Responsiveness of the Traumatic Brain Injury–Quality of Life (TBI-QOL) Measurement System

Abstract

ObjectiveTo assess the responsiveness of the Traumatic Brain Injury–Quality of Life (TBI-QOL) measurement system. DesignParticipants completed the 20 TBI-QOL item banks and the Participation Assessment with Recombined Tools–Objective (PART-O) Productivity Subscale at baseline and 6-month follow-up assessments. Participants were categorized into 4 groups (increased productivity, unchanged productivity, and decreased productivity) based on PART-O Productivity scores. Paired sample t tests were used to compare TBI-QOL scores at baseline and 6 months, and standardized response means and Cohen's d were computed to estimate effect sizes. SettingThree traumatic brain injury (TBI) Model Systems rehabilitation centers in the United States. ParticipantsTwo hundred one community-dwelling adults with TBI. InterventionsNot applicable. Main Outcome Measures20 TBI-QOL item banks. ResultsAs expected, given that there was no intervention, group mean TBI-QOL subdomain scores for the entire sample showed no change or small improvement over the 6-month study period. At the follow-up assessment, 72 participants reported increased productivity, 71 reported decreased productivity, and 58 reported the same level of productivity as they had 6 months prior. When compared with participants who reported unchanged or decreased productivity, participants who reported increased productivity on the PART-O subscale had clinically meaningful (d≥0.30) improvements on 7 TBI-QOL measures. The largest improvement was in the Independence subdomain (mean change, 7.06; df=0.84), with differences also observed in the Mobility, Positive Affect and Well-Being, Resilience, Grief/Loss, Ability to Participate, and Satisfaction with Participation subdomains. ConclusionsThe 20 TBI-QOL item banks demonstrate responsiveness to change and measurement stability in a community-dwelling sample. Researchers may use the TBI-QOL to detect changes in HRQOL after a clinical intervention and clinicians may use it in their daily practices to monitor patient recovery.