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Vu HM, Duong NN, Nguyen CD, Vu LG, Nguyen HT, Tran TH. Health-related quality of life among inpatients suffering from Traumatic brain injury in an urban setting in Vietnam. PLoS One 2024; 19:e0308372. [PMID: 39106245 DOI: 10.1371/journal.pone.0308372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 07/23/2024] [Indexed: 08/09/2024] Open
Abstract
BACKGROUND Traumatic brain injury (TBI) is a leading cause of mortality and morbidity globally. This study aimed to measure the health-related quality of life (HRQOL) of TBI patients in Vietnam and evaluate the associated factors. METHODS A longitudinal study was conducted in Thai Binh, Vietnam, from February to September 2020. The EuroQol-5 Dimensions-5 Levels (EQ-5D-5L) and EQ-Visual Analog Scale (EQ-VAS) were used to measure HRQOL. Socio-demographic characteristics, including age, gender, education level, employment status, marital status, and income, as well as clinical characteristics such as injury severity, cause of injury, comorbidities, and functional status, were collected through patient interviews and medical records. Multivariate Tobit regression analysis was performed to identify variables associated with HRQOL. RESULTS The study included 212 TBI patients. The mean scores of the VAS and EQ-5D-5L scales were 82.4/100 (SD = 14.49) and 0.9/1.0 (SD = 0.2), respectively, indicating a relatively high HRQOL. However, certain factors significantly impacted HRQOL. Unemployed patients and those with depression or higher injury severity, as measured by the Injury Severity Score (ISS), had notably lower HRQOL scores. Poor sleep quality and severe functional impairments also adversely affected HRQOL, whereas patients discharged for a longer period had slightly better HRQOL scores. CONCLUSION This study highlights that while HRQOL is relatively high among TBI patients, mental health disorders, injury severity, and functional impairments are key factors negatively impacting their quality of life. High HRQOL was defined by mean scores on the VAS and EQ-5D-5L scales, with higher scores indicating better quality of life. Home-based interventions addressing these issues could improve HRQOL for TBI patients.
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Affiliation(s)
- Hai Minh Vu
- Department of Trauma, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Nam Nhu Duong
- Department of Trauma, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Cuong Duy Nguyen
- Department of Intensive Care Unit, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Linh Gia Vu
- School for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Hien Thu Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Viet Nam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Tung Hoang Tran
- Institute of Orthopaedic and Trauma Surgery, Vietnam-Germany Hospital, Hanoi, Vietnam
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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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3
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Tyler CM, Dini ME, Perrin PB. Group-Based Patterns of Life Satisfaction and Functional Independence over the 10 Years after Traumatic Brain Injury in Older Adults: A Model Systems Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095643. [PMID: 37174163 PMCID: PMC10178698 DOI: 10.3390/ijerph20095643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/12/2023] [Accepted: 04/19/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Older adults who sustain a traumatic brain injury (TBI) have been shown to have reduced functional independence and life satisfaction relative to younger individuals with TBI. The purpose of this study was to examine the covarying patterns of functional independence and life satisfaction over the 10 years after TBI in adults who were 60 years of age or older upon injury. METHOD Participants were 1841 individuals aged 60 or older at the time of TBI, were enrolled in the longitudinal TBI Model Systems database, and had Functional Independence Measure and Satisfaction with Life Scale scores during at least one time point at 1, 2, 5, and 10 years after TBI. RESULTS A k-means cluster analysis identified four distinct group-based longitudinal patterns of these two variables. Three cluster groups suggested that functional independence and life satisfaction generally traveled together over time, with one group showing relatively high functional independence and life satisfaction over time (Cluster 2), one group showing relatively moderate functional independence and life satisfaction (Cluster 4), and one group showing relatively low functional independence and life satisfaction (Cluster 1). Cluster 3 had relatively high functional independence over time but, nonetheless, relatively low life satisfaction; they were also the youngest group upon injury. Participants in Cluster 2 generally had the highest number of weeks of paid competitive employment but lower percentages of underrepresented racial/ethnic minority participants, particularly Black and Hispanic individuals. Women were more likely to be in the cluster with the lowest life satisfaction and functional independence (Cluster 1). CONCLUSION Functional independence and life satisfaction generally accompany one another over time in older adults, although this does not always occur, as life satisfaction can still be low in a subgroup of older individuals after TBI with higher functioning. These findings contribute to a better understanding of post-TBI recovery patterns in older adults over time that may inform treatment considerations to improve age-related discrepancies in rehabilitation outcomes.
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Affiliation(s)
- Carmen M Tyler
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Mia E Dini
- Department of Psychology, University of Virginia, Charlottesville, VA 22904, USA
- Polytrauma Rehabilitation Center TBI Model Systems, Central Virginia Veterans Affairs Health Care System, Richmond, VA 23249, USA
| | - Paul B Perrin
- Department of Psychology, University of Virginia, Charlottesville, VA 22904, USA
- Polytrauma Rehabilitation Center TBI Model Systems, Central Virginia Veterans Affairs Health Care System, Richmond, VA 23249, USA
- School of Data Science, University of Virginia, Charlottesville, VA 22904, USA
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4
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Kiwanuka O, Lassarén P, Thelin EP, Hånell A, Sandblom G, Fagerdahl A, Boström L. Long-term health-related quality of life after trauma with and without traumatic brain injury: a prospective cohort study. Sci Rep 2023; 13:2986. [PMID: 36805021 PMCID: PMC9941121 DOI: 10.1038/s41598-023-30082-4] [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: 12/05/2022] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
To purpose was to assess and compare the health-related quality of life (HRQoL) and risk of depression two years after trauma, between patients with and without traumatic brain injury (TBI) in a mixed Swedish trauma cohort. In this prospective cohort study, TBI and non-TBI trauma patients included in the Swedish Trauma registry 2019 at a level II trauma center in Stockholm, Sweden, were contacted two years after admission. HRQoL was assessed with RAND-36 and EQ-5D-3L, and depression with Montgomery Åsberg depression Rating Scale self-report (MADRS-S). Abbreviated Injury Score (AIS) head was used to grade TBI severity, and American Society of Anesthesiologists (ASA) score was used to assess comorbidities. Data were compared using Chi-squared test, Mann Whitney U test and ordered logistic regression, and Bonferroni correction was applied. A total of 170 of 737 eligible patients were included. TBI was associated with higher scores in 5/8 domains of RAND-36 and 3/5 domains of EQ-5D (p < 0.05). No significant difference in MADRS-S. An AIS (head) of three or higher was associated with lower scores in five domains of RAND-36 and two domains of EQ-5D but not for MADRS-S. An ASA-score of three was associated with lower scores in all domains of both RAND-36 (p < 0.05, except mental health) and EQ-5D (p < 0.001, except anxiety/depression), but not for MADRS-S. In conclusion, patients without TBI reported a lower HRQoL than TBI patients two years after trauma. TBI severity assessed according to AIS (head) was associated with HRQoL, and ASA-score was found to be a predictor of HRQoL, emphasizing the importance of considering pre-injury health status when assessing outcomes in TBI patients.
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Affiliation(s)
- Olivia Kiwanuka
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden. .,Department of Surgery, Södersjukhuset, Stockholm, Sweden.
| | - Philipp Lassarén
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Eric P. Thelin
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Anders Hånell
- grid.8993.b0000 0004 1936 9457Department of Medical Sciences, Neurosurgery, Uppsala University, Uppsala, Sweden
| | - Gabriel Sandblom
- grid.4714.60000 0004 1937 0626Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Stockholm, Sweden
| | - Ami Fagerdahl
- grid.4714.60000 0004 1937 0626Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Stockholm, Sweden
| | - Lennart Boström
- grid.416648.90000 0000 8986 2221Department of Surgery, Södersjukhuset, Stockholm, Sweden ,grid.4714.60000 0004 1937 0626Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Stockholm, Sweden
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Keramat SA, Nguyen KH, Perales F, Seidu AA, Mohammed A, Ahinkorah BO, Comans T. Estimating the effects of physical violence and serious injury on health-related quality of life: Evidence from 19 waves of the Household, Income and Labour Dynamics in Australia Survey. Qual Life Res 2022; 31:3153-3164. [PMID: 35939253 PMCID: PMC9546951 DOI: 10.1007/s11136-022-03190-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study aims to investigate the effect of physical violence and serious injury on health-related quality of life in the Australian adult population. METHODS This study utilised panel data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. HRQoL was measured through the physical component summary (PCS), mental component summary (MCS), and short-form six-dimension utility index (SF-6D) of the 36-item Short-Form Health Survey (SF-36). Longitudinal fixed-effect regression models were fitted using 19 waves of the HILDA Survey spanning from 2002 to 2020. RESULTS This study found a negative effect of physical violence and serious injury on health-related quality of life. More specifically, Australian adults exposed to physical violence and serious injury exhibited lower levels of health-related quality of life. Who experienced physical violence only had lower MCS (β = -2.786, 95% CI: -3.091, -2.481) and SF-6D (β = -0.0214, 95% CI: -0.0248, -0.0181) scores if switches from not experiencing physical violence and serious injury. Exposed to serious injury had lower PCS (β = -5.103, 95% CI: -5.203, -5.004), MCS (β = -2.363, 95% CI: -2.480, -2.247), and SF-6D (β = -0.0585, 95% CI: -0.0598, -0.0572) score if the adults not experiencing physical violence and serious injury. Further, individuals exposed to both violence and injury had substantially lower PCS (β = -3.60, 95% CI: -4.086, -3.114), MCS (β = -6.027, 95% CI: -6.596, -5.459), and SF-6D (β = -0.0716, 95% CI: -0.0779, -0.0652) scores relative to when the individuals exposed to none. CONCLUSION Our findings indicate that interventions to improve Australian adults' quality of life should pay particular attention to those who have experienced physical violence and serious injury. Our findings suggest unmet mental health needs for victims of physical violence and serious injuries, which calls for proactive policy interventions that provide psychological and emotional therapy.
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Affiliation(s)
- Syed Afroz Keramat
- Faculty of Medicine, Centre for Health Services Research, The University of Queensland, Brisbane, QLD Australia
- Economics Discipline, Social Science School, Khulna University, Khulna, Bangladesh
| | - Kim-Huong Nguyen
- Faculty of Medicine, Centre for Health Services Research, The University of Queensland, Brisbane, QLD Australia
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Francisco Perales
- School of Social Science, The University of Queensland, Michie Building (#9), St Lucia, Brisbane, QLD 4067 Australia
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Aliu Mohammed
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | | | - Tracy Comans
- Faculty of Medicine, Centre for Health Services Research, The University of Queensland, Brisbane, QLD Australia
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Cregan K, Daisley A, Ford C, Gracey F. A qualitative exploration of fatherhood after acquired brain injury (ABI). Neuropsychol Rehabil 2022; 32:2269-2293. [PMID: 34098840 DOI: 10.1080/09602011.2021.1938142] [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: 12/27/2022]
Abstract
Acquired Brain Injury (ABI) significantly affects individuals across multiple areas of intimate, familial, and parental domains. Gender and identity are pivotal research areas in navigating life after ABI. To date, scant research has explored gendered experiences, particularly those related to the masculine lifeworld. This study aimed to explore how men who were fathers before their injuries experience fatherhood after ABI. An Interpretative phenomenological analysis (IPA) methodology was used, and seven fathers participated in the semi-structured interviews (time since injury 1-18 years, age range 27-66 years) which explored their meaning-making. Four superordinate themes were drawn from all interviews through engaging with the qualitative research process: (1) what being a father means, (2) altered relationships with others, (3) becoming lost and finding their way through, and (4) renewed fatherhood. The findings show intersectionality between pre-and post-injury comparisons of self and social identities, alongside the contextual and societal identities in the subjective fathering experiences. Through increased understanding, we may enable fathers to find new ways to resolve, reformulate, and connect to move into their future possible fatherhood. The importance of this research is in giving voice to these less represented men so that we may shape our understanding to aid future fathers post-ABI.
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Affiliation(s)
- Karen Cregan
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK.,North East London NHS Foundation Trust, London, UK
| | - Audrey Daisley
- Department of Clinical Neuropsychology, Oxford Centre for Enablement, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Catherine Ford
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Fergus Gracey
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
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7
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Seneviratne H, Mann G, Troeung L, Martini A. The association between functional independence and quality of life for individuals with acquired brain injury undergoing community-based rehabilitation and disability support. NeuroRehabilitation 2022; 51:291-302. [DOI: 10.3233/nre-220062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Following acquired brain injury (ABI), cognitive and physical barriers can prevent access to a previously enjoyed lifestyle, reducing quality of life. OBJECTIVE: This study aimed to examine predictors of health-related quality of life (HRQoL) in adults with ABI receiving post-acute community-based rehabilitation and disability support services, using tools developed for this population. METHODS: Retrospective cross-sectional design. Main outcome measures were the Quality of Life after Brain Injury Inventory (QOLIBRI) and Functional Independence and Assessment Measure (FIM + FAM) for adults with ABI (n = 67) undergoing post-acute rehabilitation in Western Australia, 2015–2021. RESULTS: Mean QOLIBRI total score (±standard deviation) was 57.2±17.4, indicating impaired HRQoL, with mood disorders likely prevalent. Regression analysis demonstrated no differences in HRQoL between different age groups, sexes or brain injury types. Shorter time since injury and lower total FIM + FAM score significantly predicted poorer HRQoL in the model. CONCLUSION: This population appears vulnerable to psychological illness, although HRQoL is addressed for a minority of clients during routine post-acute care (19%). As improvement in quality of life is a fundamental goal of rehabilitation post-ABI, understanding the relationship between potentially modifiable factors such as functional independence and HRQoL is critical to improve outcomes and provide the best chance at a satisfying life.
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Affiliation(s)
- Harshana Seneviratne
- Brightwater Research Centre, Brightwater Care Group, Osborne Park, WA, Australia
- The University of Western Australia, Crawley, WA, Australia
| | - Georgina Mann
- Brightwater Research Centre, Brightwater Care Group, Osborne Park, WA, Australia
| | - Lakkhina Troeung
- Brightwater Research Centre, Brightwater Care Group, Osborne Park, WA, Australia
| | - Angelita Martini
- Brightwater Research Centre, Brightwater Care Group, Osborne Park, WA, Australia
- The University of Western Australia, Crawley, WA, Australia
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Tran Q, Frederick H, Tran C, Baqai H, Lurie T, Solomon J, Aligabi A, Olexa J, Cardona S, Bodanapally U, Schwartzbauer G, Downing J. Blood Pressure Variability and Outcome in Traumatic Brain Injury: A Propensity Score Matching Study. West J Emerg Med 2022; 23:769-780. [PMID: 36205663 PMCID: PMC9541979 DOI: 10.5811/westjem.2022.6.55549] [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: 12/06/2021] [Accepted: 06/27/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction Patients with tIPH (used here to refer to traumatic intraparenchymal hemorrhagic contusion) or intraparenchymal hemorrhage face high rates of mortality and persistent functional deficits. Prior studies have found an association between blood pressure variability (BPV) and neurologic outcomes in patients with spontaneous IPH. Our study investigated the association between BPV and discharge destination (a proxy for functional outcome) in patients with tIPH. Methods We retrospectively reviewed the charts of patients admitted to a Level I trauma center for ≥ 24 hours with tIPH. We examined variability in hourly BP measurements over the first 24 hours of hospitalization. Our outcome of interest was discharge destination (home vs facility). We performed 1:1 propensity score matching and multivariate regressions to identify demographic and clinical factors predictive of discharge home. Results We included 354 patients; 91 were discharged home and 263 to a location other than home. The mean age was 56 (SD 21), 260 (73%) were male, 22 (6%) were on anticoagulation, and 54 (15%) on antiplatelet therapy. Our propensity-matched cohorts included 76 patients who were discharged home and 76 who were discharged to a location other than home. One measure of BPV (successive variation in systolic BP) was identified as an independent predictor of discharge location in our propensity-matched cohorts (odds ratio 0.89, 95% confidence interval 0.8–0.98; P = 0.02). Our model demonstrated good goodness of fit (P-value for Hosmer-Lemeshow test = 0.88) and very good discriminatory capability (AUROC = 0.81). High Glasgow Coma Scale score at 24 hours and treatment with fresh frozen plasma were also associated with discharge home. Conclusion Our study suggests that increased BPV is associated with lower rates of discharge home after initial hospitalization among patients with tIPH. Additional research is needed to evaluate the impact of BP control on patient outcomes.
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Affiliation(s)
- Quincy Tran
- University of Maryland School of Medicine, Baltimore, Maryland; University of Maryland School of Medicine, Research Associate Program in Emergency Medicine & Critical Care, Department of Emergency Medicine, Baltimore, Maryland; The R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland; University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland
| | - Hannah Frederick
- University of Maryland School of Medicine, Research Associate Program in Emergency Medicine & Critical Care, Department of Emergency Medicine, Baltimore, Maryland
| | - Cecilia Tran
- University of Maryland School of Medicine, Baltimore, Maryland
| | - Hammad Baqai
- University of Maryland School of Medicine, Research Associate Program in Emergency Medicine & Critical Care, Department of Emergency Medicine, Baltimore, Maryland
| | - Tucker Lurie
- University of Maryland School of Medicine, Research Associate Program in Emergency Medicine & Critical Care, Department of Emergency Medicine, Baltimore, Maryland; Wellspan York Hospital, Department of Emergency Medicine, York, Pennsylvania
| | - Julianna Solomon
- University of Maryland School of Medicine, Research Associate Program in Emergency Medicine & Critical Care, Department of Emergency Medicine, Baltimore, Maryland
| | - Ayah Aligabi
- University of Maryland School of Medicine, Research Associate Program in Emergency Medicine & Critical Care, Department of Emergency Medicine, Baltimore, Maryland
| | - Joshua Olexa
- University of Maryland School of Medicine, Department of Neurosurgery, Baltimore, Maryland
| | - Stephanie Cardona
- Mount Sinai Hospital, Department of Critical Care Medicine, York, New York
| | - Uttam Bodanapally
- The R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - Gary Schwartzbauer
- The R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland; University of Maryland School of Medicine, Department of Neurosurgery, Baltimore, Maryland
| | - Jessica Downing
- The R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Program in Trauma/Surgical Critical Care, Baltimore, Maryland
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Lorenz LS, Doonan M. Value and Cost Savings From Access to Multi-disciplinary Rehabilitation Services After Severe Acquired Brain Injury. Front Public Health 2021; 9:753447. [PMID: 34926379 PMCID: PMC8671747 DOI: 10.3389/fpubh.2021.753447] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/29/2021] [Indexed: 11/13/2022] Open
Abstract
Acquired brain injury (ABI) is a major global public health problem and source of disability. A major contributor to disability after severe ABI is limited access to multidisciplinary rehabilitation, despite evidence of sustained functional gains, improved quality of life, increased return-to-work, and reduced need for long-term care. A societal model of value in rehabilitation matches patient and family expectations of outcomes and system expectations of value for money. A policy analysis of seven studies (2009-2019) exploring outcomes and cost-savings from access to multi-disciplinary rehabilitation identified average lifetime savings of $1.50M per person, with costs recouped within 18 months. Recommendations: Increase access to multi-disciplinary rehabilitation following severe ABI; strengthen prevention focus; increase access to case management; support return-to-work; and systematically collect outcome and cost data.
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Affiliation(s)
- Laura S. Lorenz
- The Heller School for Social Policy and Management, Brandeis University, Waltham, MA, United States
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10
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Singh R, Dawson J, Mason PS, Lecky F. What are the functional consequences after TBI? The SHEFBIT cohort experience. Brain Inj 2021; 35:1630-1636. [PMID: 34711118 DOI: 10.1080/02699052.2021.1978549] [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: 10/20/2022]
Abstract
OBJECTIVES To investigate functional outcome after TBI and identify variables that predict outcome in a multiordinal regression model. BACKGROUND The results of global outcome studies after Traumatic Brain Injury(TBI) differ widely due to differences in outcome measure, attrition to follow-up and selection bias. Outcome information would inform patients/families, guide service development and target high-risk individuals. SUBJECTS/SETTING prospective cohort of 1322 admissions with TBI, assessed by face to face interviews at 1 yr. MEASURES Extended Glasgow Outcome Scale (GOSE) by structured questionnaire. RESULTS At 1 year, outcome was determined in 1207(91.3%). Mean age was 46.9(SD17.3); Almost half(49.2%) had mild injury. At one year, 42.9% achieved Good Recovery but GOSE declined in 11.4% of the cohort compared to 10 weeks including 60(4.9%) deaths. In an ordinal logistic regression, increasing TBI severity, etiology (assault), more prominent CT abnormality, past psychiatric history and alcohol intoxication were independent predictors of worse GOSE. A pseudo-R2 of 0.38 suggested that many unmeasured factors also contribute to TBI outcome. Future work needs to identify other variables that may influence outcome. CONCLUSIONS In a large TBI cohort, there is still considerable functional disability at 1 year. It may be possible to target high-risk groups for rehabilitation.
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Affiliation(s)
- Rajiv Singh
- School of Health and Related Research (Scharr), Faculty of Medicine, Dentistry and Health, University of Sheffield S1 4DA, Sheffield, United Kingdom.,Osborn Neurorehabilitation Unit, Department of Rehabilitation Medicine, Sheffield Teaching Hospitals, Sheffield, UK
| | - Jeremy Dawson
- Institute of Work Psychology, Sheffield University Management School, Sheffield, United Kingdom
| | - Prof Suzanne Mason
- School of Health and Related Research (Scharr), Faculty of Medicine, Dentistry and Health, University of Sheffield S1 4DA, Sheffield, United Kingdom
| | - Fiona Lecky
- School of Health and Related Research (Scharr), Faculty of Medicine, Dentistry and Health, University of Sheffield S1 4DA, Sheffield, United Kingdom
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11
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Sathananthan N, Dimech-Betancourt B, Morris E, Vicendese D, Knox L, Gillanders D, Das Nair R, Wong D. A single-case experimental evaluation of a new group-based intervention to enhance adjustment to life with acquired brain injury: VaLiANT (valued living after neurological trauma). Neuropsychol Rehabil 2021; 32:2170-2202. [PMID: 34433379 DOI: 10.1080/09602011.2021.1971094] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Adjustment to life with acquired brain injury (ABI) requires self-identity and behaviour to be updated, incorporating injury-related changes. Identifying and enabling new values-consistent behaviours could facilitate this process. We evaluated the feasibility, acceptability, and preliminary efficacy of VaLiANT, a new group intervention that aims to enhance "valued living" following ABI. We used a non-concurrent multiple baseline single-case experimental design (SCED) with an 8-week follow-up phase and randomization to multiple baseline lengths (5-7 weeks). Eight participants (50% women, aged 26-65; 4 Stroke, 3 Traumatic Brain Injury, 1 Epilepsy) attended eight group sessions with assessments before, during, and after the group. Target behaviour was valued living, assessed weekly by the Valued Living Questionnaire. Secondary outcomes included measures of wellbeing, mood, psychological acceptance, self-efficacy regarding ABI consequences, cognitive complaints, and intervention acceptability. Target behaviour was analysed through visual and statistical analysis while secondary outcome data were analysed via reliable change indices and descriptive statistics. Target behaviour data displayed no convincing patterns of improvement. Reliable improvements were found for most participants on secondary outcomes, particularly subjective wellbeing and anxiety. Intervention delivery was feasible with high acceptability ratings. Further investigation of VaLiANT is warranted, based on the feasibility and acceptability of intervention delivery and signals of efficacy identified across adjustment-related secondary outcomes.
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Affiliation(s)
- Nick Sathananthan
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | | | - Eric Morris
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Don Vicendese
- Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Lucy Knox
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - David Gillanders
- School of Health in Social Sciences, University of Edinburgh, Edinburgh, UK
| | - Roshan Das Nair
- Institute of Mental Health, University of Nottingham, Nottingham, UK.,School of Medicine, University of Nottingham, Nottingham, UK
| | - Dana Wong
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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12
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Vocational Outcomes After Traumatic Brain Injury; Prevalence and Risk Factors After 1 Year in a Multivariable Model. J Head Trauma Rehabil 2021; 37:104-113. [PMID: 33935225 DOI: 10.1097/htr.0000000000000687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine the prevalence of employment status (ES) or full-time study after traumatic brain injury (TBI) in a representative population and its predictive factors. DESIGN Prospective cohort study. SETTING Regional Major Trauma Centre. Participants: In total, 1734 consecutive individuals of working age, admitted with TBI to a Regional Trauma Centre, were recruited and followed up at 8 weeks and 1 year with face-to-face interview. Median age was 37.2 years (17.5-58.2); 51% had mild TBI, and 36.8% had a normal computed tomographic (CT) scan. Main Outcome Measure: Complete or partial/modified return to employment or study as an ordinal variable. RESULTS At 1 year, only 44.9% returned to full-time work/study status, 28.7% had a partial or modified return, and 26.4% had no return at all. In comparison with status at 6 weeks, 9.9% had lower or reduced work status. Lower ES was associated with greater injury severity, more CT scan abnormality, older age, mechanism of assault, and presence of depression, alcohol intoxication, or a psychiatric history. The multivariable model was highly significant (P < .001) and had a Nagelkerke R2 of 0.353 (35.3%). CONCLUSIONS Employment at 1 year is poor and changes in work status are frequent, occurring in both directions. While associations with certain features may allow targeting of vulnerable individuals in future, the majority of model variance remains unexplained and requires further investigation.
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13
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Abualait TS, Alzahrani MA, Ibrahim AI, Bashir S, Abuoliat ZA. Determinants of life satisfaction among stroke survivors 1 year post stroke. Medicine (Baltimore) 2021; 100:e25550. [PMID: 33879705 PMCID: PMC8078317 DOI: 10.1097/md.0000000000025550] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/08/2021] [Accepted: 03/25/2021] [Indexed: 01/04/2023] Open
Abstract
ABSTRACT Stroke is the major leading cause of death and severe long-term disability worldwide. The consequences of stroke, aside from diminished survival, have a significant impact on an individual's capability in maintaining self-autonomy and life satisfaction (LS). Thus, this study aimed to assess LS and other specific domains of LS in stroke survivors following their first-ever stroke, and to describe the relationship using socio-demographic and stroke-related variables.This study recruited 376 stroke survivors (244 men and 132 women, mean age: 57 years) 1 year following stroke. Data on participants' LS (measured using the Life Satisfaction Questionnaire [LiSat-11]), socio-demographics, and stroke-related variables were collected.Univariate analysis showed that LS and the 10 specific domains were not associated with the patients' gender or stroke type; however, age at onset, marital status, and vocational situation were significantly associated with some domains in LiSat-11 (Spearman's rho = 0.42-0.87; all P < 0.05). Logistic regression revealed that verbal and cognitive dysfunction were the most negative predictors of LS (odds ratio 4.1 and 3.7, respectively).LS is negatively affected in stroke survivors 1 year post onset. The results indicate that recovering social engagement is a positive predictor of higher LS in stroke survivors. More importantly, the findings revealed that cognitive and verbal dysfunctions were the most prominent negative predictors of the overall gross level of LS. Multidisciplinary rehabilitation for stroke survivors is therefore critical.
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Affiliation(s)
- Turki S. Abualait
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University
| | - Matar A. Alzahrani
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University
| | - Alaa I. Ibrahim
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University
| | - Shahid Bashir
- Neuroscience Center, King Fahad Specialist Hospital, Dammam
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14
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Aza A, Verdugo MÁ, Orgaz MB, Amor AM, Fernández M. Predictive Factors of Self-Reported Quality of Life in Acquired Brain Injury: One-Year Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030927. [PMID: 33494473 PMCID: PMC7908370 DOI: 10.3390/ijerph18030927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 11/16/2022]
Abstract
Background: The sequelae and disabilities that follow an acquired brain injury (ABI) may negatively affect quality of life (QoL). The main objective of the study is to describe the QoL after an ABI and identify the predictors of a better QoL. Methods: Prospective cohort study with follow-up measurement after one-year. The sample comprised 203 adults with ABIs (64% male) aged 18–86 years (M = 53.01, SD = 14.44). Stroke was the main etiology of the injury (55.7%), followed by a TBI (32.8%), and the average time since injury was 8 years (M = 8.25, SD = 7.83, range = 0.5–47.5). Patients assessed their QoL through the scale Calidad de Vida en Daño Cerebral (CAVIDACE self-reported version; “quality of life in brain injury” in English), an ABI-specific tool based on the eight-domain QoL model. Other variables measured were: depression, self-awareness, community integration, resilience, and social support at baseline and one-year follow-up. Results: The studied factors showed few significant changes over time. The analyses showed statistically significant differences in QoL scores in several sociodemographic (age, civil status, education, legal capacity, and dependency), injury-related (time, location, and comorbidity), rehabilitation, and personal-social variables (self-awareness, depression, social support, resilience, and community integration). The levels of dependency, depression, and satisfaction with social support were independent predictors of the total QoL score one-year follow-up. Conclusions: QoL after ABI depends on multiple elements that must be considered. There are factors such as satisfaction with social support, depression, community integration, and resilience that must be monitored throughout the rehabilitation process.
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Affiliation(s)
- Alba Aza
- Institute for Community Inclusion, Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology, University of Salamanca, 37005 Salamanca, Spain; (M.Á.V.); (A.M.A.); (M.F.)
- Correspondence: ; Tel.: +34-670576341
| | - Miguel Á. Verdugo
- Institute for Community Inclusion, Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology, University of Salamanca, 37005 Salamanca, Spain; (M.Á.V.); (A.M.A.); (M.F.)
| | - María Begoña Orgaz
- Institute for Community Inclusion, Department of Basic Psychology, Psychobiology and Behavioral Sciences Methodology, Faculty of Psychology, University of Salamanca, 37005 Salamanca, Spain;
| | - Antonio M. Amor
- Institute for Community Inclusion, Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology, University of Salamanca, 37005 Salamanca, Spain; (M.Á.V.); (A.M.A.); (M.F.)
| | - María Fernández
- Institute for Community Inclusion, Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology, University of Salamanca, 37005 Salamanca, Spain; (M.Á.V.); (A.M.A.); (M.F.)
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15
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Forslund MV, Perrin PB, Sigurdardottir S, Howe EI, van Walsem MR, Arango-Lasprilla JC, Lu J, Aza A, Jerstad T, Røe C, Andelic N. Health-Related Quality of Life Trajectories across 10 Years after Moderate to Severe Traumatic Brain Injury in Norway. J Clin Med 2021; 10:jcm10010157. [PMID: 33466321 PMCID: PMC7794850 DOI: 10.3390/jcm10010157] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/29/2020] [Accepted: 12/31/2020] [Indexed: 12/21/2022] Open
Abstract
Traumatic brain injury (TBI) has a long-lasting impact on participation and health-related quality of life (HRQL). We aimed to describe the physical and mental health trajectories and to identify their predictors across the first 10 years after TBI. A prospective longitudinal cohort of 97 individuals with moderate to severe TBI (age 16-55 years) in Norway were followed up at 1, 2, 5, and 10 years post-injury. Their socio-demographic and injury characteristics were recorded at baseline; their responses to the 36-Item Short Form Health Survey (SF-36) were collected at each follow-up. The Physical (PCS) and Mental Component Summary (MCS) scores were used as the outcome measures of physical and mental health. The predictors of the trajectories were described and examined using hierarchical linear modelling. The subscale scores showed a stable or increasing trend, but only the Role Physical and Role Emotional subscales showed clinically relevant positive changes from 1 to 10 years post-injury. Longer time, male gender, employment pre-injury, and shorter length of post-traumatic amnesia were significant predictors of better physical health trajectories; longer time, male gender, and employment pre-injury were significant predictors of better mental health trajectories. At-risk individuals may be targeted to receive rehabilitation interventions to improve their long-term quality of life outcomes.
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Affiliation(s)
- Marit V. Forslund
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, 0424 Oslo, Norway; (E.I.H.); (C.R.); (N.A.)
- Correspondence:
| | - Paul B. Perrin
- Departments of Psychology and Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA 23233, USA;
| | | | - Emilie I. Howe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, 0424 Oslo, Norway; (E.I.H.); (C.R.); (N.A.)
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0318 Oslo, Norway
| | - Marleen R. van Walsem
- Department of Neurohabilitation, Oslo University Hospital, 0424 Oslo, Norway;
- Department of Neurology, Oslo University Hospital, 0424 Oslo, Norway
- Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, Faculty of Medicine, University of Oslo, 0318 Oslo, Norway
| | - Juan Carlos Arango-Lasprilla
- Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain;
- IKERBASQUE, Basque Foundation for Science, 48013 Bilbao, Spain
- Department of Cell Biology and Histology, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
| | - Juan Lu
- Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, Richmond, VA 23233, USA;
| | - Alba Aza
- Faculty of Psychology, University of Salamanca, 37005 Salamanca, Spain;
- Institute on Community Inclusion (INICO), University of Salamanca, 37005 Salamanca, Spain
| | - Tone Jerstad
- Department of Neuroradiology, Oslo University Hospital, 0424 Oslo, Norway;
| | - Cecilie Røe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, 0424 Oslo, Norway; (E.I.H.); (C.R.); (N.A.)
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0318 Oslo, Norway
- Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, Faculty of Medicine, University of Oslo, 0318 Oslo, Norway
| | - Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, 0424 Oslo, Norway; (E.I.H.); (C.R.); (N.A.)
- Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, Faculty of Medicine, University of Oslo, 0318 Oslo, Norway
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16
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Jacobsson L, Lexell J. Functioning and disability from 10 to 16 years after traumatic brain injury. Acta Neurol Scand 2020; 141:115-122. [PMID: 31705523 DOI: 10.1111/ane.13194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 10/23/2019] [Accepted: 11/06/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES With increased long-term survival after traumatic brain injury (TBI), there is a need to understand the life situation many years after the injury. In this study, we have assessed persons on average 16 years after their injury and determined changes over 6 years in overall outcome, living condition, marital status and vocational situation, and in their functioning and disability. MATERIALS & METHODS Individuals (n = 49, mean age 45 years, 28-70 years) who were assessed 6-15 years (average 10 years) post-TBI were reassessed 12-21 years after their injury (average 16 years) using internationally established TBI outcome measures. RESULTS From the first to the second assessment, overall outcome using the Glasgow Outcome Scale (GOS) was stable for a large majority and no significant changes in marital status or vocational situation were found. There was some significant, but very small, decline regarding cognitive function, home integration and social integration. In the multiple regression analysis, there was a small significant decline in the Mayo-Portland Adaptability Inventory (MPAI-4) Adjustment subscale score for women with a moderate-to-severe injury. CONCLUSIONS The very small changes over 6 years imply that persons with a TBI can reach and maintain a stable level of functioning many years post-TBI. Women with a moderate-to-severe TBI seem to be more vulnerable and may experience a small decline in some aspects of their functioning related to anxiety, depression, irritability, pain and headache and fatigue. The relatively small sample requires further studies to confirm these findings.
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Affiliation(s)
- Lars Jacobsson
- Rehabilitation Medicine Research Group Department of Health Sciences Lund University Lund Sweden
- Department of Rehabilitation Medicine Sunderby Hospital Luleå Sweden
- Department of Health Sciences Luleå University of Technology Luleå Sweden
| | - Jan Lexell
- Rehabilitation Medicine Research Group Department of Health Sciences Lund University Lund Sweden
- Department of Rehabilitation Medicine Sunderby Hospital Luleå Sweden
- Department of Neuroscience, Rehabilitation Medicine Uppsala University Uppsala Sweden
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17
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von Steinbüchel N, Meeuwsen M, Zeldovich M, Vester JC, Maas A, Koskinen S, Covic A. Differences in Health-Related Quality of Life after Traumatic Brain Injury between Varying Patient Groups: Sensitivity of a Disease-Specific (QOLIBRI) and a Generic (SF-36) Instrument. J Neurotrauma 2020; 37:1242-1254. [PMID: 31801408 DOI: 10.1089/neu.2019.6627] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Factors associated with health-related quality of life (HRQOL) in patients after traumatic brain injury (TBI) include severity of initial injury, different grades of trauma recovery, sociodemographic status, and psychological characteristics. Yet, sensitivity of HRQOL instruments to such effects is often underexplored. Thus, we aimed to compare the capacity of the disease-specific QOLIBRI (Quality of Life after Brain Injury) and the generic Medical Outcomes Study (MOS) 36-Item Short-Form Health Survey(SF-36) to detect significant differences in HRQOL between patients. Patients (n = 795) completed HRQOL, sociodemographic, clinical, psychological, and health status questionnaires. Univariate (Wilcoxon-Mann-Whitney) and multi-variate (Wei-Lachin) non-parametric analyses were conducted using the Wilcoxon-Mann-Whitney approach to compare the sensitivity of the QOLIBRI and the SF-36. For both instruments, HRQOL was particularly influenced by patients' reliance on others, depression, anxiety, and recovery status, whereas smaller effects were found for living arrangements and participation in leisure activities. Both HRQOL instruments were sensitive to group differences, but the QOLIBRI was able to detect a greater number of and finer differences between specific patient groups, which is particularly important in clinical and therapeutic contexts. This finding is likely explained by the QOLIBRI's greater specificity to disease-specific aspects of consequences of TBI. This head-to-head HRQOL instrument comparison resulted in a recommendation for the use of the QOLIBRI when detailed insight in the subjective consequences and impact of TBI on patients is required.
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Affiliation(s)
- Nicole von Steinbüchel
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Göttingen, Germany
| | - Mirjam Meeuwsen
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Göttingen, Germany
| | - Marina Zeldovich
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Göttingen, Germany
| | | | - Andrew Maas
- Department of Neurosurgery, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium
| | - Sanna Koskinen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Amra Covic
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Göttingen, Germany
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18
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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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19
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Singh R, Choudhri K, Sinha S, Mason S, Lecky F, Dawson J. Global outcome after traumatic brain injury in a prospective cohort. Clin Neurol Neurosurg 2019; 186:105526. [PMID: 31585337 DOI: 10.1016/j.clineuro.2019.105526] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 09/13/2019] [Accepted: 09/15/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Traumatic Brain Injury(TBI) is one of the most common neurosurgical emergencies but the long-term outcome remains unclear. This study investigated the global outcome and return to work after TBI and tried to identify any relationships that exist with injury and demographic features. PATIENTS & METHODS 1322 consecutive TBI admissions over 4 years, assessed at a specialist neurorehabilitation clinic at 10weeks and 1 yr. The outcomes were Extended Glasgow Outcome Scale(GOSE), return to work, Rivermead Head Injury Follow-up Questionnaire, Rivermead Post-Concussion Symptoms and the Hospital Anxiety and Depression Score. RESULTS 1 year follow-up was achieved in 1207(91.3%). Mean age was 46.9(SD17.3) and 49.2% had mild TBI. The proportion attaining Good Recovery increased from 25.1% to 42.9% by 1 year. However 11.4% deteriorated in GOSE. Only 28.1% of individuals returned to the same pre-morbid level of work by 10 weeks, improving to 45.9% at 1 year. Over a quarter (25.6%) at 1 year were unable to make any return to work or study. Several demographic and injury variables were associated with these outcomes including TBI severity, social class, past psychiatric history and alcohol intoxication. These may allow targeting of vulnerable individuals. CONCLUSIONS In a largely representative TBI population including predominantly mild injury, there is still considerable functional disability at 1 year and many individuals are unable to make any return to pre-morbid vocation.
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Affiliation(s)
- Rajiv Singh
- Health Services Research, School of Health and Related Research (ScHARR), Faculty of Medicine, Dentistry and Health, University of Sheffield, S1 4DA, UK; Osborn Neurorehabilitation Unit, Department of Rehabilitation Medicine, Sheffield Teaching Hospitals, Sheffield, S5 7AU, UK.
| | - Kishor Choudhri
- Department of Neurosurgery, Sheffield Teaching Hospitals, Glossop Road, Sheffield, S10 2JF, UK
| | - Saurabh Sinha
- Department of Neurosurgery, Sheffield Teaching Hospitals, Glossop Road, Sheffield, S10 2JF, UK
| | - Suzanne Mason
- Health Services Research, School of Health and Related Research (ScHARR), Faculty of Medicine, Dentistry and Health, University of Sheffield, S1 4DA, UK
| | - Fiona Lecky
- Health Services Research, School of Health and Related Research (ScHARR), Faculty of Medicine, Dentistry and Health, University of Sheffield, S1 4DA, UK
| | - Jeremy Dawson
- Institute of Work Psychology, Sheffield University Management School, Conduit Road, Sheffield, S10 1FL, UK
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20
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Verdugo MA, Fernández M, Gómez LE, Amor AM, Aza A. Predictive factors of quality of life in acquired brain injury. Int J Clin Health Psychol 2019; 19:189-197. [PMID: 31516497 PMCID: PMC6732774 DOI: 10.1016/j.ijchp.2019.06.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 06/13/2019] [Indexed: 11/10/2022] Open
Abstract
The sequelae and the disability and dependence that follow an acquired brain injury (ABI) may result in a significant reduction in the quality of life (QoL) of those affected. The objective was to assess the QoL of a sample of Spanish patients with an ABI and analyze the influence of certain sociodemographic and injury-related variables on their QoL. Method: The sample comprised 421 adults (60% male; Mage = 53.12; SD = 14.87). Professionals and relatives assessed the patients’ QoL through the CAVIDACE scale, an ABI-specific tool based on the eight-domain QoL model. Results: Univariate analyses showed statistically significant differences in the QoL scores in several sociodemographic (age, civil status, education level, prior employment status, type of home, level of supports, loss of legal capacity, recognized dependence, and degree of dependence) and injury-related (time since the injury, location of the injury, and presence of post-traumatic amnesia) variables. The multiple linear regression showed that loss of legal capacity, time since the injury, prior employment status, location of the injury, and degree of dependence were significant QoL predictors. Conclusions: These findings provide knowledge for the development of programs aimed at reducing the negative impact of ABI on QoL.
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Affiliation(s)
- Miguel A Verdugo
- Facultad de Psicología, Universidad de Salamanca, Spain.,Instituto de Integración en la Comunidad (INICO), Universidad de Salamanca, Spain
| | - María Fernández
- Facultad de Psicología, Universidad de Salamanca, Spain.,Instituto de Integración en la Comunidad (INICO), Universidad de Salamanca, Spain
| | - Laura E Gómez
- Facultad de Psicología, Universidad de Oviedo, Spain.,Instituto de Integración en la Comunidad (INICO), Universidad de Salamanca, Spain
| | - Antonio M Amor
- Facultad de Psicología, Universidad de Salamanca, Spain.,Instituto de Integración en la Comunidad (INICO), Universidad de Salamanca, Spain
| | - Alba Aza
- Facultad de Psicología, Universidad de Salamanca, Spain.,Instituto de Integración en la Comunidad (INICO), Universidad de Salamanca, Spain
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21
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Proctor CJ, Best LA. Social and psychological influences on satisfaction with life after brain injury. Disabil Health J 2019; 12:387-393. [DOI: 10.1016/j.dhjo.2019.01.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 12/12/2018] [Accepted: 01/06/2019] [Indexed: 01/07/2023]
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22
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Puccio AM, Anderson MW, Fetzick A. The Transition Trajectory for the Patient with a Traumatic Brain Injury. Nurs Clin North Am 2019; 54:409-423. [PMID: 31331627 DOI: 10.1016/j.cnur.2019.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The trajectory status of patients with mild, moderate, and severe traumatic brain injury from emergency room evaluation, through acute care (intensive care if severe) and discharge is discussed. Additional considerations for elderly population and common complications associated with severe traumatic brain injury are also covered.
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Affiliation(s)
- Ava M Puccio
- Department of Neurological Surgery, Neurotrauma Clinical Trials Center, University of Pittsburgh, 200 Lothrop Street, Suite B-400, Pittsburgh, PA 15213, USA.
| | - Maighdlin W Anderson
- University of Pittsburgh School of Nursing, 324 Victoria Building, 3500 Victoria Street, Pittsburgh, PA 15261, USA
| | - Anita Fetzick
- Department of Neurological Surgery, Neurotrauma Clinical Trials Center, University of Pittsburgh, 200 Lothrop Street, Suite B-400, Pittsburgh, PA 15213, USA
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23
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Van Bost G, Van Damme S, Crombez G. Goal reengagement is related to mental well-being, life satisfaction and acceptance in people with an acquired brain injury. Neuropsychol Rehabil 2019; 30:1814-1828. [PMID: 31030643 DOI: 10.1080/09602011.2019.1608265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE After an acquired brain injury (ABI), the achievement of previous life goals may no longer be feasible. This study examined whether self-reported disengagement from previous goals and reengagement towards new, more feasible goals, are associated with higher quality of life (QOL) and life satisfaction. We also examined whether acceptance mediated these relationships. METHODS Eighty-two individuals (18-68 years of age) with an ABI completed a battery of questionnaires. We investigated the relations between goal disengagement and reengagement on the one hand, and general QOL, disease-specific QOL, life satisfaction and acceptance, on the other hand. Rehabilitation psychologists provided estimates of self-awareness and the extent of motor, communicative and cognitive impairment. RESULTS Goal reengagement, but not goal disengagement, was positively associated with mental QOL and life satisfaction, after statistically controlling for demographic and impairments. Acceptance mediated the relationship between goal reengagement on the one hand, and mental QOL and life satisfaction, on the other hand. CONCLUSION After an ABI, reengagement in feasible goals is more important in explaining mental well-being and life satisfaction than disengagement from unattainable goals. Interventions aimed at identifying and pursuing new, feasible goals may be more helpful than strategies focusing on the loss of blocked goals.
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Affiliation(s)
- Gunther Van Bost
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium.,CAR Ter Kouter Deinze, Deinze, Belgium
| | - Stefaan Van Damme
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
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24
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Lange RT, Lippa SM, French LM, Bailie JM, Gartner RL, Driscoll AE, Wright MM, Sullivan JK, Varbedian NV, Barnhart EA, Holzinger JB, Schaper AL, Reese MA, Brandler BJ, Camelo-Lopez V, Brickell TA. Long-term neurobehavioural symptom reporting following mild, moderate, severe, and penetrating traumatic brain injury in U.S. military service members. Neuropsychol Rehabil 2019; 30:1762-1785. [DOI: 10.1080/09602011.2019.1604385] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Rael T. Lange
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
- Contractor, Defense and Veterans Brain Injury Center, Silver Spring, MD, USA
| | - Sara M. Lippa
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Contractor, Defense and Veterans Brain Injury Center, Silver Spring, MD, USA
| | - Louis M. French
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Jason M. Bailie
- Defense and Veterans Brain Injury Center, Naval Hospital Camp Pendleton, CA, USA
| | - Rachel L. Gartner
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Angela E. Driscoll
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Contractor, Defense and Veterans Brain Injury Center, Silver Spring, MD, USA
| | - Megan M. Wright
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Contractor, Defense and Veterans Brain Injury Center, Silver Spring, MD, USA
| | - Jamie K. Sullivan
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Contractor, Defense and Veterans Brain Injury Center, Silver Spring, MD, USA
| | - Nicole V. Varbedian
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Contractor, Defense and Veterans Brain Injury Center, Silver Spring, MD, USA
| | - Elizabeth A. Barnhart
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Contractor, Defense and Veterans Brain Injury Center, Silver Spring, MD, USA
| | - Jayne B. Holzinger
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Contractor, Defense and Veterans Brain Injury Center, Silver Spring, MD, USA
| | - Ashley L. Schaper
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Contractor, Defense and Veterans Brain Injury Center, Silver Spring, MD, USA
| | - Maryetta A. Reese
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Contractor, Defense and Veterans Brain Injury Center, Silver Spring, MD, USA
| | - Brian J. Brandler
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Contractor, Defense and Veterans Brain Injury Center, Silver Spring, MD, USA
| | - Vanessa Camelo-Lopez
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Contractor, Defense and Veterans Brain Injury Center, Silver Spring, MD, USA
| | - Tracey A. Brickell
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Contractor, Defense and Veterans Brain Injury Center, Silver Spring, MD, USA
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Characteristics of centenarians' lifestyles and their contribution to life satisfaction: A case study conducted on Hainan Island. Arch Gerontol Geriatr 2019; 83:20-27. [PMID: 30933742 DOI: 10.1016/j.archger.2019.03.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 03/14/2019] [Accepted: 03/25/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND Centenarians represent an intriguing model for healthy aging. They appear to have adapted well to their lives and are likely to be influenced by previous lifestyle habits, and their life satisfaction is influenced by mental and psychological health. OBJECTIVE The aim of this study is to explore centenarians' lifestyles by sex and their potential contribution to life satisfaction. METHOD In order to examine the common characteristics of centenarians in Hainan and the potential differences between men and women, a cross-sectional survey was conducted with 223 cognitively-intact Chinese centenarians. We also explored the association between life satisfaction and other physical factors using binary logistic regression and principal component analysis. RESULTS The results provided supplementary evidence indicating that women tended to live longer than men. However, the difference in life satisfaction observed between the sexes was not obvious (p = 0.659). The proportion of physical factors between each sex showed a similar trend in distribution. Most centenarians' lifestyles were similar, in that they followed a light diet and did not smoke or drink alcohol. Centenarians in better physical condition and with higher self-assessment, as well as those with "alcohol and tobacco habits," were more satisfied with their life. Of the factors examined in the binary logistic regression, sleep satisfaction was the only factor significantly positively correlated with life satisfaction (p < .01). CONCLUSION The research findings elucidated physiological and psychological health in centenarians and provided a model of healthy aging strategies for reference purposes.
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Andelic N, Howe EI, Hellstrøm T, Sanchez MF, Lu J, Løvstad M, Røe C. Disability and quality of life 20 years after traumatic brain injury. Brain Behav 2018; 8:e01018. [PMID: 29888869 PMCID: PMC6043714 DOI: 10.1002/brb3.1018] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 03/19/2018] [Accepted: 05/06/2018] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES The study describes functional outcomes and health-related quality of life (HRQL) in patients with traumatic brain injury (TBI) 20 years postinjury. MATERIALS AND METHODS Forty-four survivors who acquired moderate and severe TBI during 1995-1996 were followed 10 and 20 years postinjury. Outcomes were Glasgow Outcome Scale Extended (GOSE), Community Integration Questionnaire (CIQ), and SF-36 questionnaire (SF-36). Multiple regressions were performed to examine the relationship between follow-up measurements, controlling for baseline demographics and injury severity. RESULTS There were no significant differences in baseline age and civil status between moderate and severe TBI, but patients with severe injury had significantly lower employment rates (p = 0.05). Mean age at 20-years follow-up was 50.8 (SD 11.4) years, and 73% were males. Most patients showed good recovery (52%) or moderate disability (43%). Disability levels remained stable between and within severity groups from 10 to 20 years. Community integration including social integration improved from 10 to 20 years (p = 0.01 and p = 0.005, respectively). HRQL remained stable, except for subscales Bodily Pain and Role Emotional (p = 0.02 and p = 0.06). Depression at 10 years and females were associated with poorer mental health, while productive activity at 10 years indicated better physical and mental health at 20 years postinjury, respectively. CONCLUSIONS Functional limitations persist even decades after moderate and severe TBI, with poorer prognosis for females and persons who were depressed at the 10-year follow-up. Development and evaluation of targeted long-term follow-up programs and access to rehabilitation services for these groups should be highlighted. Improved community integration despite stable functional limitations draws attention to long-term adaptation to adversity and illness.
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Affiliation(s)
- Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ulleval, Norway.,Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Emilie I Howe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ulleval, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Torgeir Hellstrøm
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ulleval, Norway
| | - Maria Fernandez Sanchez
- Institute on Community Integration (INICO), Faculty of Psychology, University of Salamanca, Salamanca, Spain
| | - Juan Lu
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia
| | - Marianne Løvstad
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Cecilie Røe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ulleval, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Ngamaba KH, Panagioti M, Armitage CJ. How strongly related are health status and subjective well-being? Systematic review and meta-analysis. Eur J Public Health 2018; 27:879-885. [PMID: 28957478 DOI: 10.1093/eurpub/ckx081] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Health status is widely considered to be closely associated with subjective well-being (SWB), yet this assumption has not been tested rigorously. The aims of this first systematic review and meta-analysis are to examine the association between health status and SWB and to test whether any association is affected by key operational and methodological factors. Methods A systematic search (January 1980-April 2017) using Web of Science, Medline, Embase, PsycInfo and Global health was conducted according to Cochrane and PRISMA guidelines. Meta-analyses using a random-effects model were performed. Results Twenty nine studies were included and the pooled effect size of the association between health status and SWB was medium, statistically significant and positive (pooled r = 0.347, 95% CI = 0.309-0.385; Q = 691.51, I2 = 94.99%, P < 0.001). However, the association was significantly stronger: (i) when SWB was operationalised as life satisfaction (r = 0.365) as opposed to happiness (r = 0.307); (ii) among studies conducted in developing countries (r = 0.423) than it was in developed countries (r = 0.336) and (iii) when multiple items were used to assess health status and SWB (r = 0.353) as opposed to single items (r = 0.326). Conclusion Improving people's health status may be one means by which governments can improve the SWB of their citizens. Life satisfaction might be preferred to happiness as a measure of SWB because it better captures the influence of health status.
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Affiliation(s)
- Kayonda Hubert Ngamaba
- Division of Psychology and Mental Health, Manchester Centre for Health Psychology, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Maria Panagioti
- NIHR School for Primary Care Research, Manchester Academic Health Science Centre, University of Manchester, UK
| | - Christopher J Armitage
- Division of Psychology and Mental Health, Manchester Centre for Health Psychology, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
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Thyer L, Brown T, Roe D. The Validity of the Canadian Occupational Performance Measure (COPM) When Used in a Sub-Acute Rehabilitation Setting with Older Adults. Occup Ther Health Care 2018; 32:137-153. [PMID: 29578811 DOI: 10.1080/07380577.2018.1446233] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This study investigated the validity of the Canadian Occupational Performance Measure (COPM) when included as one of the scales used by therapists with older adults on an inpatient sub-acute rehabilitation setting. Quantitative data from 36 participants in a sub-acute rehabilitation setting was obtained via the COPM, the Functional Independence Measure (FIM) and the Short Form 36 Health Survey (SF-36) using a pre-post methodology. Pearson's r correlations and linear regression analyses were computed. The COPM Performance admission score was significantly correlated with the FIM Total and FIM Physical admission scores (p <.05) while the COPM Satisfaction admission score was significantly correlated with the FIM Total and FIM Physical admission scores (p <.05). The COPM Performance discharge score was significantly associated with the FIM Total, FIM Physical, and SF-36 Physical Health discharge scores (p <.01) while the COPM Satisfaction discharge scores was significantly associated with the FIM Total, FIM Physical, and SF-36 Physical Health discharge scores (p <.01) respectively. Linear regression analyses determined that the COPM's Performance admission score uniquely explained 8.4% of the SF-36 Physical Health discharge score's total variance (p <.05). The results contribute to the COPM's evidence base, supporting its convergent validity and predictive validity.
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Affiliation(s)
- Laura Thyer
- a Occupational Therapist and Research Assistant, Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences , Monash University - Peninsula Campus , Frankston , Victoria , Australia
| | - Ted Brown
- b Associate Professor and Undergraduate Course Convenor, Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences , Monash University - Peninsula Campus , Frankston , Victoria , Australia
| | - Debbie Roe
- c Occupational Therapist , Casey Hospital, Monash Health , Berwick , Victoria , Australia
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Spectrum of outcomes following traumatic brain injury-relationship between functional impairment and health-related quality of life. Acta Neurochir (Wien) 2018; 160:107-115. [PMID: 28988342 PMCID: PMC5735200 DOI: 10.1007/s00701-017-3334-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 09/11/2017] [Indexed: 12/01/2022]
Abstract
Background The outcome following traumatic brain injury (TBI) is heterogeneous and poorly defined and physical disability scales like the extended Glasgow Outcome Score (GOSE) while providing valuation information in terms of broad categorisation of outcome are unlikely to capture the full spectrum of deficits. Quality of life questionnaires such as SF-36 are emerging as potential tools to help characterise factors important to patients’ recovery. This study assessed the association between physical disability and subjective health rating. The relationship is of value as it may help evaluate the impact of TBI on patients’ lives and facilitate the delivery of appropriate neuro-rehabilitation services. Methods A single-centre retrospective study was undertaken to assess the relationship between physical outcome as measured by GOSE and quality of life captured by the SF-36 questionnaire. Cronbach’s alpha was calculated for each of the eight SF-36 domains to measure internal consistency of the test. Multivariate analysis of variance was conducted to look at the association between GOSE and the physical (PCS) and mental (MCS) component scores on the SF-36. Finally, we performed a generalised linear mixed model (GLMM) to assess the relative contribution of GOSE score, age at the time of trauma, sex and TBI duration towards MCS and PCS rating. Results There is a statistically significant difference in the MCS and PCS scores based on patients’ GOSE scores. The mean scores of the eight SF-36 domains showed significant association with GOSE. GLMM demonstrated that GOSE was the strongest predictor of PCS and MCS. Age was an important variable in the PCS score while time following trauma was a significant predictor of MCS rating. Conclusions This study highlights that patients’ physical outcome following TBI is a strong predictor of the subjective mental and physical health. Nevertheless, there remains tremendous variability in individual SF-36 scores for each GOSE category, highlighting that additional factors play a role in determining quality of life.
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Zarshenas S, Tam L, Colantonio A, Alavinia SM, Cullen N. Predictors of discharge destination from acute care in patients with traumatic brain injury. BMJ Open 2017; 7:e016694. [PMID: 28860230 PMCID: PMC5589015 DOI: 10.1136/bmjopen-2017-016694] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Many studies have assessed the predictors of morbidity/mortality of patients with traumatic brain injury (TBI) in acute care. However, with the increasing rate of survival after TBI, more attention has been given to discharge destinations from acute care as an important measure of clinical priorities. This study describes the design of a systematic review compiling and synthesising studies on the prognostic factors of discharge settings from acute care in patients with TBI. METHODS AND ANALYSIS This systematic review will be conducted on peer-reviewed studies using seven databases including Medline/Medline in-Process, Embase, Cochrane Database of Systematic Reviews, Cochrane CENTRAL, PsycINFO, CINAHL and Supplemental PubMed. The reference list of selected articles and Google Scholar will also be reviewed to determine other relevant articles. This study will include all English language observational studies that focus on adult patients with TBI in acute care settings. The quality of articles will be assessed by the Quality in Prognostic Studies tool. ETHICS AND DISSEMINATION The results of this review will provide evidence that may guide healthcare providers in making more informed and timely discharge decisions to the next level of care for patient with TBI. Also, this study will provide valuable information to address the gaps in knowledge for future research. TRIAL REGISTRATION NUMBER Trial registration number (PROSPERO) is CRD42016033046.
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Affiliation(s)
- Sareh Zarshenas
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- University Health Network-Toronto Rehabilitation Institute-University Centre, Toronto, Canada
| | - Laetitia Tam
- University Health Network-Toronto Rehabilitation Institute-University Centre, Toronto, Canada
| | - Angela Colantonio
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- University Health Network-Toronto Rehabilitation Institute-University Centre, Toronto, Canada
| | - Seyed Mohammad Alavinia
- University Health Network-Toronto Rehabilitation Institute-Lyndhurst Centre, Toronto, Canada
| | - Nora Cullen
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- University Health Network-Toronto Rehabilitation Institute-University Centre, Toronto, Canada
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Cogné M, Wiart L, Simion A, Dehail P, Mazaux JM. Five-year follow-up of persons with brain injury entering the French vocational and social rehabilitation programme UEROS: Return-to-work, life satisfaction, psychosocial and community integration. Brain Inj 2017; 31:655-666. [PMID: 28406316 DOI: 10.1080/02699052.2017.1290827] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Social and vocational reintegration of persons with brain injury is an important element in their rehabilitation. AIMS To evaluate the 5-year outcome of persons with brain injury included in 2008 in the Aquitaine Unit for Evaluation, Training and Social and Vocational Counselling programme (UEROS). METHOD 57 persons with brain injury were recruited from those who completed the 2008 UEROS programme. Five years later, an interview was done to assess family and vocational status, autonomy and life satisfaction. These results were compared with those from persons completing the 1997-1999 programme. RESULTS The typical person entered the 2008 UEROS programme 6 years after a severe brain injury (42%) and was male, single and 35 years. At the 5-year follow-up, more persons lived with a partner (+23%) and lived in their own home (+21%). 47% were working vs 11% on entering the programme. Approximately half were satisfied or very satisfied with their quality of life. Having a job in 2013 was associated with a high education level, less cognitive sequelae, having a job in 2008 and no health condition. CONCLUSIONS The UEROS programme is effective with regard to return-to-work and improvement of autonomy in persons with brain injury, irrespective of length of time from injury.
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Affiliation(s)
- M Cogné
- a Rehabilitation Medicine Unit, Centre Hospitalier Universitaire of Bordeaux , Bordeaux , France.,b EA4136, University of Bordeaux , Bordeaux , France
| | - L Wiart
- a Rehabilitation Medicine Unit, Centre Hospitalier Universitaire of Bordeaux , Bordeaux , France.,c UEROS Aquitaine , Bordeaux , France
| | - A Simion
- a Rehabilitation Medicine Unit, Centre Hospitalier Universitaire of Bordeaux , Bordeaux , France.,c UEROS Aquitaine , Bordeaux , France
| | - P Dehail
- a Rehabilitation Medicine Unit, Centre Hospitalier Universitaire of Bordeaux , Bordeaux , France.,b EA4136, University of Bordeaux , Bordeaux , France
| | - J-M Mazaux
- a Rehabilitation Medicine Unit, Centre Hospitalier Universitaire of Bordeaux , Bordeaux , France.,b EA4136, University of Bordeaux , Bordeaux , France
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Secondary Health Conditions, Activity Limitations, and Life Satisfaction in Older Adults With Long-Term Spinal Cord Injury. PM R 2016; 9:356-366. [DOI: 10.1016/j.pmrj.2016.09.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 09/05/2016] [Accepted: 09/10/2016] [Indexed: 11/19/2022]
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Gerber GJ, Gargaro J, McMackin S. Community integration and health-related quality-of-life following acquired brain injury for persons living at home. Brain Inj 2016; 30:1552-1560. [PMID: 27564085 DOI: 10.1080/02699052.2016.1199896] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PRIMARY OBJECTIVE To study predictors of community integration (CI) and health-related quality-of-life (HRQoL) in a sample of Canadian adult, urban, multi-ethnic persons with acquired brain injury (ABI) receiving publicly-funded community services. Hypothesis 1 examined the predictive utility of age, ratings of disability, functioning and cognition for CI and HRQoL. Hypothesis 2 examined the correlation between CI and HRQoL. RESEARCH DESIGN Cohort study. METHODS AND PROCEDURES A convenience sample of community-residing clients completed measures with their care co-ordinators: Resident Assessment Instrument-Home Care (RAI-HC), Disability Rating Scale (DRS), Community Integration Questionnaire (CIQ) and the Quality-of-Life after Brain Injury Instrument (QOLIBRI). RESULTS Regression analysis showed DRS scores explained significant variance in CIQ and QOLIBRI. Correlations also showed that cognitive skill and ADL/IADL functioning are strongly related to CI and the Daily life and autonomy QOLIBRI sub-scale. The CIQ Total was not correlated with QOLIBRI Total, although there were some significant correlations between the CIQ social sub-scale and QOLIBRI. CONCLUSIONS Lesser degree of disability is a key predictor of greater CI and QoL. The present findings suggest that rehabilitation efforts should focus on minimizing disability and promoting social integration and involvement to avoid adverse long-term effects of ABI for community-resident persons.
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Affiliation(s)
- Gary J Gerber
- a West Park Healthcare Centre , Toronto , ON , Canada
| | - Judith Gargaro
- a West Park Healthcare Centre , Toronto , ON , Canada.,b Toronto Central Community Access Centre , Toronto , ON , Canada
| | - Sally McMackin
- b Toronto Central Community Access Centre , Toronto , ON , Canada
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Holloway M, Tyrrell L. Acquired Brain Injury, Parenting, Social Work, and Rehabilitation: Supporting Parents to Support Their Children. ACTA ACUST UNITED AC 2016; 15:234-259. [DOI: 10.1080/1536710x.2016.1220883] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Rosengren L, Brogårdh C, Jacobsson L, Lexell J. Life satisfaction and associated factors in persons with mild to moderate Parkinson’s disease. NeuroRehabilitation 2016; 39:285-94. [DOI: 10.3233/nre-161359] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Lina Rosengren
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden
| | - Christina Brogårdh
- Department of Health Sciences, Physiotherapy Research Group, Lund University, Lund, Sweden
- Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| | - Lars Jacobsson
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden
- Department of Health Science, Luleå University of Technology, Luleå, Sweden
- Department of Rehabilitation Medicine, Sunderby Hospital, Luleå, Sweden
| | - Jan Lexell
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden
- Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
- Department of Health Science, Luleå University of Technology, Luleå, Sweden
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Jörgensen S, Iwarsson S, Norin L, Lexell J. The Swedish Aging With Spinal Cord Injury Study (SASCIS): Methodology and Initial Results. PM R 2016; 8:667-77. [DOI: 10.1016/j.pmrj.2015.10.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 10/26/2015] [Accepted: 10/31/2015] [Indexed: 11/16/2022]
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Grieve R, Sadique Z, Gomes M, Smith M, Lecky FE, Hutchinson PJA, Menon DK, Rowan KM, Harrison DA. An evaluation of the clinical and cost-effectiveness of alternative care locations for critically ill adult patients with acute traumatic brain injury. Br J Neurosurg 2016; 30:388-96. [PMID: 27188663 DOI: 10.3109/02688697.2016.1161166] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND For critically ill adult patients with acute traumatic brain injury (TBI), we assessed the clinical and cost-effectiveness of: (a) Management in dedicated neurocritical care units versus combined neuro/general critical care units within neuroscience centres. (b) 'Early' transfer to a neuroscience centre versus 'no or late' transfer for those who present at a non-neuroscience centre. METHODS The Risk Adjustment In Neurocritical care (RAIN) Study included prospective admissions following acute TBI to 67 UK adult critical care units during 2009-11. Data were collected on baseline case-mix, mortality, resource use, and at six months, Glasgow Outcome Scale Extended (GOSE), and quality of life (QOL) (EuroQol 5D-3L). We report incremental effectiveness, costs and cost per Quality-Adjusted Life Year (QALY) of the alternative care locations, adjusting for baseline differences with validated risk prediction models. We tested the robustness of results in sensitivity analyses. FINDINGS Dedicated neurocritical care unit patients (N = 1324) had similar six-month mortality, higher QOL (mean gain 0.048, 95% CI -0.002 to 0.099) and increased average costs compared with those managed in combined neuro/general units (N = 1341), with a lifetime cost per QALY gained of £14,000. 'Early' transfer to a neuroscience centre (N = 584) was associated with lower mortality (odds ratio 0.52, 0.34-0.80), higher QOL for survivors (mean gain 0.13, 0.032-0.225), but positive incremental costs (£15,001, £11,123 to £18,880) compared with 'late or no transfer' (N = 263). The lifetime cost per QALY gained for 'early' transfer was £11,000. CONCLUSIONS For critically ill adult patients with acute TBI, within neuroscience centres management in dedicated neurocritical care units versus combined neuro/general units led to improved QoL and higher costs, on average, but these differences were not statistically significant. This study finds that 'early' transfer to a neuroscience centre is associated with reduced mortality, improvement in QOL and is cost-effective.
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Affiliation(s)
- R Grieve
- a Department of Health Services Research and Policy , London School of Hygiene and Tropical Medicine , London , UK
| | - Z Sadique
- a Department of Health Services Research and Policy , London School of Hygiene and Tropical Medicine , London , UK
| | - M Gomes
- a Department of Health Services Research and Policy , London School of Hygiene and Tropical Medicine , London , UK
| | - M Smith
- b National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust , London , UK
| | - F E Lecky
- c School of Health and Related Research, University of Sheffield , Sheffield , UK
| | - P J A Hutchinson
- d School of Clinical Medicine, University of Cambridge , Cambridge , UK
| | - D K Menon
- d School of Clinical Medicine, University of Cambridge , Cambridge , UK
| | - K M Rowan
- e Clinical Trials Unit, Intensive Care National Audit and Research Centre , London , UK
| | - D A Harrison
- e Clinical Trials Unit, Intensive Care National Audit and Research Centre , London , UK
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Abstract
PRIMARY OBJECTIVE To describe vocational outcome 6-15 years after a traumatic brain injury (TBI) among individuals who were productive by working or studying at the time of their TBI and determine the associations with variables related to the time of injury and at follow-up. METHODS AND PROCEDURES Thirty-four individuals with a mild TBI and 45 with a moderate-to-severe TBI were assessed on average 10 years post-injury. Logistic regression was used to determine the association between their current vocational situation and variables related to the time of injury (gender, age, injury severity and educational level) and at follow-up (time since injury, marital status and overall disability). RESULTS A total of 67% were productive at follow-up. Age at injury, injury severity and the degree of disability at follow-up were strongly associated with being productive. Younger individuals with milder TBI and less severe disability were significantly more likely to be fully productive. No significant associations were found between productivity and gender, education, time since injury or marital status. CONCLUSIONS This study indicates that return to productivity in a long-term perspective after a TBI is possible, in particular when the individual is young, has sustained a mild TBI and has a milder form of overall disability.
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Affiliation(s)
- J Lexell
- a Department of Health Sciences , Lund University , Lund.,b Department of Neurology and Rehabilitation Medicine , Skåne University Hospital , Lund , Sweden.,c Department of Health Sciences , Luleå University of Technology , Luleå
| | - A-K Wihlney
- a Department of Health Sciences , Lund University , Lund
| | - L J Jacobsson
- a Department of Health Sciences , Lund University , Lund.,c Department of Health Sciences , Luleå University of Technology , Luleå,d Department of Rehabilitation Medicine , Sunderby Hospital , Luleå , Sweden
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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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The Relationship of Health Locus of Control and Health-Related Quality of Life in the Chronic Phase After Traumatic Brain Injury. J Head Trauma Rehabil 2015; 30:424-31. [DOI: 10.1097/htr.0000000000000128] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gifre M, Gil Á, Pla L, Roig T, Monreal-Bosch P. [What happens after the accident? Psychosocial needs of people with traumatic brain injury and their families]. GACETA SANITARIA 2015; 29 Suppl 1:60-5. [PMID: 26342414 DOI: 10.1016/j.gaceta.2015.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Revised: 02/03/2015] [Accepted: 02/03/2015] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To identify factors that people with a traumatic brain injury and their families perceived as helping to improve their quality of life. METHODS Three focus groups and five interviews were conducted with a total of 37 participants: 14 persons with traumatic brain injury and 23 caregivers. A content analysis was conducted. The constant comparative method was applied. RESULTS We detected five factors that improved the quality of life of persons with a traumatic brain and their families: 1) Informal support (family and friends); 2) formal support (counseling, employment, built and bureaucratic environment); 3) type of clinical characteristics; 4) social participation, and 5) social visibility. CONCLUSIONS The needs expressed by our participants primarily focused on social and emotional factors. For persons with severe traumatic brain injury attempting to achieve the best possible community integration, a new semiology is required, not limited to medical care, but also involving social and psychological care tailored to the needs of each individual and family and their environment.
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Affiliation(s)
- Mariona Gifre
- Institut Guttmann-Hospital de Neurorrehabilitació adscrit a la Universitat Autònoma de Barcelona, Badalona, Barcelona, España; Grupo de investigación ECIS (Envejecimiento, Cultura y Salud), Departamento de Psicología, Universidad de Girona, Girona, España.
| | - Ángel Gil
- Institut Guttmann-Hospital de Neurorrehabilitació adscrit a la Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - Laura Pla
- Institut Guttmann-Hospital de Neurorrehabilitació adscrit a la Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - Teresa Roig
- Institut Guttmann-Hospital de Neurorrehabilitació adscrit a la Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - Pilar Monreal-Bosch
- Grupo de investigación ECIS (Envejecimiento, Cultura y Salud), Departamento de Psicología, Universidad de Girona, Girona, España
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Rosengren L, Jonasson SB, Brogårdh C, Lexell J. Psychometric properties of the Satisfaction With Life Scale in Parkinson's disease. Acta Neurol Scand 2015; 132:164-70. [PMID: 25639961 DOI: 10.1111/ane.12380] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2014] [Indexed: 01/24/2023]
Abstract
OBJECTIVE The Satisfaction With Life Scale (SWLS) is a global measure of life satisfaction (LS). The objective of this study was to evaluate the psychometric properties (data completeness, scaling assumptions, targeting and reliability) of the SWLS in a sample of people with Parkinson's disease (PD). MATERIALS AND METHODS A postal survey including a Swedish version of the SWLS and demographic information was administered to 174 persons with PD; 97 responded and received a second survey after 2 weeks. RESULTS The mean (SD) age and PD duration of the 97 responders were 73 (8) and 7 (6) years, respectively. Data completeness was 92% to 97% for the five items in the SWLS and 92% for the total score (5-35 points). The mean score of the SWLS was 24.2 points (7.7), indicating that this group had an average LS. The items' means and SDs were roughly parallel and the score distribution was even. The internal consistency reliability (Cronbach's alpha) was 0.90. The test-retest reliability, assessed by the intraclass correlation coefficient, was 0.78. The scale showed no systematic difference between the first and second response. The standard error of measurement was 3.6 points, and the smallest detectable difference was 10.0 points. CONCLUSIONS This evaluation of the psychometric properties of the SWLS shows that the scale has good data completeness, scaling assumptions and targeting and that the internal consistency reliability and the test-retest reliability are acceptable. Thus, the SWLS is a psychometrically sound and suitable tool to asses LS in people with PD.
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Affiliation(s)
- L. Rosengren
- Department of Health Sciences; Rehabilitation Medicine Research Group; Lund University; Lund Sweden
| | - S. B. Jonasson
- Department of Health Sciences; Rehabilitation Medicine Research Group; Lund University; Lund Sweden
- Department of Neurology and Rehabilitation Medicine; Skåne University Hospital; Lund Sweden
| | - C. Brogårdh
- Department of Health Sciences; Physiotherapy Research Group; Lund University; Lund Sweden
- Department of Neurology and Rehabilitation Medicine; Skåne University Hospital; Lund Sweden
| | - J. Lexell
- Department of Health Sciences; Rehabilitation Medicine Research Group; Lund University; Lund Sweden
- Department of Neurology and Rehabilitation Medicine; Skåne University Hospital; Lund Sweden
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Schiehser DM, Twamley EW, Liu L, Matevosyan A, Filoteo JV, Jak AJ, Orff HJ, Hanson KL, Sorg SF, Delano-Wood L. The Relationship Between Postconcussive Symptoms and Quality of Life in Veterans With Mild to Moderate Traumatic Brain Injury. J Head Trauma Rehabil 2015; 30:E21-8. [DOI: 10.1097/htr.0000000000000065] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sandhaug M, Andelic N, Langhammer B, Mygland A. Community integration 2 years after moderate and severe traumatic brain injury. Brain Inj 2015; 29:915-20. [DOI: 10.3109/02699052.2015.1022880] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Scholten AC, Haagsma JA, Andriessen TMJC, Vos PE, Steyerberg EW, van Beeck EF, Polinder S. Health-related quality of life after mild, moderate and severe traumatic brain injury: patterns and predictors of suboptimal functioning during the first year after injury. Injury 2015; 46:616-24. [PMID: 25476014 DOI: 10.1016/j.injury.2014.10.064] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 10/15/2014] [Accepted: 10/26/2014] [Indexed: 02/02/2023]
Abstract
BACKGROUND The Glasgow Outcome Scale Extended (GOSE) is the established functional outcome scale to assess disability following traumatic brain injury (TBI), however does not capture the patient's subjective perspective. Health-related quality of life (HRQL) does capture the individual's perception of disability after TBI, and has therefore been recognized as an important outcome in TBI. In contrast to GOSE, HRQL enables comparison of health outcome across various disease states and with healthy individuals. We aimed to assess functional outcome, HRQL, recovery, and predictors of 6 and 12-month outcome in a comprehensive sample of patients with mild, moderate or severe TBI, and to examine the relationship between functional impairment (GOSE) and HRQL. METHODS A prospective cohort study was conducted among a sample of 2066 adult TBI patients who attended the emergency department (ED). GOSE was determined through questionnaires or structured interviews. Questionnaires 6 and 12 months after ED treatment included socio-demographic information and HRQL measured with Short-Form Health Survey (SF-36; reflecting physical, mental and social functioning) and Perceived Quality of Life Scale (PQoL; measuring degree of satisfaction with functioning). RESULTS 996 TBI survivors with mild, moderate or severe TBI completed the 6-month questionnaire. Functional outcome and HRQL after moderate or severe TBI was significantly lower than after mild TBI. Patients with moderate TBI showed greatest improvement. After one year, the mild TBI group reached outcomes comparable to population norms. TBI of all severities highly affected SF-36 domains physical and social functioning, and physical and emotional role functioning. GOSE scores were highly related to all SF-36 domains and PQoL scores. Female gender, older age, co-morbidity and high ISS were strongest independent predictors of decreased HRQL at 6 and 12 months after TBI. CONCLUSIONS HRQL and recovery patterns differ for mild, moderate and severe TBI. This study indicates that GOSE, although clinically relevant, fails to capture the subjective perspective of TBI patients, which endorses the use of HRQL as valuable addition to established instruments in assessing disability following TBI. Influence of TBI severity on recovery, together with female gender, older age, co-morbidity and high ISS should be considered in long-term follow-up and intervention programs.
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Affiliation(s)
- A C Scholten
- Department of Public Health, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - J A Haagsma
- Department of Public Health, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - T M J C Andriessen
- Department of Neurology, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands
| | - P E Vos
- Department of Neurology, Slingeland Hospital, PO Box 169, 7000 AD Doetinchem, The Netherlands
| | - E W Steyerberg
- Department of Public Health, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - E F van Beeck
- Department of Public Health, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - S Polinder
- Department of Public Health, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, The Netherlands
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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: 121] [Impact Index Per Article: 13.4] [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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Dean D, Martinez MS, Newgard CD. Variability in early do not attempt resuscitation orders among patients with serious traumatic brain injury. Acad Emerg Med 2015; 22:54-60. [PMID: 25545694 DOI: 10.1111/acem.12555] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 07/21/2014] [Accepted: 07/27/2014] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The objective was describe the use of early do not attempt resuscitation (DNAR) orders in patients with serious traumatic brain injury (TBI) and its association with outcomes. METHODS This was a retrospective cohort study of all serious TBI patients admitted through the emergency department (ED) to acute care hospitals in California between 2002 and 2010 using ED International Classification of Diseases, 9th revision (ICD-9), admitting diagnosis codes specifying intracranial hemorrhage. DNAR placement within 24 hours of admission was the primary variable of interest. Outcomes included neurosurgical procedures and in-hospital mortality. Hospital and patient characteristics were analyzed using descriptive statistics and multivariable generalized estimation equation regression models to account for hospital-level clustering. RESULTS Of all 76,962 patients with serious TBI, 71,275 were admitted at 141 hospitals that each cared for at least 10 serious TBI patients annually and formed the primary sample. Early DNAR orders were placed in 7.5% of patients (range = 0 to 36.1% by hospital). Early DNAR use varied by trauma designation: Level I, 4.0% (95% confidence interval [CI] = 3.8% to 4.4%); Level II, 6.7% (95% CI = 6.5% to 7.1%); Level III, 9.7% (95% CI = 8.4% to 11.3%); and nontrauma hospitals, 10.8% (95% CI = 10.6% to 11.3%). Early DNAR was also less likely in teaching hospitals (9.3% vs. 4.3%). These results persisted after accounting for age, year, and hospital-level clustering. In-hospital mortality (39.4% vs. 8.7%) and neurosurgical interventions (14.5% vs. 19.7%) also differed for patients with versus without early DNAR orders. Patients 65 years of age and older constituted 87.7% of those with early DNAR orders; our findings remained qualitatively unchanged when restricted to older adults. CONCLUSIONS Use of early DNAR orders among patients with serious TBI is highly variable by individual hospital and hospital type, suggesting substantial practice variation. Associations with fewer surgical intervention and higher mortality suggest that such practice variation may be contributing to differences in TBI outcomes, particularly among older adults.
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Affiliation(s)
- Dylan Dean
- The Center for Policy and Research in Emergency Medicine; Division of Emergency Medicine; Oregon Health and Science University (OHSU); Portland OR
| | - Michael S. Martinez
- The Center for Policy and Research in Emergency Medicine; Division of Emergency Medicine; Oregon Health and Science University (OHSU); Portland OR
| | - Craig D. Newgard
- The Center for Policy and Research in Emergency Medicine; Division of Emergency Medicine; Oregon Health and Science University (OHSU); Portland OR
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Trajectories of physical health in the first 5 years after traumatic brain injury. J Neurol 2014; 262:523-31. [DOI: 10.1007/s00415-014-7595-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 11/18/2014] [Accepted: 11/20/2014] [Indexed: 10/24/2022]
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Holloway M. How is ABI assessed and responded to in non-specialist settings? Is specialist education required for all social care professionals? ACTA ACUST UNITED AC 2014. [DOI: 10.1108/scn-12-2013-0043] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– The purpose of this paper is to examine the research into prevalence of acquired brain injury in non-ABI specialist services, the impact of the invisible aspects of executive impairment and loss of insight upon functioning and to question how this is assessed and managed by generalist services.
Design/methodology/approach
– A literature search was undertaken to identify where people with an ABI may come in to contact with services that are not specifically designed to meet their needs.
Findings
– ABI is prevalent amongst users of a variety of community, inpatient and criminal justice services. The common albeit invisible consequences of ABI complicate assessment, service use and or treatment particularly in the context of a lack of under pinning knowledge and experience amongst the staff in non-specialist ABI services. As a consequence risks to children and adults are increased, opportunities for rehabilitation and growth are lost and human potential squandered. Addressing the first stage in this process, developing knowledge of the consequences of ABI and how to assess need, is a pre-requisite for change.
Practical implications
– An absence of basic underlying knowledge of the consequences of ABI impacts upon assessment and so limits the effectiveness of services. A consequence of this is manifest in the over-representation of people with an ABI to be found in non-specialist settings.
Originality/value
–Little research is undertaken from a social and community perspective into the impact of ABI over the longer term for those who have no contact with specialist services and yet, quite clearly by their use of other services, have unidentified, unrecognised and un-responded to needs.
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Rogers S, Richards KC, Davidson M, Weinstein AA, Trickey AW. Description of the moderate brain injured patient and predictors of discharge to rehabilitation. Arch Phys Med Rehabil 2014; 96:276-82. [PMID: 25305630 DOI: 10.1016/j.apmr.2014.09.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Revised: 08/26/2014] [Accepted: 09/12/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To describe patients with moderate traumatic brain injury (TBI) treated and discharged at levels I and II trauma centers in the United States; and to describe the predictors of discharge to rehabilitation after acute care. DESIGN Retrospective, cross-sectional, descriptive study. SETTING Trauma centers. PARTICIPANTS Patients with moderate TBI (N=2087; age range, 18-64 y) as reported in the 2010 National Sample Project. INTERVENTIONS None. MAIN OUTCOME MEASURE Discharge destination (rehabilitation vs home with no services). RESULTS Multivariate logistic regression models revealed that demographic, clinical, and financial characteristics influenced the likelihood of being discharged to rehabilitation. Increased age, increased severity, Medicare use, longer length of stay, and trauma center locations in the Midwest and Northeast all increased the likelihood of discharge to rehabilitation. CONCLUSIONS The decision to discharge a person with moderate TBI from acute care to rehabilitation appears to be based on factors other than just clinical need. These findings should be considered in creating more equitable access to postacute rehabilitation services for patients with moderate TBI because they risk long-term physical and cognitive problems and have the potential for productive lives with treatment.
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Affiliation(s)
- Sandra Rogers
- School of Nursing, George Mason University, Fairfax, VA.
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