years on. Interestingly, even 5-year-old children were able to discuss their HRQoL, which indicates the importance of a self-report instrument. CONCLUSIONS Results obtained from this qualitative study identify the content of the HRQoL dimensions important for C&A after TBI and their parents. Both, differences and similarities in the children's and the parents' views were investigated, to get a first insight in valid dimensions for the prospective questionnaires to be developed. In a future study, items for the questionnaires will be deducted from the small group interview material and psychometrically tested in C&A after TBI from Germany. This study will address whether all statements were assigned to the suitable dimensions and whether differences between C&A and parents persist.
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Affiliation(s)
- Ugne Krenz
- Department of Medical Psychology and Medical Sociology, Georg-August University, Göttingen, Germany
| | - Dagmar Timmermann
- Department of Medical Psychology and Medical Sociology, Georg-August University, Göttingen, Germany
| | - Anastasia Gorbunova
- Department of Medical Psychology and Medical Sociology, Georg-August University, Göttingen, Germany
| | - Michael Lendt
- Neuropediatrics, St. Mauritius Therapeutic Clinic, Meerbusch, Germany
| | - Silke Schmidt
- Department Health and Prevention, University of Greifswald, Greifswald, Germany
| | - Nicole von Steinbuechel
- Department of Medical Psychology and Medical Sociology, Georg-August University, Göttingen, Germany
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Greenham M, Botchway E, Knight S, Bonyhady B, Tavender E, Scheinberg A, Anderson V, Muscara F. Predictors of participation and quality of life following major traumatic injuries in childhood: a systematic review. Disabil Rehabil 2020; 44:2591-2607. [PMID: 33232616 DOI: 10.1080/09638288.2020.1849425] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Review the literature on predictors of participation and quality of life in children and young people who sustained a traumatic brain injury (TBI), spinal cord injury (SCI), and/or multi-trauma in a motor vehicle or other accident or trauma. DESIGN This systematic review was conducted and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The protocol was registered on PROSPERO (registration number CRD42020131698). Electronic databases were searched for studies published between January 2000 and August 2020. Prospective and retrospective cohort studies were considered and risk of bias was assessed using the Quality In Prognosis Studies (QUIPS) tool. RESULTS The search yielded 5771 articles of which 30 studies met the inclusion criteria. Nineteen studies included patients with TBI and 11 with SCI. No studies of patients with multi-trauma met criteria. Evidence was found for associations with various factors (e.g., injury severity, level of education, mental health problems), although these findings are limited due to the quality of the studies (5 studies moderate and 25 high risk of bias). CONCLUSION Research on predictors of participation and quality of life following major traumatic injuries in childhood is lacking. More methodologically sound prospective, longitudinal studies are needed across different injury groups to further elucidate predictors of outcome.IMPLICATIONS FOR REHABILITATIONWhile long-term participation and quality of life is influenced by injury characteristics (i.e., injury severity), a number of potential modifiable factors can be targeted to improve outcomes following traumatic injuries in childhood.Young people should be provided with support to stay in school and pursue further education.Early intervention and prevention of mental health problems may improve long-term outcomes.Better management of ongoing medical problems and greater support for functional independence may improve participation.
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Affiliation(s)
- Mardee Greenham
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The Royal Children's Hospital, Parkville, VIC, Australia
| | - Edith Botchway
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Sarah Knight
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Bruce Bonyhady
- Melbourne Disability Institute, Parkville, VIC, Australia
| | - Emma Tavender
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Adam Scheinberg
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.,Department of Paediatrics, Monash University, Clayton, VIC, Australia
| | - Vicki Anderson
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Frank Muscara
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
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Corti C, Poggi G, Romaniello R, Strazzer S, Urgesi C, Borgatti R, Bardoni A. Feasibility of a home-based computerized cognitive training for pediatric patients with congenital or acquired brain damage: An explorative study. PLoS One 2018; 13:e0199001. [PMID: 29924823 PMCID: PMC6010294 DOI: 10.1371/journal.pone.0199001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 03/27/2018] [Indexed: 11/28/2022] Open
Abstract
Objectives Pediatric brain damage is associated with various cognitive deficits. Cognitive rehabilitation may prevent and reduce cognitive impairment. In recent years, home-based computerized cognitive training (CCT) has been introduced in clinical practice to increase treatment opportunities for patients (telerehabilitation). However, limited research has been conducted thus far on investigating the effects of remote CCT for the juvenile population in contexts other than English-speaking countries. The aim of the present study was to investigate the feasibility of a home-based CCT in a group of Italian adolescents with brain damage. A commercially available CCT (Lumosity) developed in the English language was used due to the lack of telerehabilitation programs in the Italian language that allow stimulation of multiple cognitive domains and, at the same time, remote automatic collection of data. Thus, this investigation provides information on the possibility of introducing CCT programs available in foreign languages in countries with limited investment in the telerehabilitation field. Methods 32 adolescents aged 11–16 with a diagnosis of congenital or acquired (either traumatic or non-traumatic) brain damage participated in the study. They received 40 training sessions (5 days/week for 8 weeks). Before starting the training program, they received face-to-face demonstration of training exercises and written instructions in their mother tongue. The feasibility of both training and study design and procedures was assessed through 9 criteria taken from extant literature. Results All 9 feasibility criteria were met. 31 out of the 32 participants demonstrated adherence to the training program. 94.2% of training sessions were completed in the recommended timeframe. No significant technical issue was found. Conclusions Telerehabilitation seems to be a feasible practice for adolescents with brain damage. A training program developed in a foreign language can be used to counter the unavailability of programs in patients’ mother tongue. Trial registration The trial is registered with the ISRCTN registry with study ID ISRCTN59250807
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Affiliation(s)
- Claudia Corti
- Neuro-oncological and Neuropsychological Rehabilitation Unit, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
- * E-mail:
| | - Geraldina Poggi
- Neuro-oncological and Neuropsychological Rehabilitation Unit, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
| | - Romina Romaniello
- Neuropsychiatry and Neurorehabilitation Unit, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
| | - Sandra Strazzer
- Acquired Brain Injury Unit, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
| | - Cosimo Urgesi
- Neuropsychiatry and Neurorehabilitation Unit, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
- Laboratory of Cognitive Neuroscience, Department of Languages and Literatures, Communication, Education and Society, University of Udine, Udine, Italy
| | - Renato Borgatti
- Neuropsychiatry and Neurorehabilitation Unit, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
| | - Alessandra Bardoni
- Neuro-oncological and Neuropsychological Rehabilitation Unit, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
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Kocher Stalder C, Kottorp A, Steinlin M, Hemmingsson H. Children's and teachers' perspectives on adjustments needed in school settings after acquired brain injury. Scand J Occup Ther 2017; 25:233-242. [PMID: 28494632 DOI: 10.1080/11038128.2017.1325932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Children with acquired brain injury (ABI) often present with functional deficits that influence their societal participation and well-being. Successful reintegration into school calls for individual support to meet each child's adjustment needs. The adjustment needs of children with ABI in school settings have not previously been explored. AIM The objectives of the present study were (a) to describe adjustment needs in school settings for children with ABI and (b) to explore differences and similarities between reports from the children and their teachers. METHODS In this cross-sectional study, 20 children with ABI (mean age 12.8 ± 3.4 years; class grade 1-10) and their teachers were interviewed individually, using the School Setting Interview (SSI). Data were analyzed with descriptive and with non-parametric statistics. RESULTS (a) In the overall group, children rated that 55.6% of the 16 activities in the SSI needed no adjustment. The corresponding percentage for teachers was 48.4%. (b) In the child-teacher pairs, there was a positive relationship between teachers' and children's responses only in 3 out of 16 school activities and agreement varied strongly according to the activity in question. CONCLUSIONS AND SIGNIFICANCE It is important for occupational therapists and other professionals to specifically consider adjustment needs relating to school activities from various perspectives when aiming to provide individualized interventions.
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Affiliation(s)
- Cornelia Kocher Stalder
- a Institute of Occupational Therapy at Zurich University of Applied Sciences , Winterthur , Switzerland.,b Neuropaediatrics , University Children's Hospital Bern , Bern , Switzerland
| | - Anders Kottorp
- c Karolinksa Institutet , University Stockholm , Stockholm , Sweden.,d Department of Occupational Therapy , University of Illinois at Chicago , Chicago , USA
| | - Maja Steinlin
- b Neuropaediatrics , University Children's Hospital Bern , Bern , Switzerland
| | - Helena Hemmingsson
- e Department of Social and Welfare Studies , Linköping University , Linköping , Sweden
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Schaffer Y, Geva R. Memory outcomes following cognitive interventions in children with neurological deficits: A review with a focus on under-studied populations. Neuropsychol Rehabil 2015; 26:286-317. [PMID: 25730385 DOI: 10.1080/09602011.2015.1016537] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Given the primary role of memory in children's learning and well-being, the aim of this review was to examine the outcomes of memory remediation interventions in children with neurological deficits as a function of the affected memory system and intervention method. Fifty-seven studies that evaluated the outcome of memory interventions in children were identified. Thirty-four studies met the inclusion criteria, and were included in a systematic review. Diverse rehabilitation methods for improving explicit and implicit memory in children were reviewed. The analysis indicates that teaching restoration strategies may improve, and result in the generalisation of, semantic memory and working memory performance in children older than 7 years with mild to moderate memory deficits. Factors such as longer protocols, emotional support, and personal feedback contribute to intervention efficacy. In addition, the use of compensation aids seems to be highly effective in prospective memory tasks. Finally, the review unveiled a lack of studies with young children and the absence of group interventions. These findings point to the importance of future evidence-based intervention protocols in these areas.
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Affiliation(s)
- Yael Schaffer
- a Department of Psychology , The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University , Ramat Gan , Israel
| | - Ronny Geva
- a Department of Psychology , The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University , Ramat Gan , Israel
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Polinder S, Haagsma JA, van Klaveren D, Steyerberg EW, van Beeck EF. Health-related quality of life after TBI: a systematic review of study design, instruments, measurement properties, and outcome. Popul Health Metr 2015; 13:4. [PMID: 25722656 PMCID: PMC4342191 DOI: 10.1186/s12963-015-0037-1] [Citation(s) in RCA: 120] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 02/02/2015] [Indexed: 12/03/2022] Open
Abstract
Measurement of health-related quality of life (HRQL) is essential to quantify the subjective burden of traumatic brain injury (TBI) in survivors. We performed a systematic review of HRQL studies in TBI to evaluate study design, instruments used, methodological quality, and outcome. Fifty-eight studies were included, showing large variation in HRQL instruments and assessment time points used. The Short Form-36 (SF-36) was most frequently used. A high prevalence of health problems during and after the first year of TBI was a common finding of the studies included. In the long term, patients with a TBI still showed large deficits from full recovery compared to population norms. Positive results for internal consistency and interpretability of the SF-36 were reported in validity studies. The Quality of Life after Brain Injury instrument (QOLIBRI), European Brain Injury Questionnaire (EBIQ), Child Health Questionnaire (CHQ), and the World Health Organization Quality of Life short version (WHOQOL-BREF) showed positive results, but evidence was limited. Meta-analysis of SF-36 showed that TBI outcome is heterogeneous, encompassing a broad spectrum of HRQL, with most problems reported in the physical, emotional, and social functioning domain. The use of SF-36 in combination with a TBI-specific instrument, i.e., QOLIBRI, seems promising. Consensus on preferred methodologies of HRQL measurement in TBI would facilitate comparability across studies, resulting in improved insights in recovery patterns and better estimates of the burden of TBI.
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Affiliation(s)
- Suzanne Polinder
- Erasmus MC, Department of Public Health, PO Box 2040, 3000 Rotterdam, CA The Netherlands
| | - Juanita A Haagsma
- Erasmus MC, Department of Public Health, PO Box 2040, 3000 Rotterdam, CA The Netherlands
| | - David van Klaveren
- Erasmus MC, Department of Public Health, PO Box 2040, 3000 Rotterdam, CA The Netherlands
| | - Ewout W Steyerberg
- Erasmus MC, Department of Public Health, PO Box 2040, 3000 Rotterdam, CA The Netherlands
| | - Ed F van Beeck
- Erasmus MC, Department of Public Health, PO Box 2040, 3000 Rotterdam, CA The Netherlands
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DeMatteo CA, Hanna SE, Yousefi-Nooraie R, Lin CYA, Mahoney WJ, Law MC, McCauley D. Quality-of-life after brain injury in childhood: time, not severity, is the significant factor. Brain Inj 2014; 28:114-21. [PMID: 24328806 DOI: 10.3109/02699052.2013.848380] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Little is known about the impact of acquired brain injury (ABI) on the long-term quality-of-life (QoL) in children and youth. The objectives of this study were to illustrate the long-term QoL trajectories at 5 years post-ABI. METHODS The QoL of children between 5-18 years (n = 94) admitted to McMaster Children's Hospital with ABI were assessed longitudinally for a minimum of 5 years post-injury using the Child Health Questionnaire. Independent t-tests were used to examine differences in QoL between the study cohort and a normative sample at different time points. Mixed-effects models were used to identify predictors for QoL. RESULTS The QoL of children with ABI was significantly poorer (p < 0.05) than the normative data on all domains and at all-time points except at baseline. The CHQ physical summary score (PHSS) showed a significant decline immediately after injury and a significant recovery at 8 months post-injury; while the CHQ psychosocial summary score (PSSS) showed a significant immediate decline, which remained over the course of the study. Pre-morbid school record, time post-injury and mechanism of injury significantly predicted the CHQ PSSS. CONCLUSIONS QoL is impacted by ABI regardless of severity. This impact is further affected by time post-injury.
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Kizony R, Tau S, Bar O, Engel Yeger B. Comparing memory and meta-memory abilities between children with acquired brain injury and healthy peers. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:1666-1673. [PMID: 24726285 DOI: 10.1016/j.ridd.2014.03.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 03/18/2014] [Accepted: 03/18/2014] [Indexed: 06/03/2023]
Abstract
This study compared visual memory and meta-memory abilities of children with ABI to that of healthy peers. Participants included 16 children (aged 13.55 ± 3.29 years) with moderate or severe ABI and 16 healthy children (aged 12.44 ± 3.24 years) with typical development. Children completed the Contextual Memory Test for Children (CMT-CH). The study group showed significantly lower immediate and delayed recall abilities. While the controls used the context for better memorizing, most of the children with ABI used rehearsals. In both groups better delayed recall correlated with the use of a more efficient strategy. Meta-memory should be an integral part of the assessment for children with ABI. Therapists should enhance child's self-awareness to his/her abilities and encourage the use of strategies (e.g. context) for memorizing in daily life.
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Affiliation(s)
- Rachel Kizony
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel; Department of Occupational Therapy, Sheba Medical Center, Tel Hashomer, Israel.
| | - Shoshi Tau
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel; Ministry of Education, Local Resource Center for Special Education Services, Raanana, Israel
| | - Orly Bar
- Pediatric Rehabilitation Department, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel
| | - Batya Engel Yeger
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel
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Langfristige psychosoziale Entwicklung nach schwerem Schädel-Hirn-Trauma im Kindesalter. Monatsschr Kinderheilkd 2014. [DOI: 10.1007/s00112-014-3114-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Soo C, Tate R, Brookes N. Psychosocial adjustment following acquired brain injury in childhood and adolescence: Executive, behavioural and emotional contributions. Brain Inj 2014; 28:906-14. [DOI: 10.3109/02699052.2014.888762] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Katia S, Normand B, Céline L. Current needs, the future of adolescents and young adults having sustained a moderate or severe Traumatic Brain Injury (TBI) and the potential of their social participation. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/ojtr.2014.21009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Pieper P, Garvan C. Health-related quality-of-life in the first year following a childhood concussion. Brain Inj 2013; 28:105-13. [DOI: 10.3109/02699052.2013.847208] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Arango-Lasprilla JC, Krch D, Drew A, De Los Reyes Aragon CJ, Stevens LF. Health-related quality of life of individuals with traumatic brain injury in Barranquilla, Colombia. Brain Inj 2012; 26:825-33. [PMID: 22583173 DOI: 10.3109/02699052.2012.655364] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To assess health-related quality of life (HRQoL) of individuals with traumatic brain injury (TBI) in Barranquilla, Colombia. PARTICIPANTS/METHODS Thirty-one individuals with TBI and 61 healthy controls completed the SF-36, a self-report HRQoL measure composed of eight component areas: physical health problems, pain, role limitations due to physical problems or due to emotional problems, emotional well-being, social functioning, energy/fatigue and general health perceptions. RESULTS The samples were statistically similar with respect to age, gender and education and statistically different with respect to depression, SES, social support and cognition. Compared to healthy controls, individuals with TBI had significantly lower means on all SF-36 sub-scales. However, after adjusting for depression, SES, social support and cognitive performance, significant differences remained on three of the SF-36 sub-scales. Specifically, individuals with TBI had lower adjusted means on Role-Physical (p-value < 0.005), Role-Emotional (p-value < 0.005) and Bodily Pain (p-value < 0.05). CONCLUSION Even after controlling for depression, SES, social support and cognitive performance, individuals with TBI living in Barranquilla Colombia report having poorer quality of life across various domains, including Role-Physical, Role-Emotional and Bodily Pain. These findings suggest the need for rehabilitation health professionals to develop and implement culturally-appropriate interventions to improve quality of life in Colombian individuals with TBI.
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Renström B, Söderman K, Domellöf E, Emanuelson I. Self-reported health and influence on life situation 5–8 years after paediatric traumatic brain injury. Brain Inj 2012; 26:1405-14. [DOI: 10.3109/02699052.2012.694559] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Di Battista A, Soo C, Catroppa C, Anderson V. Quality of life in children and adolescents post-TBI: a systematic review and meta-analysis. J Neurotrauma 2012; 29:1717-27. [PMID: 22435594 DOI: 10.1089/neu.2011.2157] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
UNLABELLED Traumatic brain injury is (TBI) a leading cause of morbidity and mortality in children and adolescents in first-world nations. Research from our team investigating adult survivors of pediatric TBI indicate that survivors of severe TBI are particularly vulnerable to global impairments, including poorer school performance, greater employment difficulties, poor quality of life (QoL), and increased risk of mental health problems. Investigation into less observable consequences, including QoL, has emerged recently as an important outcome to assess in TBI populations. The status of QoL in pediatric TBI populations is mixed, likely a reflection of the varied methodological and theoretical perspectives on QoL. AIM This systematic study will clarify the nature of QoL in survivors of pediatric TBI, and identify predictors of QoL in this group. Of 419 articles identified, 11 studies met our inclusion criteria, and 9 were ultimately analyzed in this review. Four studies reported good QoL and 5 poor QoL. The difference between good and poor QoL was statistically significant due to TBI severity [chi-square(3)=77.38, p<0.001], timing of outcome assessment [chi-square(1)=565, p<0.001], and definition of QoL [chi-square(3)=34.73, p<0.001]. The odds of having a poor QoL increased 5.8 times (RR=1.21) when injuries were more severe. Good outcomes are contingent on milder injuries, proxy reporting, and early assessment, whereas poor outcomes reflect more severe injuries and later assessment (≤ 6 months versus ≥ 1 year post-trauma, respectively).
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Affiliation(s)
- Ashley Di Battista
- Psychology and Critical Care and Neurosciences Research, Murdoch Childrens Research Institute, and University of Melbourne, Melbourne, Victoria, Australia.
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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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Chesire DJ, Canto AI, Buckley VA. Hospital–School Collaboration to Serve the Needs of Children With Traumatic Brain Injury. JOURNAL OF APPLIED SCHOOL PSYCHOLOGY 2011. [DOI: 10.1080/15377903.2011.540513] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Erickson SJ, Montague EQ, Gerstle MA. Health-related quality of life in children with moderate-to-severe traumatic brain injury. Dev Neurorehabil 2010; 13:175-81. [PMID: 20450467 DOI: 10.3109/17518420903479867] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate health-related quality of life (HRQOL) in a sample of ethnically diverse children with traumatic brain injury (TBI). METHODS Twenty children with moderate-severe TBI and their parents were recruited from a TBI clinic at a paediatric rehabilitation hospital. Children's self-reported HRQOL was assessed with the Pediatric Quality of Life Inventory. Parents completed a parallel proxy measure. RESULTS Children reported significantly lower Psychosocial HRQOL compared to their Total HRQOL, driven largely by low School HRQOL scores. Compared to other paediatric populations, children with TBI reported lower or equivalent HRQOL. Compared with children's self-reports, parents reported even lower HRQOL for their children across primary domains, with fair-to-moderate convergence between informants. CONCLUSIONS Results provide preliminary evidence that children who have suffered moderate-severe TBI experience relatively poor HRQOL, particularly in the School domain. Limited convergence between informants suggests that children and parents perceive HRQOL differently, with parents reporting lower HRQOL.
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Affiliation(s)
- Sarah J Erickson
- University of New Mexico, Department of Psychology, 1 UNM, MSC03 2220, Albuquerque, NM 87131, USA.
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Sjö NM, Spellerberg S, Weidner S, Kihlgren M. Training of attention and memory deficits in children with acquired brain injury. Acta Paediatr 2010; 99:230-6. [PMID: 19900175 DOI: 10.1111/j.1651-2227.2009.01587.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
UNLABELLED This pilot study concerns cognitive rehabilitation of children with acquired brain injury (ABI). AIM The aim is threefold; to determine (1) whether the Amsterdam Memory and Attention Training for Children (AMAT-C) programme for children with ABI can be integrated in the child's school, (2) whether supervision in the school-setting maintains the child's motivation throughout the training programme and (3) whether positive changes in memory, attention and executive functions are found with this implementation of the training method. METHODS Seven children with memory and/or attention deficits after ABI were trained with AMAT-C. Measures used were programme evaluation questions, neuropsychological tests and a questionnaire concerning executive functions. RESULTS Overall, children, parents and trainers were satisfied with the programme and the children were motivated throughout the programme. The children showed significant improvements in neuropsychological subtests, primarily in tests of learning and memory. No overall change in executive functions was noted. CONCLUSION Provision of AMAT-C training and supervision at the child's school appears to ensure (1) satisfaction with the programme, (2) sustaining of motivation and (3) improvements in learning and memory.
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Affiliation(s)
- N Madsen Sjö
- Center for Rehabilitation of Brain Injury, University of Copenhagen, Copenhagen, Denmark.
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Johnson AR, DeMatt E, Salorio CF. Predictors of outcome following acquired brain injury in children. ACTA ACUST UNITED AC 2009; 15:124-32. [PMID: 19489083 DOI: 10.1002/ddrr.63] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Acquired brain injury (ABI) in children and adolescents can result from multiple causes, including trauma, central nervous system infections, noninfectious disorders (epilepsy, hypoxia/ischemia, genetic/metabolic disorders), tumors, and vascular abnormalities. Prediction of outcomes is important, to target interventions, allocate resources, provide education to family or caregivers, and begin appropriate planning for the future. Researchers have identified several factors associated with better or worse outcomes after ABI, including variables related to the injury itself, postinjury factors related to intervention or trajectory of recovery, and preinjury or demographic factors. When examining the scientific literature, it is important to identify how "outcome" is defined, as the predictors may change depending on the outcome studied. In addition, key variables may be specific to the etiology of injury. Therefore, predictors of outcome cannot be generalized across the various etiologies of ABI, and this review will discuss predictors within the context of multiple etiologies of ABI. This article reviews the current literature on predicting outcomes after pediatric ABI, and areas in need of further research are discussed.
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Affiliation(s)
- Abigail R Johnson
- Department of Pediatric Rehabilitation, Kennedy Krieger Institute, 707 N. Broadway, Baltimore, MD 21205, USA
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Soo C, Tate RL, Williams L, Waddingham S, Waugh MC. Development and validation of the Paediatric Care and Needs Scale (PCANS) for assessing support needs of children and youth with acquired brain injury. Dev Neurorehabil 2008; 11:204-14. [PMID: 18781503 DOI: 10.1080/17518420802259498] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIM The Paediatric Care and Needs Scale (PCANS) is a newly developed scale that assesses support needs following childhood acquired brain injury (ABI). It yields three measures of support: overall, extent and intensity. The developmental process of the PCANS is described and concurrent and construct validity examined. METHOD In the validation study, 32 parents/caregivers of children with ABI aged 5-18 years completed the PCANS and other validating measures: Vineland Adaptive Behavior Scales (VABS), Functional Independence Measure for Children (Wee-FIM) and King's Outcome Scale of Childhood Head Injury (KOSCHI). VABS and Wee-FIM sub-scales examining similar and dissimilar domains to the PCANS were used to investigate convergent and divergent validity, respectively. Discriminant validity analysis used sub-groups dichotomized by VABS and KOSCHI data. RESULTS Statistically significant correlation coefficients of moderate-to-strong magnitude were found between the PCANS support intensity score and most of the VABS, Wee-FIM and KOSCHI variables (r(s) = -0.46 to r(s) = -0.77, p < 0.01). Some evidence for convergent and divergent validity was also found. Correlation coefficients between similar domains of the PCANS and other scales were moderately high (e.g. VABS socialization vs PCANS psychosocial items, r(s) = -0.64, p < 0.01). Conversely, correlation coefficients between dissimilar domains were low (e.g. Wee-FIM self-care vs PCANS psychosocial items, r(s) = -0.29). In terms of discriminant group differences, PCANS support extent and intensity scores were able to distinguish between sub-groups dichotomized by VABS and KOSCHI scores. CONCLUSIONS These findings provide preliminary evidence for the validity of the PCANS for assessing support needs after paediatric ABI.
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Affiliation(s)
- Cheryl Soo
- Faculty of Medicine, Rehabilitation Studies Unit, Northern Clinical School, University of Sydney, Australia.
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Abstract
PURPOSE OF REVIEW Traumatic brain injury is the leading cause of death in the pediatric population. The purpose of this review is to highlight recent contributions in evaluation, management, and predictors of outcome in pediatric traumatic brain injury. RECENT FINDINGS Advances have been made in defining the critical Glasgow Coma Score for predicting poor outcome and in developing the Relative Head Injury Severity Score, which can assess severity of traumatic brain injury from administrative datasets. More information regarding the radiation risks of head computed tomography imaging and guidelines for the appropriate use of imaging have recently been evaluated. Important steps have also been taken to reduce secondary brain injury through the use of hypertonic saline and induced hypothermia. There continues to be long-term neurodevelopmental deficits among survivors and new tools to assess these deficits have been developed and tested. Finally, increased investigation into understanding the impact of minority race and socioeconomic status has on outcome following traumatic brain injury has determined the existence of disturbing disparities. SUMMARY Traumatic brain injury is the leading cause of mortality and is a major public health issue in the pediatric population. There have been many recent contributions in the diagnosis, treatment, and long-term morbidity of traumatic brain injury. Ongoing work is needed to improve outcomes of traumatic brain injury equitably for all patients.
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Abstract
Health Related Quality of Life (HRQOL) is an important outcome in the delivery of health care. Research on the HRQOL in young people with cerebral palsy (CP) has relied on proxy-reports from parents. The purpose of this study was to investigate the self-reported HRQOL of young people with CP. A survey was mailed to 229 adolescents with CP in South Australia, of which 118 responded (51.5%). Seventy-one participants 11 to 17 years of age, self-reported HRQOL on the Pediatric Quality of Life Inventory 4.0 (PedsQL). Thirty-eight youth were deemed by their parent/guardian as having insufficient cognitive ability to self-report HRQOL and nine respondents returned their surveys incomplete. The mean PedsQL Physical Function score was 57.3 (SD = 24.3), the mean Psychosocial Function score was 64.5 (SD = 15.9), and the Overall PedsQL score was 62.0 (SD = 16.7). Compared to norms for children without disabilities, 67% of participants had an Overall PedsQL score greater than 1 SD below the mean. PedsQL scores were related to gross motor function classification level (Spearman's rho = -0.54), number of health issues (rho = -0.51), and socioeconomic status (rho = 0.28), but not age, gender, quality of sleep, or whether parent assistance was needed to complete the PedsQL. The results have implications for policy and efforts to identify and address barriers to full and satisfying participation in mainstream schools and community activities.
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