Abstract

BackgroundConsequences after Traumatic brain injury (TBI) affect the injured person’s self-image and quality of life. The purpose was to assess the health related quality of life (HRQoL) at 12 months after a TBI in patients admitted to regional trauma centres, and to evaluate the metric properties of the Norwegian version of the Quality of Life After Brain Injury (QOLIBRI) questionnaire.MethodsTwo hundred four patients with TBI of all severities were included. HRQoL at 12 months post-injury was measured by the QOLIBRI. It has a total scale and 6 subscales (satisfied with Cognition, Self, Daily Life and Autonomy and Social Relationships, and bothered by Emotions and Physical Problems). Demographic and injury related data were registered. Disability was registered by Glasgow Outcome Scale Extended (GOSE) and Rivermead Post-Concussion Questionnaire, and mental health by Hospital Anxiety and Depression Scale. Descriptive statistics, internal consistency by Cronbach’s alpha and Corrected Item-Total Correlations were calculated. Rasch analysis, Principal Component Analysis (PCA) and Structural Equation Modelling (SEM) were applied.ResultsMean age was 37.6 (SD 15.4) years; 72% were men, and 41% had higher education. Over 60% were severely injured. Mean Glasgow Coma Scale score was 9.3 (SD 4.5). According to the GOSE 5.9% had severe disability, 45.5% had moderate disability, and 48.5% had good recovery at 12 months post-injury. The QOLIBRI scales had a high internal consistency (α = 0.75–0.96), and only Physical Problems had an α < 0.85. In the Rasch analysis all subscales and their items fit the Rasch model, except for the depression item in the Emotion subscale. PCA and SEM analyses supported a six-factor structure in a second-order latent model. The QOLIBRI supports an underlying unidimensional HRQoL model. The SEM model fit statistics of the second-order model indicated a moderate fit to the observed data (CFI = 0.86, TLI = 0.85, RMSEA = 0.076, SRMR = 0.061, χ2 = 1315.76, df = 623, p-value < 0.001).ConclusionThe Norwegian QOLIBRI has favourable psychometric properties, but there were some weaknesses related to its measurement properties of the total score when tested on a TBI population where many had severe TBI, and many had good recovery.

Highlights

  • Consequences after Traumatic brain injury (TBI) affect the injured person’s self-image and quality of life

  • We investigated the metric properties of the Norwegian version of the Quality of Life After Brain Injury (QOLIBRI) with respect to its internal consistency, scale properties and factor structure

  • The proportion of patients with severe TBI (STBI) based on the Glasgow Coma Scale (GCS) criteria in this study was equivalent to that in other QOLIBRI studies; the current study contained a larger percentage of patients with good recovery (48.5%) than the international (28%) and Finnish studies (1.3%)

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Summary

Introduction

Consequences after Traumatic brain injury (TBI) affect the injured person’s self-image and quality of life. Traumatic brain injury (TBI) can have physical, cognitive, emotional and behavioural consequences, and the resulting impairments can give activity limitations and participation restrictions which subsequently representing lifelong disabilities [1,2,3,4,5,6,7,8,9]. These disabilities affect the injured person’s self-image and their quality of life [4, 10, 11]. HRQoL can be operationalized through assessments of physical, psychological (emotional and cognitive), social and daily life domains, and these assessments are predominantly self-reported [10]

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