Psychological Health Status Research Articles

The physical, psychological, and social impacts of participation in the Invictus Pathways Program: A qualitative analysis of veterans' perceptions and experiences.

UniSA's Invictus Pathways Program (IPP) is motivated by the spirit of the Invictus Games to mobilise the benefits of sport to aid physical, psychological, and social wellbeing. Originally developed to assist veterans to train for and participate in the Invictus Games, the program has extended its scope to promote recovery and wellbeing for all veterans through physical activity. This paper describes the expectations and experiences of the IPP from the perspective of program participants. Objective measures of physical and psychological wellbeing were collected by survey, to enable description of the participating veterans' wellbeing status. Semi-structured interviews were conducted with 15 participants of the IPP who had not participated in an Invictus Games or Warrior Games. Reflexive thematic analysis was used to analyse the interview data. Coding and themes were developed through a mixture of inductive and deductive approaches to analysis. Initial themes related to previous life experience, expectations of participation, and outcomes of participation were preconceived, but the analysis provided scope for an inductive approach to formulate additional themes. Five of the participants had very high K10 scores, and scores above the norm for PCL-C, whilst one would be classified with an alcohol disorder. The qualitative analysis identified five higher order themes: Life experiences prior to participation in the IPP, Making a choice to participate in the IPP, Expectations of participation in the IPP, Impact of participation in the IPP, and Future Plans. There were perceptions that the IPP was beneficial for the participating veterans, irrespective of their physical and psychological health status. Participants described the positive impact of the IPP on their physical fitness, their social engagement, and their sense of belonging within the IPP and the university. Participants perceived the IPP to be an opportunity for them to 'give back' by contributing to the education of the students delivering the IPP. Participants reported the intention to continue being physically active. For some, this meant selection in an Invictus Games team, for others, this meant getting involved in community sporting organisations. The Invictus Pathways Program has been shown to have a positive impact on the physical and psychological wellbeing of the veterans who participated in its initial stages. As the program evolves, the longitudinal impact of participation, for veterans and their families, will be assessed.

PHYSICAL AND MENTAL HEALTH STATUS OF TEACHERS AND SOFTWARE PROFESSIONALS WORKING FROM HOME DURING COVID-19

The study attempted to investigate the physical and mental health of teachers and software professionals working from home since the start of COVID-19. The data was collected between March and April months of 2022.The study was conducted in the Bheemadol, Tanuku ,Tadepalligudem mandals of West Godavari district, Andhra Pradesh.The sample consisted of 120 respondents (60 teachers and 60 software professionals). The age group of the respondents was 25-35 years. Equal number of male and female respondents were selected for the study. The questionnaire developed by Verma and Pershad (1985) was used to measure the physical and mental health of teachers and software professionals the data was used analyzed by descriptive and inferential statistics. The study concluded that teachers were experiencing good physical and mental health status when compared to IT professionals. Interestingly nearly 50% of the respondents irrespective of gender were found to have good physical and psychological health status while working from home. However, significant difference was found in the physical and mental health status of teachers and software professionals.

Mind, Body, and Pandemic: Understanding the Complex Relationships Between Subjective Well-Being, Physical Activity, and Perceived Multi-Dimensional COVID-19 Impact

In response to the need for further research on factors influencing university students’ well-being during challenging circumstances, this study tests a potential mechanism to unravel the complex relationships between perceived impacts of COVID-19 on psychological health, academic performance, and financial status, subjective well-being, and physical activity. The main objective was to investigate these intricate associations among university students. A nationwide online survey involving 848 Greek-speaking university students (70.8% females, average age = 27.65) was conducted. The results revealed both direct effects of subjective well-being on participants’ perceptions of COVID-19 impact on their financial status and psychological health, as well as indirect effects mediated by physical activity. The study also examined gender and age effects. These findings emphasize the importance of empirically examining the outcomes linked to subjective well-being and provide supporting evidence that higher levels of subjective well-being can lead to positive consequences. By shedding light on the interplay between subjective well-being, perceived pandemic impact, and physical activity, this study enriches our understanding of how university students cope with adverse circumstances like the COVID-19 pandemic.

Power distribution in universities on mixed depression among students from a psychological perspective

BackgroundThe allocation of power in universities has a direct impact on students’ mental health, and whether the allocation of power is reasonable or not can lead to mixed depression symptoms in students’ learning process. Mixed type depression usually not only has symptoms of depression, but also is accompanied by manic symptoms. The fundamental way to improve the internal governance structure of universities is to establish a power balance mechanism, effectively ensuring the balanced allocation of students’ political, academic, and democratic power, and forming a scientific and reasonable power structure.Subjects and MethodsThe study selected 50 students respectively from two universities as the research subjects, divided into an experimental group and a control group. The experimental group conducted a balanced allocation of internal governance structure, while the control group adopted traditional management methods. The depression status of two groups of students is compared and analyzed after one month of intervention.ResultsThe study used Excel 2010 and SPSS 23.0 to organize and analyze the data. The results showed that there was no significant difference in mental health indicators between the experimental group and the control group before the power allocation reform (P>0.05), and after intervention, the values of mental health indicators in the experimental group were significantly higher than those in the control group (P<0.05).ConclusionsAccording to the results, it can be seen that the internal power allocation in universities has a certain impact on the mixed depression of college students, and after replanning and rational allocation, the psychological health status of college students can be significantly improved.AcknowledgementGeneral item of pedagogy of national social science foundation (No. BIA210163).

Quality of life of Medicine students of the National University of Córdoba, Argentina

Quality of life (QoL), according to the WHO, includes the perception that a person has about their physical health, level of independence, social relationships, system of values ​​and goals, expectations, standards and concerns. The medical student faces a high level of competitiveness in the course of his academic training with an increase in the workload as he progresses; this causes symptoms such as anxiety, stress, sadness, among others. If these aspects are not treated or are masked, they can turn into depression, generalized anxiety, burnout and even suicide (2). To describe the QoL of the students of medicina at the National University of Córdoba, considering the complete training cycle divided into two groups from 1 to 3° and from 4 to 5°. Cross-sectional study, through the Guarani System of the UNC. The WHOQoL-BREF online questionnaire, which uses the Likert scale, was applied to all students. This assesses the global QoL and satisfaction regarding the state of physical and psychological health, interpersonal relationships and environment. p was considered significant <0.05. This work was approved by the Adult CIEIS. 854 responses were obtained, 72% were female, 43% were from another province/country and 63% corresponded to the 1-3° group. Of these, 37% rated their QoL as “fairly good”, while 36% of the 4-5th grade group perceived their QoL as “normal” (p:0.0469). The most influential variables correspond to the supply of money for their needs (p:0.0005), sexual satisfaction (p:0.0056) and access to health services (p:0.0042) . Cronbach's alpha was 0.8899. QoL is better perceived in the 1-3 year group and economic supply, sexual satisfaction and access to health services were the main points to take care of in this medicine students.

Investigation of mid-term functional skills and psychological factors in female patients undergoing total knee arthroplasty

Background/Aim: Previous studies have yielded conflicting clinical, psychological, and functional outcomes in patients undergoing total knee arthroplasty (TKA). This study aimed to more precisely evaluate the clinical outcomes, mid-term general physical and psychological health status, functional abilities, and improvements in patients’ quality-of-life undergoing TKA. Methods: This cross-sectional study included 25 female patients older than 55 years who underwent unilateral TKA due to osteoarthritis (OA). The Five Repetition Sit-to-Stand Test (5STS), Stair-Climbing Test (SCT), 6-Minute Walking Test (6MWT), Berg Balance Scale (BBS), Tampa Scale for Kinesiophobia (TSK), and Short Form Health Survey (SF-12) scores of the patients were evaluated using means. Meanwhile, the Lower Limb Length (LLL), Navicular Drop Test (NDT), Proprioception Assessment, Foot Posture Index (FPI-6), Foot Function Index (FFI), Lower Extremity Functional Scale (LEFS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Oxford Knee Score (OKS) were evaluated by comparing the operated (OP) sides that underwent TKA with the non-operated (NONOP) sides diagnosed with OA. Results: The study found that LLL (P=0.001), abduction/adduction forefoot on rearfoot (ABD) (P=0.017), and T.FPI-6 (P=0.014) in the FPI-6 parameters, as well as KOOS (P&lt;0.001), OKS (P&lt;0.001), LEFS (P&lt;0.001), and FFI (P&lt;0.001) results, were significantly in favor of the OP limb. Besides some parameters in FPI-6, no significant difference was found between the OP and NONOP extremities in terms of prone and supine proprioception values (P&gt;0.05). Conclusion: Overall, it was found that TKA plays a crucial role in recovery and regaining functional skills. Including preoperative evaluations with a control group and patients of both sexes in future studies and examining the relationships between the conducted tests and scales may contribute to better evaluating the results.

Sense of danger, sense of country's mastery, and sense of personal mastery as concomitants of psychological distress and subjective well-being in a sample of Poles following Russia's invasion of Ukraine: Prospective analyses.

This study investigated psychological toll of the ongoing war in neighboring Ukraine in a sample of adult Poles (N= 1245). Data were collected online in early February and August 2022. Prospective analyses that accounted for psychological health status assessed before the Russian invasion showed that higher levels of sense of danger due to the war predicted higher levels of psychological distress and lower levels of affect balance close to 6 months after Russia attacked Ukraine. Sense of country's mastery (i.e. beliefs that government, its major institutions, and citizens would effectively cope with various emergencies and crises) served as a protective factor. Likewise, Poles who had confidence in their personal mastery (e.g., beliefs in ability to exercise control over life challenges) exhibited less distress and more subjective well-being. These findings emerged after controlling for sociodemographic factors, the presence of stressful experiences associated with the COVID-19 pandemic, and other life events. Wars dramatically reverberate beyond the borders of the countries involved. People's own sense of mastery and their trust in the resilience of their governmental and public institutions are critical in times of coping with existential security threats and wars.

Exploration of Inflammatory Biomarkers and Psychological Cardiovascular Disease Risk Factors Among Community Dwelling Adults: A Gender Comparison Study.

Patients with rheumatic disease (RD) are at high risk for cardiovascular disease (CVD), which is the leading non-communicable chronic disease cause of death worldwide. Inflammatory biomarkers and psychological health status are reliable predictors of CVD in patients with RD. The primary aim of this study was to compare the inflammatory biomarkers and psychological CVD risk factors (CRFs) between a group of community-dwelling adults with RD and CRFs and a group of their peers with CRFs only. The secondary aim of this study was to analyze and compare the collected data by gender in the RD group. Data were collected and analyzed from 355 participants, with the 135 participants with physician-diagnosed RD assigned to the RD group and the remainder (n = 220) assigned to the comparison group. The measures used included a demographic datasheet, medical information, serum homocysteine (Hcy) levels, high sensitive C-reactive protein (hs-CRP) levels, and depression and global sleep-quality scale scores. The RD group had higher ratios of hypertension and depression diagnoses than the comparison group. The gender analysis of the RD group found significantly more-severe sleep disturbances in women than men and a significantly higher mean value of Hcy in men than women. The women in the RD group were significantly older, less educated, and less employed than their male counterparts and thus may be presumed to at higher risk of health illiteracy. Gender-tailored interventions to modify the risk factors of CVD identified in this study for patients with RD are recommended.

Relationship Between Freshmen's Psychological Health and Family Economic Status in Chinese Universities: A Latent Profile Analysis.

With the rapid social changes, psychological health problems among freshmen in universities have become increasingly serious. Many researchers have studied the psychological health status of college freshmen using quantitative methods. However, most researchers have studied the psychological health of college freshmen by treating variables as the central concept and analysis unit, which has limitations on the variable-centered research method. Therefore, this study aims to explore the impact of family economic status and demographic variables on the psychological health of college freshmen, as well as the potential types of psychological health among college freshmen. Based on the SCL-90 and the self-evaluation of the family economic status of college freshmen, latent profile analysis (LPA) was used to analyze the psychological health of 1497 college freshmen selected through a whole-group sampling method. Freshmen completed the questionnaire from October 18 to October 20, 2022. Then, multinomial logistic regression analysis and variance analysis were conducted using SPSS 25.0 to analyze the impact of family economic status and demographic variables on different psychological health subtypes of college freshmen from a university in Eastern China. There is obvious heterogeneity in the psychological health of college freshmen, which can be divided into three groups: psychological health group (69.54%), psychological distress group (24.65%), and psychological risk group (5.81%). The latent categories of psychological health among college freshmen differ by gender and family economic status. The psychological health status of female students is significantly better than that of male students. In addition, the lower the self-evaluation of family economic status of college freshmen, the lower their psychological health level. Three categories of mental health exist for college freshmen, with significant group heterogeneity. Gender and family economic status significantly influenced mental health outcomes with female students faring better. The study's significance lies in providing useful recommendations for educational administrators and developing targeted interventions for college freshmen. Given the practical realities of mental health education efforts, personalized strategies that utilize peer support, counseling, and psychological services can be adopted to assist freshmen in acclimating to university life and maintaining mental wellness. The findings suggest considering the role of family economic status and gender in promoting mental health and the need for further research to develop comprehensive and effective interventions.

The Impact of COVID-19-Pandemic on Psychological Health and Educational Status of the Dental Students from the Instructor and Student’s Viewpoints

The Impact of COVID-19-Pandemic on Psychological Health and Educational Status of the Dental Students from the Instructor and Student’s Viewpoints

Main trends in physical and psycho-emotional health of preschool children in Ukraine

Children are increasingly at risk of various diseases, which has a rather negative impact on their intellectual development and can slow down social development in general, and therefore there is a need to address this issue. The main purpose of this study was to examine and analyse the state of physical, psychological, and social health of children in Ukraine based on preschool educational institutions in Mukachevo. The study used the Sensorimotor technique and the computer programme Efecton Studio 2009 to investigate preschool children’s visual-motor reactions. The Rufier-Dixon and Henchy tests were used to assess the cardiovascular and respiratory systems. It was found that every third child has problems in physical or intellectual development. It was substantiated that the tense sanitary and epidemiological situation in the country, environmental pollution, lower living standards of most families and access to medical care, insufficient physical activity, as well as environmental problems contribute to the deterioration of the psychophysical state of preschool children. It was emphasised that maintaining a healthy physical condition is an important element for the normal functioning and growth of a young organism. It was emphasised that the period of adaptation to school, which current preschoolers will go through in the future, depends considerably on the child’s health, as healthy children can better cope with mental and physical stress. It was found that most preschoolers have limited knowledge about healthy lifestyles. Only 28% of children understand what food is healthy, and 18% know the importance of eating fresh food. This indicates the need for more active work with children on healthy eating and lifestyles in general. It was found that many adults also do not have a holistic understanding of the principles of proper nutrition and do not discuss these issues with children, and therefore it is important to pay attention to adult education in the field of health and nutrition. The practical significance of the study is that all the theoretical provisions, conclusions and recommendations can be used by teachers and students of educational institutions to improve knowledge about the trends in the health status of preschoolers and schoolchildren in Ukraine, as well as by other scientists for in-depth study of the problem.

Psychological problems among husbands of women diagnosed with breast cancer in Punjab, Pakistan

The study examined the psychological health status of husbands whose wives were diagnosed with breast cancer. It was hypothesised that husbands of women with breast cancer would significantly suffer from more psychological distress, stress, anger, and somatic symptoms than husbands of healthy women. Using the purpose sampling method, a total of hundred participants (n = 100), including fifty husbands of women with breast cancer, while fifty husbands of women without breast cancer (healthy women) were selected from Faisalabad, Punjab, Pakistan. The ages of husbands ranged from 31 to 50 years with mean age (M = 41.57; SD =5.91). Data was gathered through the Personal Information Form and other measures like the Psychological Distress Scale, Subscales of Stress, Anger and Somatic Symptoms Scale. Statistical analysis through independent samples t-test revealed a significant difference among husbands of women with and without breast cancer in relation to psychological distress, stress, anger, and somatic symptoms. Husbands of breast cancer patients are more prone to develop psychological problems as they encounter extremely tough challenges in life. From acceptance to breast cancer treatment, they face new hurdles with constant psychological pressure in psychological issues like psychological distress, stress, and somatic symptoms.

Model of psychosocial determinants of health in processes of social exclusion.

The substantial increase in the number of families facing social exclusion in Europe and its direct relationship with health inequities is a challenge for studies approaching the social determinants of health and policies dealing with welfare and social inclusion. We start from the premise that reducing inequality (SDG10), has a value and contributes on other goals such as improving health and well-being (SDG3), ensuring quality education (SDG4), promoting gender equality (SDG5) and decent work (SDG8). In this study, we identify disruptive risk factors and psychological and social well-being factors that influence self-perceived health in trajectories of social exclusion. The research materials used a checklist of exclusion patterns, life cycles and disruptive risk factors, Goldberg's General Health Questionnaire (GHQ-12), Ryff's Psychological Well-being (PWB) Scale and Keyes' Social Well-being Scale. The sample consists of 210 people (aged between 16 and 64 years): 107 people in a situation of social inclusion and 103 people in a situation of social exclusion. The data treatment involved statistical analysis, including correlation study and multiple regression analysis, aimed at developing a model of psychosocial factors that may act as health modulators, considering social factors as predictors in the regression model. The results showed that individuals in the sample, in a situation of social exclusion, have a greater accumulation of disruptive risk factors, and these are related to having fewer psychosocial and cognitive resources to cope with stressful situations: less self-acceptance, less mastery of the environment, less purpose in life, less level of social integration and social acceptance. Finally, analysis showed that in the absence of social integration and purpose in life, self-perceived health statuses decline. This work allows us to use the model obtained as a basis for confirming that there are dimensions of psychological and social well-being that should be considered stress-buffering factors in trajectories of social exclusion. These findings can help design psychoeducational programs for prevention and intervention with the aim of improving psychological adjustment and health states, as well as to promote proactive and reactive policies to reduce health inequalities.

The Application of Islamic Counseling to Overcome Post-Suicide Attemption in Female Adolescent with Minor Depression

&lt;p&gt;Suicide is an act of recklessness to end one's life so that someone dies. The main cause of suicide is depression, a condition of psychiatric pressure characterized by disappointment, anxiety, hopelessness, loss of meaning in life and thoughts of suicide. This study aims to analyze the application of Islamic counseling to overcome post-suicide attempts in young women who experience minor depression. The research used a qualitative-descriptive approach with a focus on case studies on 3 young girls who had attempted suicide. Sampling technique with purposive sampling. Retrieval of data using interviews, observations and documentation records. Data analysis using a thematic approach. The results of the study show that the application of Islamic counseling is effective in dealing with post-suicide attempts in female adolescents who experience minor depression. In general, before attending counseling, adolescents experience depression and suicidal thoughts, but after attending counseling, adolescents feel relieved, happy, repent and return to the right path according to religious teachings. The application of Islamic counseling is able to provide positive changes from the spiritual, cognitive, affective and conative dimensions, so that the counselee has a psychological and spiritual health condition (mental health and spiritual health).&lt;/p&gt;

Cross-Cultural Efficacy of the Acceptance and Cognitive Restructuring Intervention Program (ACRIP) on the Internet Gaming Disorder Symptoms of Selected Asian Adolescents.

Empirical evidence shows that Internet Gaming Disorder (IGD) with poor psychological well-being increases. IGD hasbecome an emerging issue of significant public health concern andthe World Health Organization has recently recognized it as a mental health condition. This study examined the efficacy of the Acceptance and Cognitive Restructuring Intervention Program (ACRIP) in reducing the symptoms of IGD and improving the psychological well-being of adolescent gamers from select Asian cultures after proving it effective in a prior study in the Indian setting. The development of the ACRIP employed a sequential exploratory research design and randomized controlled trial on thirty participants. Internet Gaming Disorder (IGDS9-SF) and Ryff's Psychological well-being (PWB) scales were used to measure the severity of the gaming disorder and the state of psychological health of the experimental and control groups. Power analysis ascertained the study with a power of 0.90, indicating a strong probability of obtaining a statistically significant effect. Statistical analyses using paired t-test and MANOVA on post-test mean scores on IGD and PWB of the experimental group showed a significant difference which suggested that the ACRIP is efficacious and culture-free.

부모 온정적 양육행동, 유아 내재화 문제행동, 유아 놀이상호작용이 유아 사회적 유능감에 미치는 영향

Objectives The purpose of this study is to analyze the effects of parental warm parenting behavior, child’s internalization problem behavior, and child’s play interaction on child’s social competence.&#x0D; Methods This study used 7th data from the Korean Children’s Panel, and correlation analysis and stepwise multiple regression analysis were performed to analyze the correlation and influence of variables.&#x0D; Results Research results were as follows. First, parental warm parenting behavior, child’s internalization problem behavior, and child’s play interaction were found to have an effect on child’s social competence. And mother's warm parenting behavior showed the highest explanatory power for child’s social competence. Second, among the sub-factors of internalization problem behavior, atrophy had the greatest influence in all of the sub-factors of social competence, assertiveness, cooperation, self-control, and accountability.&#x0D; Conclusions Through this study, it was found that in order to develop an child’s social competence, both parents must show interest and affection for the child and show parenting behavior that encourages and supports the child. Furthermore, It was found that parents and teachers should help child maintain their psychological health status and support positive interactions with peers when playing.

Machine learning-based algorithms to predict severe psychological distress among cancer patients with spinal metastatic disease

BACKGROUND CONTEXTMetastatic spinal disease is an advanced stage of cancer patients and often suffer from terrible psychological health status; however, the ability to estimate the risk probability of this adverse outcome using current available data is very limited. PURPOSEThe goal of this study was to propose a precise model based on machine learning techniques to predict psychological status among cancer patients with spinal metastatic disease. STUDY DESIGN/SETTINGA prospective cohort study. PATIENT SAMPLEA total of 1043 cancer patients with spinal metastatic disease were included. OUTCOME MEASURESThe main outcome was severe psychological distress. METHODSThe total of patients was randomly divided into a training dataset and a testing dataset on a ratio of 9:1. Patients' demographics, lifestyle choices, cancer-related features, clinical manifestations, and treatments were collected as potential model predictors in the study. Five machine learning algorithms, including XGBoosting machine, random forest, gradient boosting machine, support vector machine, and ensemble prediction model, as well as a logistic regression model were employed to train and optimize models in the training set, and their predictive performance was assessed in the testing set. RESULTSUp to 21.48% of all patients who were recruited had severe psychological distress. Elderly patients (p<0.001), female (p =0.045), current smoking (p=0.002) or drinking (p=0.003), a lower level of education (p<0.001), a stronger spiritual desire (p<0.001), visceral metastasis (p=0.005), and a higher Eastern Cooperative Oncology Group (ECOG) score (p<0.001) were significantly associated with worse psychological health. With an area under the curve (AUC) of 0.865 (95% CI: 0.788–0.941) and an accuracy of up to 0.843, the gradient boosting machine algorithm performed best in the prediction of the outcome, followed by the XGBooting machine algorithm (AUC: 0.851, 95% CI: 0.768–0.934; Accuracy: 0.826) and ensemble prediction (AUC: 0.851, 95% CI: 0.770–0.932; Accuracy: 0.809) in the testing set. In contrast, the AUC of the logistic regression model was only 0.836 (95% CI: 0.756–0.916; Accuracy: 0.783). CONCLUSIONSMachine learning models have greater predictive power and can offer useful tools to identify individuals with spinal metastatic disease who are experiencing severe psychological distress.

Exploring the completeness of comprehensive geriatric assessment in relation to care outcomes in hospitalized older patients

Exploring the completeness of comprehensive geriatric assessment in relation to care outcomes in hospitalized older patients

FORMATION OF STRATEGIC REGIONAL DEVELOPMENT OF GAZUZI TOURISM AND RECREATION AFTER THE WAR IN UKRAINE

In the current conditions of the war (Russia against Ukraine), and before that the coronovirus pandemic, the tourism industry, one of the first to suffer and receive significant financial losses, also lost human resources and infrastructure. Therefore, at present, the question of the developed strategies for the development of tourism both in the country and at the regional level, and especially the question of the resort and recreation sphere, is acute. The potential of the sphere of tourism and recreation of the opportunities and resources of the natural, infrastructure of the Transcarpathian region, which after the war can be directed to the development of the tourist and recreational business and bring significant economic profit, has been studied. It was found that the functioning of the tourism and recreation industry is determined by three imperatives: economic, social, and ecological. The necessity of sanatorium-resort institutions in Transcarpathia is substantiated, the issue will become especially acute after the war, when it will be necessary to heal children and improve their psychological state of health, disturbed by the war. The necessity of developing a regional level mechanism for the development of tourism and recreation in Ukraine after the end of the war, aimed at monitoring changes in the external and internal environment of the functioning of regional tourism and recreation or introducing changes for better development of the industry and opportunities, which will contribute to competitiveness in achieving strategic goals, is proposed. and economic development. At the same time, cooperation between authorities and local self-government is necessary, and most importantly, support for the tourism sector.

Sensitivity of outcome instruments in a priori selected patient groups after traumatic brain injury: Results from the CENTER-TBI study.

Traumatic brain injury (TBI) can negatively impact patients' lives on many dimensions. Multiple instruments are available for evaluating TBI outcomes, but it is still unclear which instruments are the most sensitive for that purpose. This study examines the sensitivity of nine outcome instruments in terms of their ability to discriminate within and between specific patient groups, selected a priori as identified from the literature, at three different time points within a year after TBI (i.e., 3, 6, and 12 months post injury). The sensitivity of the instruments to sociodemographic (sex, age, education), premorbid (psychological health status), and injury-related (clinical care pathways, TBI and extracranial injury severity) factors was assessed by means of cross-sectional multivariate Wei-Lachin analyses. The Glasgow Outcome Scale Extended (GOSE)-the standard in the field of TBI for measuring functional recovery-demonstrated the highest sensitivity in most group comparisons. However, as single functional scale, it may not be able to reflect the multidimensional nature of the outcome. Therefore, the GOSE was used as a reference for further sensitivity analyses on more specific outcome scales, addressing further potential deficits following TBI. The physical component summary score (PCS) of the generic health-related quality of life (HRQOL) instruments (SF-36v2/-12v2) and the TBI-specific HRQOL instruments (QOLIBRI/-OS) were most sensitive in distinguishing recovery after TBI across all time points and patient groups, followed by the RPQ assessing post-concussion symptoms and the PHQ-9 measuring depression. The SF-36v2/-12v2 mental component summary score and the GAD-7 measuring anxiety were less sensitive in several group comparisons. The assessment of the functional recovery status combined with generic HRQOL (the PCS of the SF-12v2), disease-specific HRQOL (QOLIBRI-OS), and post-concussion symptoms (RPQ) can provide a sensitive, comprehensive, yet time-efficient evaluation of the health status of individuals after TBI in different patient groups.