Abstract

Current research indicates that pediatric patients experience quality-of-life (QOL) issues during recovery from concussion. However, measures of health related QOL issues in youth have generally focused on chronic illness and do not address the unique experience of brain injury. The Pediatric Life After Concussion Evaluation Scale (PLACES) was developed to gain a better understanding of youth perspectives on QOL during recovery from concussion. The PLACES is a self-rating instrument examining patient perspectives on cognition, emotion, social life, and school support. Study participants were 277 patients, receiving treatment for concussion at a single regional concussion clinic. Examination of reliability using Cronbach’s alpha indicated strong performance with internal consistency (r =.92). The Post-Concussion Symptom Scale (PCSS) was used for comparison as this measure is commonly used to examine patient symptoms in clinical settings. Convergent and divergent validity of the PLACES was examined. Convergent validity was evident across the two measures (r=.732, p=.001). Exploratory factor analysis identified 5 factors and indicated divergent factors related to emotion, social concerns, and school. Analyses demonstrated that the PLACES domains measure different aspects of quality of life issues during recovery from concussion than traditional symptom scales, thereby offering support for the proposed domain structure of the PLACES. This measure appears to provide additional information that is clinically relevant and not available on symptom scales. Initial psychometrics indicate that the PLACES has the potential to function as a QOL measure specific to concussion and will assist in greater specificity of treatment during recovery.

Highlights

  • Emerging research indicates that for many individuals who sustain a concussion there is an impact on quality of life (QOL) during recovery and possibly after initial symptoms abate

  • The Pediatric Life After Concussion Evaluation Scale (PLACES) consists of a demographic section and 20 questions in four domains, Cognition, Social, Emotion, and School Support and provides scores for each domain and a Total score that sums all item scores

  • The PLACES consists of a demographic section and 20 questions in four domains, Cognition (Cognition), Social, Emotion, and School Support

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Summary

Introduction

Emerging research indicates that for many individuals who sustain a concussion there is an impact on quality of life (QOL) during recovery and possibly after initial symptoms abate. Physical symptoms are the most apparent in the immediate period after concussion, symptoms related to cognition and mood emerge more gradually [8,9]. It is not unusual for patients with concussion to experience negative emotions during the recovery period [8, 10,11]. Secondary symptoms related to frustration, emotional response, and regulation of executive functions may

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