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Mamman R, Grewal J, Garrone JN, Schmidt J. Biopsychosocial factors of quality of life in individuals with moderate to severe traumatic brain injury: a scoping review. Qual Life Res 2024; 33:877-901. [PMID: 37925675 PMCID: PMC10972932 DOI: 10.1007/s11136-023-03511-0] [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] [Accepted: 08/24/2023] [Indexed: 11/07/2023]
Abstract
PURPOSE Individuals with moderate to severe traumatic brain injury (TBI) experience changes in their quality-of-life (QOL) post-injury. Given the vast literature that exists about QOL after TBI, a scoping review was performed to identify the different biopsychosocial factors that affect a person's QOL after a moderate to severe TBI. METHODS A scoping review was conducted using the following electronic databases: MEDLINE, CINAHL, Embase, and PsycINFO. Terms relating to TBI and QOL were used. RESULTS There were 7576 articles obtained from the databases, resulting in 535 full-text articles. Ultimately, 52 articles were extracted, which consisted of biopsychosocial QOL factors after TBI. The biopsychosocial factors of QOL after TBI included 19 biological factors (i.e., sex, TBI severity, cognition), 16 psychological factors (i.e., depression, self-efficacy, coping styles), and 19 social factors (i.e., employment, social participation, social support). Factors such as fatigue, self-awareness, transition, and discharge from hospitals are known issues in TBI literature but were minimally reported in studies in this review, identifying them as potential gaps in research. CONCLUSION Identifying biopsychosocial factors relating to QOL after TBI can enable health services to develop targeted rehabilitation programs for individuals with TBI.
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Affiliation(s)
- Rinni Mamman
- Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Jasleen Grewal
- Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | | | - Julia Schmidt
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, Canada.
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
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McCabe C, Sica A, Doody N, Fortune DG. Self-awareness and quality of relationships after acquired brain injury: Systematic review without meta-analysis (SWiM). Neuropsychol Rehabil 2024; 34:335-361. [PMID: 36908086 DOI: 10.1080/09602011.2023.2186437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 02/25/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Relational aspects of self-awareness following Acquired Brain Injury (ABI) are increasingly being recognized. However, research underpinning the nature of the association between self-awareness and quality of relationships has yet to be synthesized. METHOD Searches, which were completed between February 2022 and February 2023, consisted of combining terms related to ABI, self-awareness, and quality of relationships. Data were analyzed using the Synthesis Without Meta-Analysis (SWiM) approach. RESULTS Associations between self-awareness and relationship quality across eight studies identified for this review differed in direction and significance. A more consistent pattern emerged, however, when studies assessing the quality of specific types of relationships i.e., spousal (N = 1) and therapeutic (N = 3), were compared to studies assessing the quality of a person's broader network of relationships (N = 4). In particular, good awareness was positively associated with the quality of specific relationships (r = 0.66) whereas it was negatively associated with the quality of a person's broader network of relationships (r = -0.35). CONCLUSION Results are discussed with consideration given to measures assessing the quality of specific relationships. In particular, such measures may tap into important patterns of interaction between two individuals, such as those related to attunement or communication, which may be valuable preconditions for improving awareness.
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Affiliation(s)
- Corinne McCabe
- Department of Psychology, University of Limerick, Co Limerick, Limerick, Ireland
| | - Andrea Sica
- Acquired Brain Injury Ireland, Dublin, Ireland
| | - Niamh Doody
- Department of Psychology, University of Limerick, Co Limerick, Limerick, Ireland
| | - Donal G Fortune
- Department of Psychology, University of Limerick, Co Limerick, Limerick, Ireland
- HSE CHO 3 Mid West, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
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3
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Wender CLA, Ray LN, Sandroff BM, Krch D. Exercise as a behavioral approach to improve mood in persons with traumatic brain injury. PM R 2023. [PMID: 37874561 DOI: 10.1002/pmrj.13091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/12/2023] [Accepted: 10/17/2023] [Indexed: 10/25/2023]
Abstract
Mood disturbance is a common, long-term, negative consequence of traumatic brain injury (TBI) that is insufficiently addressed by most traditional treatment modalities. A large body of evidence supports the efficacy of exercise training (ET) to broadly improve mood, as measured most often by the Profile of Mood States (POMS). However, this behavioral approach is not used nearly enough in the TBI population, and when it is, mood is rarely measured. This scoping review will evaluate the use of POMS as a mood measure in TBI research and to establish a rationale for using ET as a behavioral approach to broadly improve mood in persons with TBI.
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Affiliation(s)
- Carly L A Wender
- Center for Traumatic Brain Injury Research, Kessler Foundation, East Hanover, New Jersey, USA
- Department of Physical Medicine and Rehabilitation, Rutgers-NJ Medical School, Newark, New Jersey, USA
| | - LaShawnna N Ray
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Brian M Sandroff
- Department of Physical Medicine and Rehabilitation, Rutgers-NJ Medical School, Newark, New Jersey, USA
- Center for Neuropsychology & Neuroscience Research, Kessler Foundation, West Orange, New Jersey, USA
| | - Denise Krch
- Center for Traumatic Brain Injury Research, Kessler Foundation, East Hanover, New Jersey, USA
- Department of Physical Medicine and Rehabilitation, Rutgers-NJ Medical School, Newark, New Jersey, USA
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4
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Von Steinbuechel N, Zeldovich M, Greving S, Olabarrieta-Landa L, Krenz U, Timmermann D, Koerte IK, Bonfert MV, Berweck S, Kieslich M, Brockmann K, Roediger M, Lendt M, Staebler M, Schmidt S, Muehlan H, Cunitz K. Quality of Life after Brain Injury in Children and Adolescents (QOLIBRI-KID/ADO)-The First Disease-Specific Self-Report Questionnaire after Traumatic Brain Injury. J Clin Med 2023; 12:4898. [PMID: 37568300 PMCID: PMC10419542 DOI: 10.3390/jcm12154898] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/18/2023] [Accepted: 07/22/2023] [Indexed: 08/13/2023] Open
Abstract
The subjective impact of the consequences of pediatric traumatic brain injury (pTBI) on different life dimensions should be assessed multidimensionally and as sensitively as possible using a disease-specific health-related quality of life (HRQoL) instrument. The development and psychometrics of the first such self-report questionnaire for children and adolescents after TBI are reported here. Focus group interviews with children, adolescents, and their parents, cognitive debriefing, item pool generation and reduction using Delphi expert panels were performed. The resulting version was psychometrically tested on 300 individuals aged 8-17 years. After item reduction based on factor analyses, differential item functioning, reliability, and validity were investigated. The final 35 items were associated with six scales (Cognition, Self, Daily Life and Autonomy, Social Relationships, Emotions, Physical Problems). Internal consistency and construct validity were satisfactory. Health-related Quality of life (HRQoL) was significantly lower in older and in female participants, as well as those with cognitive disabilities, anxiety, depression and post-concussion symptoms, than in comparative groups. The new QOLIBRI-KID/ADO is a comprehensive, multidimensional, reliable, and valid instrument, comparable in content and items to the QOLIBRI adult version. Therefore, disease-specific HRQoL can now be measured across the lifespan and may support the amelioration of treatment, care, rehabilitation, and daily life of children and adolescents after TBI.
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Affiliation(s)
- Nicole Von Steinbuechel
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany; (M.Z.); (S.G.); (U.K.); (D.T.); (K.C.)
- Institute of Psychology, University Innsbruck, Innrain 52f, 6020 Innsbruck, Austria
| | - Marina Zeldovich
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany; (M.Z.); (S.G.); (U.K.); (D.T.); (K.C.)
| | - Sven Greving
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany; (M.Z.); (S.G.); (U.K.); (D.T.); (K.C.)
| | - Laiene Olabarrieta-Landa
- Departamento de Ciencias de la Salud de la Universidad Pública de Navarra, Campus de Arrosadía, 31006 Pamplona, Spain;
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
| | - Ugne Krenz
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany; (M.Z.); (S.G.); (U.K.); (D.T.); (K.C.)
| | - Dagmar Timmermann
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany; (M.Z.); (S.G.); (U.K.); (D.T.); (K.C.)
| | - Inga K. Koerte
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, LMU University Hospital, Ludwig-Maximilian University, Nussbaumstrasse 5, 80336 Munich, Germany;
| | - Michaela Veronika Bonfert
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, Dr. von Hauner Children’s Hospital, LMU University Hospital, Haydnstr. 5, 80336 Munich, Germany;
| | - Steffen Berweck
- Specialist Center for Paediatric Neurology, Neurorehabilitation and Epileptology, Schoen Klinik, Krankenhausstraße 20, 83569 Vogtareuth, Germany;
| | - Matthias Kieslich
- Department of Paediatric Neurology, Hospital of Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany;
| | - Knut Brockmann
- Interdisciplinary Pediatric Center for Children with Developmental Disabilities and Severe Chronic Disorders, Department of Pediatrics and Adolescent Medicine, University Medical Center, Robert-Koch-Str. 40, 37075 Göttingen, Germany;
| | - Maike Roediger
- Department of Pediatric Intensive Care Medicine and Neonatology, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany;
| | - Michael Lendt
- Neuropediatrics, St. Mauritius Therapeutic Clinic, Strümper Straße 111, 40670 Meerbusch, Germany;
| | - Michael Staebler
- Hegau-Jugendwerk GmbH, Neurological Rehabilitation Center for Children, Adolescents and Young Adults, Kapellenstr. 31, 78262 Gailingen am Hochrhein, Germany;
| | - Silke Schmidt
- Department of Health and Prevention, University of Greifswald, Robert-Blum-Str. 13, 17487 Greifswald, Germany; (S.S.); (H.M.)
| | - Holger Muehlan
- Department of Health and Prevention, University of Greifswald, Robert-Blum-Str. 13, 17487 Greifswald, Germany; (S.S.); (H.M.)
| | - Katrin Cunitz
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany; (M.Z.); (S.G.); (U.K.); (D.T.); (K.C.)
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Zhang Y, Li J, Yang L. Health-related quality of life of Chinese patients with chronic kidney disease: a study based on four EQ-5D-3L value sets. Sci Rep 2023; 13:7863. [PMID: 37188868 DOI: 10.1038/s41598-023-35002-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/11/2023] [Indexed: 05/17/2023] Open
Abstract
Provide reference data on which EQ-5D-3L value set should be used with Chinese patients with chronic kidney disease (CKD); assess differences in health-related quality of life (HRQoL) based on the use of the Chinese (from 2014 and 2018), the UK, and the Japanese value sets; and examine differences in utility scores for key preventive influencing factors. Data from 373 patients with CKD recruited for a cross-sectional multicenter HRQoL survey were used. Differences among utility scores based on the four value sets were determined using Wilcoxon signed rank test. Intra-class correlation coefficient (ICCs) and Bland-Altman plots were used to evaluate consistency among utility scores and Tobit regression model was used to analyze the influencing factors of utility scores. There were significant differences between utility scores based on the four value sets, with the Chinese 2018 value set yielding the highest utility (0.957). ICCs between the value sets for China 2014, the UK, and Japan were all greater than 0.9, whereas the ICCs between the value sets for China 2018 and the other three were all less than 0.7. The influencing factors of utility scores included CKD stages, age, education level, city, and primary renal disease. This was the first study to report findings on the health utility of patients with CKD based on the two Chinese EQ-5D-3L value sets. Overall, the Chinese value sets performed similarly to the other two value sets (UK and Japan) commonly used in the Chinese population; however, value sets for different countries were not interchangeable. In Chinese contexts, the two value sets for China were recommended and the choice of which one should consider whether the value set of choice was established with a sample that is consistent with the targeted population.
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Affiliation(s)
- Ye Zhang
- Population Development Studies Center, Renmin University of China, Beijing, 100872, People's Republic of China
- School of Sociology and Population Studies, Renmin University of China, Beijing, 100872, People's Republic of China
| | - Jinyue Li
- School of Statistics, Renmin University of China, Beijing, 100872, People's Republic of China
| | - Li Yang
- School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, People's Republic of China.
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Laic RAG, Verheyden J, Bruyninckx D, Lebegge P, Sloten JV, Depreitere B. Profound prospective assessment of radiological and functional outcome 6 months after TBI in elderly. Acta Neurochir (Wien) 2023; 165:849-864. [PMID: 36922467 DOI: 10.1007/s00701-023-05546-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/02/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Recovery after traumatic brain injury (TBI) in older adults is usually affected by the presence of comorbidities, leading to more severe sequelae in this age group than in younger patients. However, there are only few reports that prospectively perform in-depth assessment of outcome following TBI in elderly. OBJECTIVE This study aims at documenting structural brain characteristics and functional outcome and quality of life in elderly patients 6 months after TBI and comparing these data with healthy volunteers undergoing the same assessments. METHODS Thirteen TBI patients ≥ 65 years old, admitted to the University Hospitals Leuven (Belgium), between 2019 and 2022 due to TBI, including all injury severities, and a group of 13 healthy volunteers with similar demographic characteristics were prospectively included in the study. At admission, demographic, injury, and CT scan data were collected in our database. Six months after the accident, a brain MRI scan and standardized assessments of frailty, sleep quality, cognitive function, motor function, and quality of life were conducted. RESULTS A total of 13 patients and 13 volunteers were included in the study, with a median age of 74 and 73 years, respectively. Nine out of the 13 patients presented with a mild TBI. The patient group had a significantly higher level of frailty than the control group, presenting a mean Reported Edmonton Frailty Scale score of 5.8 (SD 2.7) vs 0.7 (SD 1.1) (p < 0.01). No statistically significant differences were found between patient and control brain volumes, fluid attenuated inversion recovery white matter hyperintensity volumes, number of lesions and blackholes, and fractional anisotropy values. Patients demonstrated a significantly higher median reaction time in the One Touch Stockings of Cambridge (22.3 s vs 17.6, p = 0.03) and Reaction Time (0.5 s vs 0.4 s, p < 0.01) subtests in the Cambridge Neuropsychological Test Automated Battery. Furthermore, patients had a lower mean score on the first Box and Blocks test with the right hand (46.6 vs 61.7, p < 0.01) and a significantly higher mean score in the Timed-Up & Go test (13.1 s vs 6.2 s, p = 0.02) and Timed Up & Go with cognitive dual task (16.0 s vs 10.2 s, p < 0.01). Substantially lower QOLIBRI total score (60.4 vs 85.4, p < 0.01) and QOLIBRI-OS total score (53.8 vs 88.5, p < 0.01) were also observed in the patients' group. CONCLUSION In this prospective study, TBI patients ≥ 65 years old when compared with elder controls showed slightly worse cognitive performance and poorer motor function, higher fall risk, but a substantially reduced QoL at 6 months FU, as well as significantly higher frailty, even when the TBI is classified as mild. No statistically significant differences were found in structural brain characteristics on MRI. Future studies with larger sample sizes are needed to refine the impact of TBI versus frailty on function and QoL in elderly.
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Steward KA, Kretzmer T. Anosognosia in moderate-to-severe traumatic brain injury: A review of prevalence, clinical correlates, and diversity considerations. Clin Neuropsychol 2022; 36:2021-2040. [PMID: 34429014 DOI: 10.1080/13854046.2021.1967452] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
METHOD A comprehensive search of peer-reviewed articles was conducted from September to November 2020 using Google Scholar and PubMed databases. Key terms included "anosognosia," "self-awareness," "traumatic brain injury," and variants thereof. Our search was restricted to articles published in English within the last 25 years, although a few historical articles were included due to scientific merit. Articles were chosen based on methodological quality, inclusion of solely or predominantly msevTBI sample, and relevance to the current topic. CONCLUSIONS Anosognosia is a multifaceted and domain-specific construct that affects the majority of those with msevTBI. It is related to TBI severity, injuries in right-hemispheric and cortical midline regions, specific aspects of executive function, psychological function, and cultural factors. We offer pragmatic advice for clinicians working with this population and discuss implications for the field regarding "best practices" of anosognosia assessment and intervention.
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Affiliation(s)
- Kayla A Steward
- Department of Mental Health and Behavioral Sciences, James A. Haley Veterans' Hospital, Tampa, FL, USA
| | - Tracy Kretzmer
- Department of Mental Health and Behavioral Sciences, James A. Haley Veterans' Hospital, Tampa, FL, USA
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Retel Helmrich IRA, van Klaveren D, Andelic N, Lingsma H, Maas A, Menon D, Polinder S, Røe C, Steyerberg EW, Van Veen E, Wilson L. Discrepancy between disability and reported well-being after traumatic brain injury. J Neurol Neurosurg Psychiatry 2022; 93:jnnp-2021-326615. [PMID: 35537823 PMCID: PMC9279746 DOI: 10.1136/jnnp-2021-326615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 02/15/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Following traumatic brain injury (TBI), the clinical focus is often on disability. However, patients' perceptions of well-being can be discordant with their disability level, referred to as the 'disability paradox'. We aimed to examine the relationship between disability and health-related quality of life (HRQoL) following TBI, while taking variation in personal, injury-related and environment factors into account. METHODS We used data from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury study. Disability was assessed 6 months post-injury by the Glasgow Outcome Scale-Extended (GOSE). HRQoL was assessed by the SF-12v2 physical and mental component summary scores and the Quality of Life after Traumatic Brain Injury overall scale. We examined mean total and domain HRQoL scores by GOSE. We quantified variance in HRQoL explained by GOSE, personal, injury-related and environment factors with multivariable regression. RESULTS Six-month outcome assessments were completed in 2075 patients, of whom 78% had mild TBI (Glasgow Coma Scale 13-15). Patients with severe disability had higher HRQoL than expected on the basis of GOSE alone, particularly after mild TBI. Up to 50% of patients with severe disability reported HRQoL scores within the normative range. GOSE, personal, injury-related and environment factors explained a limited amount of variance in HRQoL (up to 29%). CONCLUSION Contrary to the idea that discrepancies are unusual, many patients with poor functional outcomes reported well-being that was at or above the boundary considered satisfactory for the normative sample. These findings challenge the idea that satisfactory HRQoL in patients with disability should be described as 'paradoxical' and question common views of what constitutes 'unfavourable' outcome.
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Affiliation(s)
| | - David van Klaveren
- Department of Public Health, Center for Medical Decision Making, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
- Predictive Analytics and Comparative Effectiveness Center, Institute for Clinical Research and Health Policy Studies/Tufts Medical Center, Boston, Massachusetts, USA
| | - Nada Andelic
- Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Department of Health and Society, University of Oslo, Oslo, Norway
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Hester Lingsma
- Department of Public Health, Center for Medical Decision Making, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Andrew Maas
- Department of Neurosurgery, University Hospital Antwerp, Edegem, Antwerp, Belgium
| | - David Menon
- Division of Anaesthesia, Cambridge University, Cambridge, Cambridgeshire, UK
| | - Suzanne Polinder
- Department of Public Health, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Cecilie Røe
- Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Department of Health and Society, University of Oslo, Oslo, Norway
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Ewout W Steyerberg
- Department of Public Health, Center for Medical Decision Making, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Ernest Van Veen
- Department of Public Health, Center for Medical Decision Making, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
- Department of Intensive Care, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Lindsay Wilson
- Division of Psychology, University of Stirling, Stirling, UK
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Pettemeridou E, Constantinidou F. The cortical and subcortical substrates of quality of life through substrates of self-awareness and executive functions, in chronic moderate-to-severe TBI. Brain Inj 2022; 36:110-120. [DOI: 10.1080/02699052.2022.2034960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Eva Pettemeridou
- Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus
- Kios Innovation & Research Center of Excellence, University of Cyprus, Nicosia, Cyprus
| | - Fofi Constantinidou
- Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
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10
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Health and Well-Being of Persons of Working Age up to Seven Years after Severe Traumatic Brain Injury in Northern Sweden: A Mixed Method Study. J Clin Med 2022; 11:jcm11051306. [PMID: 35268397 PMCID: PMC8911135 DOI: 10.3390/jcm11051306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/21/2022] [Accepted: 02/23/2022] [Indexed: 02/04/2023] Open
Abstract
Purpose: To explore the health and well-being of persons seven years after severe traumatic brain injury (STBI). Material and methods: Follow-up of 21 persons 1 and 7 years after STBI using surveys for functional outcome, anxiety/depression, health and mental fatigue. Interviews were conducted and analysed using qualitative content analysis. Convergent parallel mixed method then merged and analysed the results into an overall interpretation. Results: Good recovery, high functional outcome and overall good health were relatively unchanged between 1 and 7 years. Well-being was a result of adaptation to a recovered or changed life situation. Persons with good recovery had moved on in life. Persons with moderate disability self-estimated their health as good recovery but reported poorer well-being. For persons with severe disability, adaptation was an ongoing process and health and well-being were low. Only a few persons reported anxiety and depression. They had poorer health but nevertheless reported well-being. Persons with moderate and severe mental fatigue had low functional outcomes and overall health and none of them reported well-being. Conclusions: The life of a person who has suffered STBI is still affected to a lesser or greater degree several years after injury due to acceptance of a recovered or changed life situation. Further studies are needed on how health and well-being can be improved after STBI in the long-term perspective.
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von Steinbuechel N, Rauen K, Bockhop F, Covic A, Krenz U, Plass AM, Cunitz K, Polinder S, Wilson L, Steyerberg EW, Maas AIR, Menon D, Wu YJ, Zeldovich M, Investigators TCENTERTBIPA. Psychometric Characteristics of the Patient-Reported Outcome Measures Applied in the CENTER-TBI Study. J Clin Med 2021; 10:2396. [PMID: 34071667 PMCID: PMC8199160 DOI: 10.3390/jcm10112396] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 01/31/2023] Open
Abstract
Traumatic brain injury (TBI) may lead to impairments in various outcome domains. Since most instruments assessing these are only available in a limited number of languages, psychometrically validated translations are important for research and clinical practice. Thus, our aim was to investigate the psychometric properties of the patient-reported outcome measures (PROM) applied in the CENTER-TBI study. The study sample comprised individuals who filled in the six-months assessments (GAD-7, PHQ-9, PCL-5, RPQ, QOLIBRI/-OS, SF-36v2/-12v2). Classical psychometric characteristics were investigated and compared with those of the original English versions. The reliability was satisfactory to excellent; the instruments were comparable to each other and to the original versions. Validity analyses demonstrated medium to high correlations with well-established measures. The original factor structure was replicated by all the translations, except for the RPQ, SF-36v2/-12v2 and some language samples for the PCL-5, most probably due to the factor structure of the original instruments. The translation of one to two items of the PHQ-9, RPQ, PCL-5, and QOLIBRI in three languages could be improved in the future to enhance scoring and application at the individual level. Researchers and clinicians now have access to reliable and valid instruments to improve outcome assessment after TBI in national and international health care.
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Affiliation(s)
- Nicole von Steinbuechel
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany; (F.B.); (A.C.); (U.K.); (A.M.P.); (K.C.); (Y.-J.W.); (M.Z.)
| | - Katrin Rauen
- Department of Geriatric Psychiatry, Psychiatric Hospital Zurich, University of Zurich, Minervastrasse 145, 8032 Zurich, Switzerland; or
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Feodor-Lynen-Straße 17, 81377 Munich, Germany
| | - Fabian Bockhop
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany; (F.B.); (A.C.); (U.K.); (A.M.P.); (K.C.); (Y.-J.W.); (M.Z.)
| | - Amra Covic
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany; (F.B.); (A.C.); (U.K.); (A.M.P.); (K.C.); (Y.-J.W.); (M.Z.)
| | - Ugne Krenz
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany; (F.B.); (A.C.); (U.K.); (A.M.P.); (K.C.); (Y.-J.W.); (M.Z.)
| | - Anne Marie Plass
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany; (F.B.); (A.C.); (U.K.); (A.M.P.); (K.C.); (Y.-J.W.); (M.Z.)
| | - Katrin Cunitz
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany; (F.B.); (A.C.); (U.K.); (A.M.P.); (K.C.); (Y.-J.W.); (M.Z.)
| | - Suzanne Polinder
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands; (S.P.); (E.W.S.)
| | - Lindsay Wilson
- Department of Psychology, University of Stirling, Stirling FK9 4LJ, UK;
| | - Ewout W. Steyerberg
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands; (S.P.); (E.W.S.)
- Department of Biomedical Data Sciences, Leiden University Medical Center, 2333 RC Leiden, The Netherlands
| | - Andrew I. R. Maas
- Department of Neurosurgery, Antwerp University Hospital and University of Antwerp, 2650 Edegem, Belgium;
| | - David Menon
- Division of Anaesthesia, University of Cambridge/Addenbrooke’s Hospital, Box 157, Cambridge CB2 0QQ, UK;
| | - Yi-Jhen Wu
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany; (F.B.); (A.C.); (U.K.); (A.M.P.); (K.C.); (Y.-J.W.); (M.Z.)
| | - Marina Zeldovich
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany; (F.B.); (A.C.); (U.K.); (A.M.P.); (K.C.); (Y.-J.W.); (M.Z.)
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12
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Assessing the Severity of Traumatic Brain Injury-Time for a Change? J Clin Med 2021; 10:jcm10010148. [PMID: 33406786 PMCID: PMC7795933 DOI: 10.3390/jcm10010148] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 12/23/2020] [Accepted: 12/30/2020] [Indexed: 01/09/2023] Open
Abstract
Traumatic brain injury (TBI) has been described to be man's most complex disease, in man's most complex organ. Despite this vast complexity, variability, and individuality, we still classify the severity of TBI based on non-specific, often unreliable, and pathophysiologically poorly understood measures. Current classifications are primarily based on clinical evaluations, which are non-specific and poorly predictive of long-term disability. Brain imaging results have also been used, yet there are multiple ways of doing brain imaging, at different timepoints in this very dynamic injury. Severity itself is a vague concept. All prediction models based on combining variables that can be assessed during the acute phase have reached only modest predictive values for later outcome. Yet, these early labels of severity often determine how the patient is treated by the healthcare system at large. This opinion paper examines the problems and provides caveats regarding the use of current severity labels and the many practical and scientific issues that arise from doing so. The objective of this paper is to show the causes and consequences of current practice and propose a new approach based on risk classification. A new approach based on multimodal quantifiable data (including imaging and biomarkers) and risk-labels would be of benefit both for the patients and for TBI clinical research and should be a priority for international efforts in the field.
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13
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Villalobos D, Caperos JM, Bilbao Á, Bivona U, Formisano R, Pacios J. Self-Awareness Moderates the Association Between Executive Dysfunction and Functional Independence After Acquired Brain Injury. Arch Clin Neuropsychol 2020; 35:1059–1068. [PMID: 32743646 DOI: 10.1093/arclin/acaa048] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/15/2020] [Accepted: 06/19/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Impaired self-awareness (SA) is a common symptom after suffering acquired brain injury (ABI) which interferes with patient's rehabilitation and their functional independence. SA is associated with executive function and declarative memory, two cognitive functions that are related to participants' daily living functionality. Through this observational study, we aim to explore whether SA may play a moderator role in the relation between these two cognitive processes and functional independence. METHOD A sample of 69 participants with ABI completed a neuropsychological assessment focused on executive function and declarative memory which also included a measure of SA and functional independence. Two separated linear models were performed including functional independence, SA, and two neuropsychological factors (declarative memory and executive function) derived from a previous principal component analysis. RESULTS Moderation analysis show a significant interaction between SA and executive function, reflecting an association between lower executive functioning and poorer functional outcome, only in participants with low levels of SA. Notwithstanding, declarative memory do not show a significant interaction with SA, even though higher declarative memory scores were associated with better functional independence. CONCLUSIONS SA seems to play a moderator effect between executive function, but not declarative memory, and functional independence. Accordingly, participants with executive deficits and low levels of SA might benefit from receiving specific SA interventions in the first instance, which would in turn positively impact on their functional independence.
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Affiliation(s)
- Dolores Villalobos
- Department of Psychology, Faculty of Health Sciences, Camilo José Cela University, Villafranca del Castillo, Madrid, Spain
- Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Technical University of Madrid, Complutense University of Madrid, Madrid, Spain
- Department of Experimental Psychology, School of Psychology, Complutense University, Madrid, Spain
| | - José M Caperos
- Fundación San Juan de Dios, Madrid, Spain
- Departamento de Psicología, Universidad Pontificia Comillas, Madrid, Spain
| | - Álvaro Bilbao
- Centro de Referencia Estatal de Atención al Daño Cerebral (CEADAC), Madrid, Spain
| | - Umberto Bivona
- Istituto di Ricovero e Cura a Carattere Scientifico, Santa Lucia Foundation, Rome, Italy
| | - Rita Formisano
- Istituto di Ricovero e Cura a Carattere Scientifico, Santa Lucia Foundation, Rome, Italy
| | - Javier Pacios
- Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Technical University of Madrid, Complutense University of Madrid, Madrid, Spain
- Department of Experimental Psychology, School of Psychology, Complutense University, Madrid, Spain
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14
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Gaertner LHC, Tsur N, Haller CS. Patients’ recovery after severe TBI is associated with their close relatives’ interpersonal functioning: a 12-months prospective cohort study. Brain Inj 2020; 34:764-772. [DOI: 10.1080/02699052.2020.1753241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Lynn H. C. Gaertner
- Department of Psychology, Harvard University, Cambridge, Massachusetts, USA
- Department of Psychology, University of Luebeck, Luebeck, Germany
| | - Noga Tsur
- School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Chiara S. Haller
- Department of Psychology, Harvard University, Cambridge, Massachusetts, USA
- Division of Public Psychiatry, Massachusetts Mental Health Center, Harvard Medical School, Boston, Massachusetts, USA
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15
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Pettemeridou E, Kennedy MR, Constantinidou F. Executive functions, self-awareness and quality of life in chronic moderate-to-severe TBI. NeuroRehabilitation 2020; 46:109-118. [DOI: 10.3233/nre-192963] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Eva Pettemeridou
- Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus
- KIOS Innovation & Research Center of Excellence, University of Cyprus, Nicosia, Cyprus
| | - Mary R.T. Kennedy
- Communication Sciences and Disorders, Chapman University, Irvine, CA, USA
| | - Fofi Constantinidou
- Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
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16
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Yeo YX, Pestell CF, Bucks RS, Allanson F, Weinborn M. Metacognitive knowledge and functional outcomes in adults with acquired brain injury: A meta-analysis. Neuropsychol Rehabil 2019; 31:453-478. [PMID: 31876262 DOI: 10.1080/09602011.2019.1704421] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Pronounced difficulties in functional outcomes often follow acquired brain injury (ABI), and may be due, in part, to deficits in metacognitive knowledge (being unaware of one's cognitive strengths and limitations). A meta-analytic review of the literature investigating the relationship between metacognitive knowledge and functional outcomes in ABI is timely, particularly given the presence of apparently inconsistent findings. Twenty-two articles revealed two distinct methods of measuring metacognitive knowledge: (1) absolute (the degree of inaccurate self-appraisal regardless of whether the error tends towards under- or over-confident estimations) and (2) relative (the degree and the direction of the inaccuracy) discrepancy. Separate meta-analyses were conducted for absolute and relative discrepancy studies to assess the relationship between metacognitive knowledge and functional outcomes (affect-related quality of life, family and community integration, and work outcomes). The pattern of results found suggested that better metacognitive knowledge is related to better overall functional outcomes, but the relationship may differ depending on the outcome domain. These findings generally support the importance of focusing on metacognitive knowledge to improve outcomes following ABI. Nonetheless, the relatively small effect sizes observed suggest that other predictors of functional outcome should be investigated, including other subdomains of metacognition.
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Affiliation(s)
- Yong Xiang Yeo
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - Carmela F Pestell
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - Romola S Bucks
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - Fiona Allanson
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - Michael Weinborn
- School of Psychological Science, University of Western Australia, Perth, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
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17
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Adaptation and validation of the self-report version of the scale for measuring quality of life in people with acquired brain injury (CAVIDACE). Qual Life Res 2019; 29:1107-1121. [DOI: 10.1007/s11136-019-02386-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2019] [Indexed: 01/25/2023]
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18
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Gorgoraptis N, Zaw-Linn J, Feeney C, Tenorio-Jimenez C, Niemi M, Malik A, Ham T, Goldstone AP, Sharp DJ. Cognitive impairment and health-related quality of life following traumatic brain injury. NeuroRehabilitation 2019; 44:321-331. [DOI: 10.3233/nre-182618] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Nikos Gorgoraptis
- Department of Neurology, Imperial College Healthcare NHS Trust, London, UK
- Department of Medicine, Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK
| | - Joanna Zaw-Linn
- Department of Medicine, Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK
| | - Claire Feeney
- Department of Medicine, Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK
- Imperial Centre for Endocrinology, Imperial College Healthcare NHS Trust, Charing Cross and St. Mary’s Hospitals, London, UK
| | - Carmen Tenorio-Jimenez
- Department of Medicine, Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK
| | - Mari Niemi
- Department of Medicine, Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK
| | - Aysha Malik
- Department of Medicine, Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK
| | - Timothy Ham
- Department of Neurology, Imperial College Healthcare NHS Trust, London, UK
- Department of Medicine, Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK
| | - Anthony P. Goldstone
- Department of Neurology, Imperial College Healthcare NHS Trust, London, UK
- Department of Medicine, Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK
- Imperial Centre for Endocrinology, Imperial College Healthcare NHS Trust, Charing Cross and St. Mary’s Hospitals, London, UK
| | - David J. Sharp
- Department of Neurology, Imperial College Healthcare NHS Trust, London, UK
- Department of Medicine, Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK
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19
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Chang YJ, Liang WM, Yu WY, Lin MR. Psychometric Comparisons of the Quality of Life after Brain Injury between Individuals with Mild and Those with Moderate/Severe Traumatic Brain Injuries. J Neurotrauma 2019; 36:126-134. [PMID: 29877126 DOI: 10.1089/neu.2017.5499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This study compared psychometric properties of the Taiwanese version of the Quality of Life after Brain Injury (QOLIBRI) between patients with mild and those with moderate/severe traumatic brain injury (TBI). Of 683 participants, 548 had sustained a mild injury with Glasgow Coma Scale (GCS) scores of 13-15, and 135 had a moderate/severe injury with GCS scores of 3-12. The QOLIBRI comprises six domains: Cognition, Self, Daily Life and Autonomy, Social Relationships, Emotions, and Physical Problems. Results of the Rasch analysis showed that two items of "Problems with seeing/hearing" and "Finding one's way about" were underfitting in the mild TBI group while the item "Problems with seeing/hearing" was underfitting and the item "TBI effects" was overfitting in the moderate/severe TBI group. The largest differential item functioning (DIF) between the mild and moderate/severe TBI groups appeared in the item "Energy," followed by those of "Being slow/clumsy" and "Problems with seeing/hearing." For both the mild and moderate/severe TBI groups, the two domains of Emotions and Physical Problems displayed strong ceiling effects, low person reliability and separation, and an incomplete range of the person measure covered by the item difficulty, while the remaining four domains had acceptable performances. While the psychometric performance of the QOLIBRI at the domain level was similar between the mild and moderate/severe TBI groups, certain items exhibited different functioning between the two groups. The reason why the two domains of the Emotions and Physical Problems performed poorly in the two TBI severity groups could be due to cross-cultural effects. The meanings of these DIF items, particularly for patients with a mild TBI, and factors contributing to the ceiling effect of the Emotions and Physical Problems domains in other ethnic Chinese populations need to be investigated further.
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Affiliation(s)
- Yu-Jun Chang
- 1 Epidemiology and Biostatistics Center, Changhua Christian Hospital, Changhua, Taiwan
- 2 Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Wen-Miin Liang
- 3 School of Public Health, China Medical University, Taichung, Taiwan
| | - Wen-Yu Yu
- 4 Department of Emergency Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Mau-Roung Lin
- 2 Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan
- 4 Department of Emergency Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- 5 Master Program in Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
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20
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Chesnel C, Jourdan C, Bayen E, Ghout I, Darnoux E, Azerad S, Charanton J, Aegerter P, Pradat-Diehl P, Ruet A, Azouvi P, Vallat-Azouvi C. Self-awareness four years after severe traumatic brain injury: discordance between the patient’s and relative’s complaints. Results from the PariS-TBI study. Clin Rehabil 2017; 32:692-704. [DOI: 10.1177/0269215517734294] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objective: To evaluate the patient’s awareness of his or her difficulties in the chronic phase of severe traumatic brain injury (TBI) and to determine the factors related to poor awareness. Design/Setting/Subjects: This study was part of a larger prospective inception cohort study of patients with severe TBI in the Parisian region (PariS-TBI study). Intervention/Main measures: Evaluation was carried out at four years and included the Brain Injury Complaint Questionnaire (BICoQ) completed by the patient and his or her relative as well as the evaluation of impairments, disability and quality of life. Results: A total of 90 patient-relative pairs were included. Lack of awareness was measured using the unawareness index that corresponded to the number of discordant results between the patient and relative in the direction of under evaluation of difficulties by the patient. The only significant relationship found with lack of awareness was the subjective burden perceived by the relative (Zarit Burden Inventory) ( r = 0.5; P < 0.00001). There was no significant relationship between lack of awareness and injury severity, pre-injury socio-demographic data, cognitive impairments, mood disorders, functional independence (Barthel index), global disability (Glasgow Outcome Scale), return to work at four years or quality of life (Quality Of Life after Brain Injury scale (QOLIBRI)). Conclusion: Lack of awareness four years post severe TBI was not related to the severity of the initial trauma, sociodemographic data, the severity of impairments, limitations of activity and participation, or the patient’s quality of life. However, poor awareness did significantly influence the weight of the burden perceived by the relative.
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Affiliation(s)
- Camille Chesnel
- Service de Médecine Physique et de Réadaptation, APHP – Hôpital Raymond Poincaré, Garches, France
| | - Claire Jourdan
- Service de Médecine Physique et de Réadaptation, APHP – Hôpital Raymond Poincaré, Garches, France
- HANDIReSP EA 4047, Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France
| | - Eleonore Bayen
- Laboratoire d’Économie et de Gestion des Organisations de Santé (LEDa-LEGOS), Université Paris-Dauphine, Paris, France
- Université Pierre et Marie Curie, Paris, France
- Service de Médecine Physique et de Réadaptation, APHP – Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Paris, France
| | - Idir Ghout
- Unité de Recherche Clinique (URC), APHP – Hôpital Ambroise Paré, Boulogne, France
| | - Emmanuelle Darnoux
- Centre Ressources Francilien du Traumatisme Crânien (CRFTC), Paris, France
| | - Sylvie Azerad
- Unité de Recherche Clinique (URC), APHP – Hôpital Ambroise Paré, Boulogne, France
| | - James Charanton
- Centre Ressources Francilien du Traumatisme Crânien (CRFTC), Paris, France
| | - Philippe Aegerter
- Unité de Recherche Clinique (URC), APHP – Hôpital Ambroise Paré, Boulogne, France
- UMR-S 1168, Université de Versailles Saint-Quentin, Versailles, France
| | - Pascale Pradat-Diehl
- Université Pierre et Marie Curie, Paris, France
- Service de Médecine Physique et de Réadaptation, APHP – Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Paris, France
| | - Alexis Ruet
- Service de Médecine Physique et de Réadaptation, APHP – Hôpital Raymond Poincaré, Garches, France
| | - Philippe Azouvi
- Service de Médecine Physique et de Réadaptation, APHP – Hôpital Raymond Poincaré, Garches, France
- HANDIReSP EA 4047, Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France
| | - Claire Vallat-Azouvi
- HANDIReSP EA 4047, Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France
- Antenne UEROS-SAMSAH92-UGECAM IDF, Hôpital Raymond Poincaré, Garches, France
- EA 2027: Laboratoire de Psychopathologie et Neuropsychologie, Université Paris 8, Saint-Denis, France
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21
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Haller CS. Twelve-month prospective cohort study of patients with severe traumatic brain injury and their relatives: Coping, satisfaction with life and neurological functioning. Brain Inj 2017; 31:1903-1909. [DOI: 10.1080/02699052.2017.1346295] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Chiara S. Haller
- Department of Psychology, Harvard University, Cambridge, MA, USA; Division of Public Psychiatry, Massachusetts Mental Health Center, Boston, MA, USA
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22
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von Steinbüchel N, Real RGL, Sasse N, Wilson L, Otto C, Mullins R, Behr R, Deinsberger W, Martinez-Olivera R, Puschendorf W, Petereit W, Rohde V, Schmidt H, Sehmisch S, Stürmer KM, von Wild K, Gibbons H. German validation of Quality of Life after Brain Injury (QOLIBRI) assessment and associated factors. PLoS One 2017; 12:e0176668. [PMID: 28542226 PMCID: PMC5443488 DOI: 10.1371/journal.pone.0176668] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 04/12/2017] [Indexed: 01/07/2023] Open
Abstract
The consequences of traumatic brain injury (TBI) for health-related quality of life (HRQoL) are still poorly understood, and no TBI-specific instrument has hitherto been available. This paper describes in detail the psychometrics and validity of the German version of an internationally developed, self-rated HRQoL tool after TBI-the QOLIBRI (Quality of Life after Brain Injury). Factors associated with HRQoL, such as the impact of cognitive status and awareness, are specifically reported. One-hundred seventy-two participants after TBI were recruited from the records of acute clinics, most of whom having a Glasgow Coma Scale (GCS) 24-hour worst score and a Glasgow Outcome Scale (GOSE) score. Participants had severe (24%), moderate (11%) and mild (56%) injuries as assessed on the GCS, 3 months to 15 years post-injury. The QOLIBRI uses 37 items to measure "satisfaction" in the areas of "Cognition", "Self", "Daily Life and Autonomy", and "Social Relationships", and "feeling bothered" by "Emotions"and "Physical Problems". The scales meet standard psychometric criteria (α = .84 to .96; intra-class correlation-ICC = .72 to .91). ICCs (0.68 to 0.90) and αs (.83 to .96) were also good in a subgroup of participants with lower cognitive performance. The six-subscale structure of the international sample was reproduced for the German version using confirmatory factor analyses and Rasch analysis. Scale validity was supported by systematic relationships observed between the QOLIBRI and the GOSE, Patient Competency Rating Scale for Neurorehabilitation (PCRS-NR), Hospital Anxiety and Depression Scale (HADS), Profile of Mood States (POMS), Short Form 36 (SF-36), and Satisfaction with Life Scale (SWLS). The German QOLIBRI contains novel information not provided by other currently available measures and has good psychometric criteria. It is potentially useful for clinicians and researchers, in post-acute and rehabilitation studies, on a group and individual level.
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Affiliation(s)
- Nicole von Steinbüchel
- Institute of Medical Psychology and Medical Sociology, University Medical Center Goettingen, Goettingen, Germany
| | - Ruben G. L. Real
- Institute of Medical Psychology and Medical Sociology, University Medical Center Goettingen, Goettingen, Germany
| | - Nadine Sasse
- Institute of Medical Psychology and Medical Sociology, University Medical Center Goettingen, Goettingen, Germany
| | - Lindsay Wilson
- Department of Psychology, University of Stirling, Stirling, United Kingdom
| | - Christiane Otto
- Institute of Medical Psychology and Medical Sociology, University Medical Center Goettingen, Goettingen, Germany
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Ryan Mullins
- Institute of Medical Psychology and Medical Sociology, University Medical Center Goettingen, Goettingen, Germany
| | - Robert Behr
- Department of Neurosurgery, Clinical Center Fulda, Fulda, Germany
| | | | - Ramon Martinez-Olivera
- Department of Neurosurgery & Neurotraumatology at Bergmannsheil University Hospital Bochum, Bochum, Germany
| | | | - Werner Petereit
- Department of Neurosurgery, Clinical Center Bernburg, Bernburg, Germany
| | - Veit Rohde
- Department of Neurosurgery, University Medical Center Goettingen, Goettingen, Germany
| | - Holger Schmidt
- Institute of Medical Psychology and Medical Sociology, University Medical Center Goettingen, Goettingen, Germany
- Department of Neurology, University Medical Center Goettingen, Goettingen, Germany
| | - Stephan Sehmisch
- Trauma surgery, plastic and reconstructive surgery, University Medical Center Goettingen, Goettingen, Germany
| | - Klaus Michael Stürmer
- Trauma surgery, plastic and reconstructive surgery, University Medical Center Goettingen, Goettingen, Germany
| | | | - Henning Gibbons
- Institute of Medical Psychology and Medical Sociology, University Medical Center Goettingen, Goettingen, Germany
- Department of Psychology, University of Bonn, Bonn, Germany
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23
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Formisano R, Silvestro D, Azicnuda E, Longo E, Barba C, Rigon J, D'Ippolito M, Giustini M, Bivona U. Quality of life after brain injury (QOLIBRI): Italian validation of the proxy version. Intern Emerg Med 2017; 12:187-198. [PMID: 27686362 DOI: 10.1007/s11739-016-1536-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 09/09/2016] [Indexed: 11/27/2022]
Abstract
To validate the proxy version of the Quality of Life after Brain Injury (QOLIBRI) questionnaire to utilize caregivers for comparison and to evaluate the correspondence between patients' self-perceived and caregivers' perception of patients' Health-Related Quality of Life (HRQoL). Ninety-two patients with severe TBI and their main caregivers were enrolled. Patients' and caregivers' HRQoL was assessed by the Patient-QOLIBRI (Pt-QOLIBRI) and the Proxy-QOLIBRI (Pro-QOLIBRI), respectively. The Pro-QOLIBRI is a modified version of the QOLIBRI to investigate caregivers' perception of patients' HRQoL (Pro-QOLIBRIpatient-centered), and their degree of satisfaction and botheredness (Pro-QOLIBRIcaregiver centered). The patients' disability and their social reintegration was investigated by means of Glasgow Outcome Scale Extended and Community Integration Questionnaire. Pro-QOLIBRI has good internal consistency and homogeneity. There was also positive correlation between the level of satisfaction measured by Pro-QOLIBRI but not by Pt-QOLIBRI, and the disability severity and social integration of the patients. The comparison between the Pt-QOLIBRI and Pro-QOLIBRI confirmed the usefulness of the Pro-QOLIBRI, especially the caregiver-centered version, to predict the social reintegration of survivors. To our knowledge this is the first study that correlates the HRQoL of survivors, as self-perceived and as perceived by the caregivers with social reintegration.
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Affiliation(s)
- Rita Formisano
- IRCCS, Rehabilitation Hospital Santa Lucia Foundation, Via Ardeatina 306, 00142, Rome, Italy.
| | - Daniela Silvestro
- IRCCS, Rehabilitation Hospital Santa Lucia Foundation, Via Ardeatina 306, 00142, Rome, Italy
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Eva Azicnuda
- IRCCS, Rehabilitation Hospital Santa Lucia Foundation, Via Ardeatina 306, 00142, Rome, Italy
| | | | - Carmen Barba
- Pediatric Neurology Unit, A. Meyer Children's Hopsital, University of Florence, Florence, Italy
| | - Jessica Rigon
- IRCCS San Camillo Hopsital Foundation, Venezia-Lido, Italy
| | - Mariagrazia D'Ippolito
- IRCCS, Rehabilitation Hospital Santa Lucia Foundation, Via Ardeatina 306, 00142, Rome, Italy
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Umberto Bivona
- IRCCS, Rehabilitation Hospital Santa Lucia Foundation, Via Ardeatina 306, 00142, Rome, Italy
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Haller CS, Delhumeau C, De Pretto M, Schumacher R, Pielmaier L, Rebetez MML, Haller G, Walder B. Trajectory of disability and quality-of-life in non-geriatric and geriatric survivors after severe traumatic brain injury. Brain Inj 2017; 31:319-328. [DOI: 10.1080/02699052.2016.1255777] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Chiara S. Haller
- Department of Psychology, Harvard University, Cambridge, Boston, MA, USA
- Division of Public Psychiatry, Massachusetts Mental Health Center, Boston, MA, USA
| | - Cecile Delhumeau
- Division of Anaesthesiology, University Hospitals of Geneva (HUG), Geneva, Switzerland
| | - Michael De Pretto
- Division of Anaesthesiology, University Hospitals of Geneva (HUG), Geneva, Switzerland
| | - Rahel Schumacher
- Division of Cognitive and Restorative Neurology, Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | | | | | - Guy Haller
- Division of Anaesthesiology, University Hospitals of Geneva (HUG), Geneva, Switzerland
- Division of Clinical Epidemiology, University Hospitals of Geneva (HUG), Geneva, Switzerland
| | - Bernhard Walder
- Division of Anaesthesiology, University Hospitals of Geneva (HUG), Geneva, Switzerland
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Soberg HL, Roe C, Brunborg C, von Steinbüchel N, Andelic N. The Norwegian version of the QOLIBRI - a study of metric properties based on a 12 month follow-up of persons with traumatic brain injury. Health Qual Life Outcomes 2017; 15:14. [PMID: 28103876 PMCID: PMC5248455 DOI: 10.1186/s12955-017-0589-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 01/13/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Consequences after Traumatic brain injury (TBI) affect the injured person's self-image and quality of life. The purpose was to assess the health related quality of life (HRQoL) at 12 months after a TBI in patients admitted to regional trauma centres, and to evaluate the metric properties of the Norwegian version of the Quality of Life After Brain Injury (QOLIBRI) questionnaire. METHODS Two hundred four patients with TBI of all severities were included. HRQoL at 12 months post-injury was measured by the QOLIBRI. It has a total scale and 6 subscales (satisfied with Cognition, Self, Daily Life and Autonomy and Social Relationships, and bothered by Emotions and Physical Problems). Demographic and injury related data were registered. Disability was registered by Glasgow Outcome Scale Extended (GOSE) and Rivermead Post-Concussion Questionnaire, and mental health by Hospital Anxiety and Depression Scale. Descriptive statistics, internal consistency by Cronbach's alpha and Corrected Item-Total Correlations were calculated. Rasch analysis, Principal Component Analysis (PCA) and Structural Equation Modelling (SEM) were applied. RESULTS Mean age was 37.6 (SD 15.4) years; 72% were men, and 41% had higher education. Over 60% were severely injured. Mean Glasgow Coma Scale score was 9.3 (SD 4.5). According to the GOSE 5.9% had severe disability, 45.5% had moderate disability, and 48.5% had good recovery at 12 months post-injury. The QOLIBRI scales had a high internal consistency (α = 0.75-0.96), and only Physical Problems had an α < 0.85. In the Rasch analysis all subscales and their items fit the Rasch model, except for the depression item in the Emotion subscale. PCA and SEM analyses supported a six-factor structure in a second-order latent model. The QOLIBRI supports an underlying unidimensional HRQoL model. The SEM model fit statistics of the second-order model indicated a moderate fit to the observed data (CFI = 0.86, TLI = 0.85, RMSEA = 0.076, SRMR = 0.061, χ2 = 1315.76, df = 623, p-value < 0.001). CONCLUSION The Norwegian QOLIBRI has favourable psychometric properties, but there were some weaknesses related to its measurement properties of the total score when tested on a TBI population where many had severe TBI, and many had good recovery.
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Affiliation(s)
- Helene Lundgaard Soberg
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Postbox 4950, Nydalen 0424 Oslo, Norway
| | - Cecilie Roe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Postbox 4950, Nydalen 0424 Oslo, Norway
| | - Cathrine Brunborg
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Nicole von Steinbüchel
- Institute of Medical Psychology and Medical Sociology, University Medical Centre Göttingen, Göttingen, Germany
| | - Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Postbox 4950, Nydalen 0424 Oslo, Norway
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Actigraphic and Sleep Diary Measures in Veterans With Traumatic Brain Injury: Discrepancy in Selected Sleep Parameters. J Head Trauma Rehabil 2017; 31:136-46. [PMID: 26959667 DOI: 10.1097/htr.0000000000000225] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To examine the discrepancy between sleep diary and actigraphic measures of sleep in Veterans with moderate-severe post-acute traumatic brain injury (TBI) and to explore whether these discrepancies vary according to participant characteristics. SETTING VA Medical Center in the Rocky Mountain United States. PARTICIPANTS Nineteen males with moderate-severe post-acute TBI and insomnia symptoms as measured by the Insomnia Severity Index. DESIGN Descriptive, cross-sectional. MAIN MEASURES Sleep diary, wrist actigraphy, Ohio State University TBI-Identification Method, Insomnia Severity Index, and Hospital Anxiety and Depression Scale. RESULTS There was poor agreement between actigraphic and sleep diary measurements of (1) total sleep time, (2) wake after sleep onset, and (3) sleep onset latency. On average, actigraphy measured greater duration of all 3 sleep parameters. Discrepancies were not found to be associated with specific TBI characteristics or mood-related symptoms. CONCLUSION When measuring sleep-related outcomes among Veterans with moderate-severe post-acute TBI, notable mismatches were found between actigraphic and self-reported sleep diary data. Knowledge regarding measure-related limitations is important for both clinical and research practices among those with moderate-severe post-acute TBI.
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Quality of life in persons after traumatic brain injury as self-perceived and as perceived by the caregivers. Neurol Sci 2016; 38:279-286. [DOI: 10.1007/s10072-016-2755-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 10/27/2016] [Indexed: 10/20/2022]
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Haller CS. The Relatives’ Big Five Personality Influences the Trajectories of Recovery of Patients After Severe TBI: A Multilevel Analysis. J Pers 2016; 85:481-493. [DOI: 10.1111/jopy.12254] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Assessment of Health-Related Quality of Life after TBI: Comparison of a Disease-Specific (QOLIBRI) with a Generic (SF-36) Instrument. Behav Neurol 2016; 2016:7928014. [PMID: 27022207 PMCID: PMC4753323 DOI: 10.1155/2016/7928014] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 10/26/2015] [Accepted: 11/04/2015] [Indexed: 11/17/2022] Open
Abstract
Psychosocial, emotional, and physical problems can emerge after traumatic brain injury (TBI), potentially impacting health-related quality of life (HRQoL). Until now, however, neither the discriminatory power of disease-specific (QOLIBRI) and generic (SF-36) HRQoL nor their correlates have been compared in detail. These aspects as well as some psychometric item characteristics were studied in a sample of 795 TBI survivors. The Shannon H (') index absolute informativity, as an indicator of an instrument's power to differentiate between individuals within a specific group or health state, was investigated. Psychometric performance of the two instruments was predominantly good, generally higher, and more homogenous for the QOLIBRI than for the SF-36 subscales. Notably, the SF-36 "Role Physical," "Role Emotional," and "Social Functioning" subscales showed less satisfactory discriminatory power than all other dimensions or the sum scores of both instruments. The absolute informativity of disease-specific as well as generic HRQoL instruments concerning the different groups defined by different correlates differed significantly. When the focus is on how a certain subscale or sum score differentiates between individuals in one specific dimension/health state, the QOLIBRI can be recommended as the preferable instrument.
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Stephens JA, Williamson KNC, Berryhill ME. Cognitive Rehabilitation After Traumatic Brain Injury: A Reference for Occupational Therapists. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2015; 35:5-22. [PMID: 26623474 DOI: 10.1177/1539449214561765] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Nearly 1.7 million Americans sustain a traumatic brain injury (TBI) each year. These injuries can result in physical, emotional, and cognitive consequences. While many individuals receive cognitive rehabilitation from occupational therapists (OTs), the interdisciplinary nature of TBI research makes it difficult to remain up-to-date on relevant findings. We conducted a literature review to identify and summarize interdisciplinary evidence-based practice targeting cognitive rehabilitation for civilian adults with TBI. Our review summarizes TBI background, and our cognitive remediation section focuses on the findings from 37 recent (since 2006) empirical articles directly related to cognitive rehabilitation for individuals (i.e., excluding special populations such as veterans or athletes). This manuscript is offered as a tool for OTs engaged in cognitive rehabilitation and as a means to highlight arenas where more empirical, interdisciplinary research is needed.
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Dymowski AR, Ponsford JL, Willmott C. Cognitive training approaches to remediate attention and executive dysfunction after traumatic brain injury: A single-case series. Neuropsychol Rehabil 2015; 26:866-94. [PMID: 26493353 DOI: 10.1080/09602011.2015.1102746] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Attentional deficits are common following traumatic brain injury (TBI) and interfere with daily functioning. This study employed a single-case design to examine the effects of individualised strategy training on attention beyond the effects of computerised training using Attention Process Training 3 (APT-3), and to examine the participants' subjective experience of these approaches. An ABCA (baseline, APT-3, strategy training, follow-up) design was repeated across three participants with severe TBI. Outcomes were measured on alternate versions of the oral Symbol Digit Modalities Test (SDMT) and cancellation tasks; generalisation with the Test of Everyday Attention (TEA) and self and significant other (SO) ratings on the Rating Scale of Attentional Behaviour (RSAB); and participant experiences with semi-structured interviews. Planned Tau-U analyses revealed improvements in speed of processing on the SDMT and the automatic condition of the cancellation task after APT-3 and at follow-up, but with most improvement after strategy training. Limited generalisation was evident on TEA subtests and self-RSAB ratings. SO-RSAB ratings were mixed after APT-3, but demonstrated improvement after strategy training. Variability in attentional deficits and everyday attentional requirements between patients required individualised goals and approaches to rehabilitation. This study highlights the need for individualised rehabilitation of attention to improve everyday functioning after TBI.
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Affiliation(s)
- Alicia Rhian Dymowski
- a School of Psychological Sciences , Monash University , Clayton , Victoria , Australia.,b Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare , Richmond , Victoria , Australia
| | - Jennie Louise Ponsford
- a School of Psychological Sciences , Monash University , Clayton , Victoria , Australia.,b Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare , Richmond , Victoria , Australia.,c Centre of Excellence in Traumatic Brain Injury Rehabilitation, National Trauma Research Institute, Alfred Hospital , Prahran , Victoria , Australia
| | - Catherine Willmott
- a School of Psychological Sciences , Monash University , Clayton , Victoria , Australia.,b Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare , Richmond , Victoria , Australia
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Bivona U, Formisano R, De Laurentiis S, Accetta N, Rita Di Cosimo M, Massicci R, Ciurli P, Azicnuda E, Silvestro D, Sabatini U, Falletta Caravasso C, Augusto Carlesimo G, Caltagirone C, Costa A. Theory of mind impairment after severe traumatic brain injury and its relationship with caregivers’ quality of life. Restor Neurol Neurosci 2015; 33:335-45. [DOI: 10.3233/rnn-140484] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Carlo Caltagirone
- Fondazione Santa Lucia – Rome, Italy
- Università di Roma Tor Vergata – Rome, Italy
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Llorens R, Noé E, Ferri J, Alcañiz M. Videogame-based group therapy to improve self-awareness and social skills after traumatic brain injury. J Neuroeng Rehabil 2015; 12:37. [PMID: 25889914 PMCID: PMC4404289 DOI: 10.1186/s12984-015-0029-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 03/27/2015] [Indexed: 11/28/2022] Open
Abstract
Background This study determines the feasibility of different approaches to integrative videogame-based group therapy for improving self-awareness, social skills, and behaviors among traumatic brain injury (TBI) victims and retrieves participant feedback. Methods Forty-two adult TBI survivors were included in a longitudinal study with a pre- and post-assessments. The experimental intervention involved weekly one-hour sessions conducted over six months. Participants were assessed using the Self-Awareness Deficits Interview (SADI), Patient Competency Rating Scale (PCRS), the Social Skills Scale (SSS), the Frontal Systems Behavior Scale (FrSBe), the System Usability Scale (SUS). Pearson's chi-squared test (χ2) was applied to determine the percentage of participants who had changed their clinical classification in these tests. Feedback of the intervention was collected through the Intrinsic Motivation Inventory (IMI). Results SADI results showed an improvement in participant perceptions of deficits (χ2 = 5.25, p < 0.05), of their implications (χ2 = 4.71, p < 0.05), and of long-term planning (χ2 = 7.86, p < 0.01). PCRS results confirm these findings (χ2 = 5.79, p < 0.05). SSS results were also positive with respect to social skills outcomes (χ2 = 17.52, p < 0.01), and FrSBe results showed behavioral improvements (χ2 = 34.12, p < 0.01). Participants deemed the system accessible (80.43 ± 8.01 out of 100) and regarded the intervention as interesting and useful (5.74 ± 0.69 out of 7). Conclusions Integrative videogame-based group therapy can improve self-awareness, social skills, and behaviors among individuals with chronic TBI, and the approach is considered effective and motivating.
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Affiliation(s)
- Roberto Llorens
- Instituto Interuniversitario de Investigación en Bioingeniería y Tecnología Orientada al Ser Humano, Universitat Politècnica de València, Camino de Vera s/n, 46022, Valencia, Spain. .,Servicio de Neurorrehabilitación y Daño Cerebral de los Hospitales NISA, Fundación Hospitales NISA, Río Tajo 1, 46011, Valencia, Spain.
| | - Enrique Noé
- Servicio de Neurorrehabilitación y Daño Cerebral de los Hospitales NISA, Fundación Hospitales NISA, Río Tajo 1, 46011, Valencia, Spain.
| | - Joan Ferri
- Servicio de Neurorrehabilitación y Daño Cerebral de los Hospitales NISA, Fundación Hospitales NISA, Río Tajo 1, 46011, Valencia, Spain.
| | - Mariano Alcañiz
- Instituto Interuniversitario de Investigación en Bioingeniería y Tecnología Orientada al Ser Humano, Universitat Politècnica de València, Camino de Vera s/n, 46022, Valencia, Spain. .,Ciber, Fisiopatología Obesidad y Nutrición, CB06/03 Instituto de Salud Carlos III, Univesity of Jaume I, Av. Sos Baynat s/n, 12071, Castellón, Spain.
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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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Muehlan H, Wilson L, von Steinbüchel N. A Rasch Analysis of the QOLIBRI Six-Item Overall Scale. Assessment 2015; 23:124-30. [PMID: 25676283 DOI: 10.1177/1073191115569844] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The Quality Of Life after BRain Injury (QOLIBRI) consortium has developed a short six-item scale (QOLIBRI-OS) to screen health-related quality of life after traumatic brain injury. The goal of the current study is to examine further psychometric qualities of the Quality Of Life after BRain Injury-Overall Scale (QOLIBRI-OS) at the item level using Rasch analysis with particular emphasis on the operating characteristics of the items. METHOD A total of 921 participants with traumatic brain injury were recruited. The analysis sample was restricted to 795 participants with Glasgow Coma Score and Glasgow Outcome Score-Extended available in order to ensure a well-characterized sample. RESULTS Overall fit statistics indicate sufficient reliability of the QOLIBRI-OS. The assumption of unidimensionality could be confirmed with reservation. The range of item locations is small, whereas item thresholds cover a wide range of the latent trait. The majority of parameter estimations for all class intervals of the respective test are in accordance with the model assumptions. CONCLUSION The results show that, despite marginal misfits to the model, the six items representing the QOLIBRI-OS could establish a Rasch scale.
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Affiliation(s)
- Holger Muehlan
- Ernst-Moritz-Arndt University of Greifswald, Greifswald, Germany
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Assistive technology-based programs to promote communication and leisure activities by three children emerged from a minimal conscious state. Cogn Process 2014; 16:69-78. [PMID: 25077461 DOI: 10.1007/s10339-014-0625-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 07/15/2014] [Indexed: 10/25/2022]
Abstract
This study proposed the use of assistive technology (AT) to promote communication and leisure opportunities by three children with traumatic brain injury (TBI). Furthermore, it assessed the effects of such technology on the indices of positive participation and provided a social validation procedure. Three children emerged from a minimal conscious state and presenting extensive motor disabilities were involved. The intervention program allowed the participants to request and to choice preferred items independently and to perform literacy through a keyboard emulator. A multiple probe design across behaviors with post-intervention check was employed. Outcome measures were correct requests, understandable words, intervals with positive participation, and scores of social validation assessment. Request and choice behaviors and literacy improved significantly during intervention phases. During post-intervention check, all participants consolidated their performance. Moreover, indices of positive participation increased during intervention phases. Scores of social validation assessment showed that the combination of both behaviors was preferable to the same considered separately. AT program showed to be suitable for promoting constructive engagement and literacy behaviors by children with TBI. Future research is needed to generalize this data to a larger sample and to develop new technology for people with different levels of disabilities due to TBI.
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Dai CY, Liu WM, Chen SW, Yang CA, Tung YC, Chou LW, Lin LC. Anosognosia, neglect and quality of life of right hemisphere stroke survivors. Eur J Neurol 2014; 21:797-801. [DOI: 10.1111/ene.12413] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 02/10/2014] [Indexed: 11/30/2022]
Affiliation(s)
- C.-Y. Dai
- Department of Nursing; Central Taiwan University of Science and Technology; Taichung Taiwan
| | - W.-M. Liu
- Department of Nursing; Central Taiwan University of Science and Technology; Taichung Taiwan
| | - S.-W. Chen
- Department of Nursing; Central Taiwan University of Science and Technology; Taichung Taiwan
| | - C.-A. Yang
- Department of Nursing; National Taichung University of Science and Technology; Taichung Taiwan
| | - Y.-C. Tung
- Department of Nursing; Central Taiwan University of Science and Technology; Taichung Taiwan
| | - L.-W. Chou
- Department of Physical Medicine and Rehabilitation; China Medical University Hospital; School of Chinese Medicine; College of Chinese Medicine; China Medical University; Taichung Taiwan
| | - L.-C. Lin
- Institute of Clinical and Community Health Nursing; National Yang-Ming University; Taipei Taiwan
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