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von Steinbuechel N, Zeldovich M, Timmermann D, Krenz U, Koerte IK, Bonfert MV, Berweck S, Kieslich M, Henrich M, Brockmann K, Buchheim A, Roediger M, Lendt M, Auer C, Neu A, Kaiser A, Driemeyer J, Greving S, Wartemann U, Pinggera D, Thomé C, Suss J, Muehlan H, Cunitz K. Final Validation of the Quality of Life after Brain Injury for Children and Adolescents (QOLIBRI-KID/ADO) Questionnaire. CHILDREN (BASEL, SWITZERLAND) 2024; 11:438. [PMID: 38671655 PMCID: PMC11049366 DOI: 10.3390/children11040438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/18/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024]
Abstract
Until recently, no disease-specific health-related quality of life (HRQoL) questionnaire existed for pediatric traumatic brain injuries (TBIs). In this revalidation study, the psychometric properties and the validity of the 35-item QOLIBRI-KID/ADO questionnaire in its final German version were examined in 300 children and adolescents. It is the first self-reported TBI-specific tool for measuring pediatric HRQoL in individuals aged between 8 and 17 years. The six-factor model fits the data adequately. The questionnaire's internal consistency was excellent for the total score and satisfactory to excellent for the scale scores. Intraclass correlations indicated good test-retest reliability, and the measure's construct validity was supported by the overlap between the QOLBRI-KID/ADO and the PedsQL, which measures generic HRQoL. The discriminant validity tests showed that older children and girls reported a significantly lower HRQoL than comparison groups, and this was also true of children who were anxious or depressed, or who suffered from post-concussion symptoms, replicating the results of the questionnaire's first developmental study. Our results suggest that the QOLIBRI-KID/ADO is a reliable and valid multidimensional tool that can be used together with the adult version in clinical contexts and research to measure disease-specific HRQoL after pediatric TBI throughout a person's life. This may help improve care, treatment, daily functioning, and HRQoL after TBI.
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Affiliation(s)
- Nicole von Steinbuechel
- Institute of Psychology, University of Innsbruck, Universitaetsstr. 5-7, 6020 Innsbruck, Austria; (N.v.S.); (M.Z.); (A.B.)
| | - Marina Zeldovich
- Institute of Psychology, University of Innsbruck, Universitaetsstr. 5-7, 6020 Innsbruck, Austria; (N.v.S.); (M.Z.); (A.B.)
- Faculty of Psychotherapy Science, Sigmund Freud University Vienna, 1020 Vienna, Austria
| | - Dagmar Timmermann
- Department of Psychosomatic Medicine and Psychotherapy, Division of Medical Psychology and Medical Sociology, University Medical Center Goettingen, Waldweg 37A, 37073 Goettingen, Germany;
| | - Ugne Krenz
- University Medical Center Goettingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany; (U.K.); (S.G.)
| | - Inga K. Koerte
- cBRAIN/Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilian University Hospital, LMU University, Nussbaumstrasse 5, 80336 Munich, Germany;
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Mass General Brigham, 55 Fruit Street, Boston, MA 02114, USA
| | - Michaela V. 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; (M.K.); (M.H.)
| | - Marlene Henrich
- Department of Paediatric Neurology, Hospital of Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; (M.K.); (M.H.)
| | - 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;
| | - Anna Buchheim
- Institute of Psychology, University of Innsbruck, Universitaetsstr. 5-7, 6020 Innsbruck, Austria; (N.v.S.); (M.Z.); (A.B.)
| | - Maike Roediger
- Department of Pediatrics and Adolescent Medicine, General Pediatrics, Intensive Care Medicine and Neonatology & Department of Pediatric Cardiology, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany;
| | - Michael Lendt
- Neuropediatrics, St. Mauritius Therapeutic Clinic, Strümper Straße 111, 40670 Meerbusch, Germany;
| | - Christian Auer
- Johannes Kepler University Linz, Altenberger Straße 69, 4020 Linz, Austria;
- Department of Neurosurgery, Kepler Univesity Hospital GmbH, Wagner-Jauregg-Weg 15, 4020 Linz, Austria
| | - Axel Neu
- Department of Neurology and Neuropediatry, VAMED Klinik Geesthacht GmbH, Johannes-Ritter-Straße 100, 21502 Geesthacht, Germany; (A.N.); (A.K.)
| | - Alexander Kaiser
- Department of Neurology and Neuropediatry, VAMED Klinik Geesthacht GmbH, Johannes-Ritter-Straße 100, 21502 Geesthacht, Germany; (A.N.); (A.K.)
| | - Joenna Driemeyer
- Department of Pediatrics, University of Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany;
| | - Sven Greving
- University Medical Center Goettingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany; (U.K.); (S.G.)
| | - Ulrike Wartemann
- Department of Neuropediatrics, VAMED Klinik Hohenstücken GmbH, Brahmsstraße 38, 14772 Brandenburg an der Havel, Germany;
| | - Daniel Pinggera
- Department of Neurosurgery, Tirol Kliniken GmbH, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (D.P.); (C.T.)
| | - Claudius Thomé
- Department of Neurosurgery, Tirol Kliniken GmbH, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (D.P.); (C.T.)
| | - Joachim Suss
- Department of Pediatric Surgery, Wilhelmstift Catholic Children’s Hospital, Liliencronstraße 130, 22149 Hamburg, Germany;
| | - Holger Muehlan
- Department of Health and Prevention, University of Greifswald, Robert-Blum-Str. 13, 17487 Greifswald, Germany;
| | - Katrin Cunitz
- Institute of Psychology, University of Innsbruck, Universitaetsstr. 5-7, 6020 Innsbruck, Austria; (N.v.S.); (M.Z.); (A.B.)
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Von-Siebold-Str. 5, 37075 Goettingen, Germany
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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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Recker R, Alshaikh E, Kaur A, Yeates KO, Yang J. Change in health-related quality of life and functional disability over time post-concussion in youth. Qual Life Res 2023; 32:3339-3347. [PMID: 37486548 DOI: 10.1007/s11136-023-03480-4] [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: 07/07/2023] [Indexed: 07/25/2023]
Abstract
PURPOSE Concussions can have detrimental on children's cognitive, emotional, behavioral, and/or social functioning. We sought to examine changes in health-related quality of life (HRQOL) and functional disability from pre-injury to 1-week post-concussion, and to symptom resolution among youth ages 11-17 with a concussion. METHODS In this prospective, longitudinal cohort study, 83 concussed youth, ages 11-17, self-reported post-concussion symptoms daily as well as HRQOL and functional disability at baseline (pre-injury, retrospective), 1-week post-concussion, and symptom resolution. We modeled changes in overall and sub-scale HRQOL and functional disability scores over time from pre-injury to 1-week post-concussion and from 1-week post-concussion to symptom resolution using a piecewise linear mixed model, adjusting for potential covariables. Estimated fixed effects with a corresponding adjusted coefficient (beta), along with their 95% confidence intervals are presented. RESULTS Overall HRQOL worsened from pre-injury to 1-week post-injury (β = - 5.40, 95%CI - 9.22, - 1.58) but did not change from 1-week post-injury to symptom resolution. Physical HRQOL worsened from pre-injury to 1-week post-injury (β = - 9.90, 95%CI - 14.65, - 5.14) but improved from 1-week post-injury to symptom resolution (β = 1.64, 95%CI 0.50, 2.78), while psychosocial HRQOL showed no change over time. Functional disability worsened from pre-injury to 1-week post-injury (β = 8.36, 95%CI 5.93, 10.79) but with no change from 1-week post-injury to symptom resolution. Youth with symptom duration > 14 days reported worse HRQOL and functional disability than those who recovered in ≤ 14 days and greater daily post-concussion symptom scores were associated with worse HRQOL and functional disability. CONCLUSION Concussions have a negative impact on overall and physical HRQOL and functional disability in youth acutely post-injury. Ratings of HRQOL could be used to inform clinical treatment decisions to assist with the recovery process.
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Affiliation(s)
- Robyn Recker
- Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, 43205, USA
| | - Enas Alshaikh
- Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, 43205, USA
| | - Archana Kaur
- Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, 43205, USA
| | - Keith Owen Yeates
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Jingzhen Yang
- Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, 43205, USA.
- College of Medicine, The Ohio State University, Columbus, OH, 43210, USA.
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Gale V, Carlton J. Including Young Children in the Development and Testing of Patient Reported Outcome (PRO) Instruments: A Scoping Review of Children's Involvement and Qualitative Methods. THE PATIENT 2023; 16:425-456. [PMID: 37402059 DOI: 10.1007/s40271-023-00637-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND Qualitative research during the development/testing of Patient Reported Outcome Measures (PROMs) is recommended to support content validity. However, it is unclear if and how young children (≤ 7 years) can be involved in this research because of their unique cognitive needs. OBJECTIVES Here we investigate the involvement of children (≤ 7 years) in qualitative research for PROM development/testing. This review aimed to identify (1) which stages of qualitative PROM development children ≤ 7 years had been involved in, (2) which subjective health concepts had been explored within qualitative PROM development with this age group, and (3) which qualitative methods had been reported and how these compared with existing methodological recommendations. METHODS This scoping review systematically searched three electronic databases (searches re-run prior to final analysis on 29 June 2022) with no date restrictions. Included studies had samples of at least 75% aged ≤ 7 years or reported distinct qualitative methods for children ≤ 7 years in primary qualitative research to support concept elicitation or PROM development/testing. Articles not in English and PROMs that did not enable children ≤ 7 years to self-report were excluded. Data on study type, subjective health and qualitative methods were extracted and synthesised descriptively. Methods were compared with recommendations from guidance. RESULTS Of 19 included studies, 15 reported concept elicitation research and 4 reported cognitive interviewing. Most explored quality of life (QoL)/health-related quality of life (HRQoL). Some concept elicitation studies reported that creative/participatory activities had supported children's engagement, but results and reporting detail varied considerably across studies. Cognitive interviewing studies reported less methodological detail and fewer methods adapted for young children compared with concept elicitation studies. They were limited in scope regarding assessments of content validity, mostly focussing on clarity while relevance and comprehensiveness were explored less. DISCUSSION Creative/participatory activities may be beneficial in concept elicitation research with children ≤ 7 years, but future research needs to explore what contributes to the success of young children's involvement and how researchers can adopt flexible methods. Cognitive interviews with young children are limited in frequency, scope and reported methodological detail, potentially impacting PROM content validity for this age group. Without detailed reporting, it is not possible to determine the feasibility and usefulness of children's (≤ 7 years) involvement in qualitative research to support PROM development and assessment.
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Affiliation(s)
- Victoria Gale
- School of Health and Related Research, The University of Sheffield, Sheffield, UK.
| | - Jill Carlton
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
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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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Nalder E, King G, Hunt AW, Hartman LR, Szigeti Z, Drake E, Shah R, Shahzad M, Resnick M, Pereira G, Lenton E. Indicators of life success from the perspective of individuals with traumatic brain injury: a scoping review. Disabil Rehabil 2023; 45:330-343. [PMID: 35037526 DOI: 10.1080/09638288.2021.2025274] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE The purpose was to synthesize qualitative literature and identify indicators of life success (positive life outcomes and experiences) that can help in understanding resiliency in the context of traumatic brain injury (TBI). METHODS This scoping review involved searching nine online databases for population (TBI) and context (qualitative literature). Searches retrieved 42 852 articles and, after two-stage screening, 76 articles met the inclusion criteria of reporting indicators of life success from the perspective of individuals with TBI. RESULTS Most studies were conducted in North America, Australia, or Europe. Participants were people living with TBI (mild to severe), of all age ranges. Positive life experiences were organized within four domains: understanding of oneself and one's life, social relationships and interaction, doing (engagement in activities, sense of control and accomplishment), and hope for the future. CONCLUSIONS The positive life experiences reflect both processes and outcomes (indicators of success) and highlight the need for a multidimensional approach when seeking to understand resiliency following TBI. The transactional framework of life experiences can be applied in future TBI resiliency research to understand how individuals negotiate adversity through experiences promoting understanding of oneself and the world, social relationships, engagement in activity and hope. Implications for rehabilitationRehabilitation services should consider how to afford opportunities for engagement in activity, social interaction, meaning making (i.e., coming to new understandings), and hope.With respect to engaging in activity and social relationships, having social interaction, being understood, being active and productive, having autonomy, and having accomplishments, reflect important experiences to enable within rehabilitation services.Rehabilitation professionals should consider how providing opportunities for their clients to have positive life experiences may contribute toward an adaptive and empowered mindset.
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Affiliation(s)
- Emily Nalder
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- March of Dimes Canada, East York, Canada
| | - Gillian King
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Bloorview Research Institute & Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Anne W Hunt
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Laura R Hartman
- Bloorview Research Institute & Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Zara Szigeti
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Bloorview Research Institute & Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Emma Drake
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Riya Shah
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Maryam Shahzad
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Myles Resnick
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Giles Pereira
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Erica Lenton
- Gerstein Science Information Centre, University of Toronto, Toronto, Canada
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Timmermann D, Krenz U, Schmidt S, Lendt M, Salewski C, Brockmann K, von Steinbüchel N. Health-Related Quality of Life after Pediatric Traumatic Brain Injury: A Qualitative Comparison of Perspectives of Children and Adolescents after TBI and a Comparison Group without a History of TBI. J Clin Med 2022; 11:jcm11226783. [PMID: 36431260 PMCID: PMC9697382 DOI: 10.3390/jcm11226783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 11/11/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The assessment of the impact of pediatric traumatic brain injury (TBI) on the health-related quality of life (HRQoL) of the children and adolescents affected can be ameliorated by a disease-specific instrument. Such an instrument does not yet exist. This qualitative study investigates how children and adolescents after TBI subjectively perceive their HRQoL and whether and how this differs from the perspective of individuals without a history of TBI. METHODS Eight problem-centered interviews were conducted with 11 children and adolescents around four years after mild TBI and with eight children and adolescents around three years after moderate to severe TBI. Nine problem-centered interviews were conducted with 25 participants without a history of TBI. The interviews were recorded and transcribed verbatim. The statements were assigned to inductively and deductively derived categories relevant to the HRQoL of children and adolescents after TBI and compared with those of individuals without a history of TBI. RESULTS The HRQoL of children and adolescents after TBI tended to display both structural and content-related differences, independently of TBI severity, on several HRQoL dimensions, in contrast to the comparison group. For example, participants after TBI reported a broader range of negative emotions (such as worry, sadness, shame, and guilt), permanent physical impairments, felt that they were treated differently from others, and perceived cognitive limitations. CONCLUSIONS The results of this qualitative study identified HRQoL dimensions that are relevant to children and adolescents after TBI and underlined the need for the development of a disease-specific instrument.
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Affiliation(s)
- Dagmar Timmermann
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany
- Correspondence:
| | - Ugne Krenz
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany
| | - Silke Schmidt
- Department Health and Prevention, University of Greifswald, Robert-Blum-Str. 13, 17487 Greifswald, Germany
| | - Michael Lendt
- Neuropediatrics, St. Mauritius Therapeutic Clinic, Strümper Straße 111, 40670 Meerbusch, Germany
| | - Christel Salewski
- Department of Health Psychology, Germany’s State Distance-Learning University Hagen, Universitätsstr. 33, 58097 Hagen, Germany
| | - Knut Brockmann
- Division of Pediatric Neurology, Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Germany
| | - Nicole von Steinbüchel
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany
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Khan N, Ryan NP, Crossley L, Hearps S, Catroppa C, Anderson V. Global and domain-specific self-esteem after pediatric traumatic brain injury: Contribution of injury characteristics and parent mental health. Neuropsychol Rehabil 2022; 32:1835-1853. [PMID: 35287558 DOI: 10.1080/09602011.2022.2050408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This prospective, longitudinal case-control study examined global and domain-specific aspects of self-esteem 6-months following pediatric traumatic brain injury (TBI) and evaluated the contribution of injury-related factors and parent mental health to child self-esteem. Participants included 103 children with mild-severe TBI representing consecutive admissions to the emergency department of the Royal Children's Hospital, Melbourne, Australia. Forty-three age-and-sex matched typically developing controls were recruited for comparison. Information regarding injury characteristics including age at injury and clinical indicators of TBI severity were collected for participants at recruitment, with research magnetic resonance imaging conducted 2-8 weeks later. At 6 months post-injury, children rated their global and domain-specific self-esteem (Harter Self-Perception Profile for Children), and ratings of parent mental health were collected (General Health Questionnaire). Self-esteem for behavioural and academic domains was significantly poorer for children with TBI relative to TD children. In the TBI group, higher child-rated scores of global and domain-specific aspects of self-esteem were associated with more severe TBI, presence of frontal neuropathology, younger age at injury, and lower parental symptoms of anxiety/insomnia. Given the psychological status of parents represents a potentially modifiable risk factor, it may form the target of clinical interventions designed to bolster child self-esteem following pediatric TBI.
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Affiliation(s)
- Noor Khan
- Brain and Mind Research, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.,Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Nicholas P Ryan
- Brain and Mind Research, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.,Psychology, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Cognitive Neuroscience Unit, Deakin University, Geelong, Australia
| | - Louise Crossley
- Brain and Mind Research, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | - Stephen Hearps
- Brain and Mind Research, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | - Cathy Catroppa
- Brain and Mind Research, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.,Psychology, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Vicki Anderson
- Brain and Mind Research, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.,Psychology, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
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Levy TJ, Tyner CE, Amaral S, Lefkowitz DS, Kessler SK, Levin LS. 5-Year Activity and Participation Outcomes of the First Successful Pediatric Bilateral Hand Transplantation: A Case Report. Phys Occup Ther Pediatr 2022; 42:663-679. [PMID: 35379065 DOI: 10.1080/01942638.2022.2057210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIMS Describe the 5-year outcomes of the first successful pediatric bilateral hand transplantation. METHODS The child underwent quadrimembral amputation at age two and received bilateral hand allografts at age eight. Rehabilitation included biomechanical, neurorehabilitation, and occupational approaches in acute and outpatient settings. Therapist observed outcomes, patient-reported measures, and parent-reported measures were repeated over a 5-year period. RESULTS Observation assessments revealed functional dexterity skills and modified independence to full independence with self-care activities. The parent reported the child had moderate difficulty with upper extremity functioning 25-, 41-, and 48-months post-transplantation, and mild difficulty at 60-months; the child reported no difficulties in this domain at 41 months. Five years post-transplantation the child reported enjoying many age-appropriate activities, and high-quality peer relations were endorsed by both parent and child. CONCLUSION The child developed hand movements for daily activities and was completing daily activities with improved efficiency. Health-related quality of life outcomes were favorable.
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Affiliation(s)
- Todd J Levy
- Center for Rehabilitation, Occupational Therapy, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Callie E Tyner
- Center for Health Assessment Research and Translation, University of Delaware, Newark, Delaware, USA
| | - Sandra Amaral
- Departments of Pediatrics and Epidemiology, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Debra S Lefkowitz
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sudha K Kessler
- Division of Neurology, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - L Scott Levin
- Paul B Magnusson Professor and Chairman of Orthopedic Surgery, Department of Orthopedic Surgery, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, USA.,Division of Plastic and Reconstructive Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, USA.,Department of Orthopaedic Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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