German validation of Quality of Life after Brain Injury (QOLIBRI) assessment and associated factors

Abstract

The consequences of traumatic brain injury (TBI) for health-related quality of life (HRQoL) are still poorly understood, and no TBI-specific instrument has hitherto been available. This paper describes in detail the psychometrics and validity of the German version of an internationally developed, self-rated HRQoL tool after TBI—the QOLIBRI (Quality of Life after Brain Injury). Factors associated with HRQoL, such as the impact of cognitive status and awareness, are specifically reported. One-hundred seventy-two participants after TBI were recruited from the records of acute clinics, most of whom having a Glasgow Coma Scale (GCS) 24-hour worst score and a Glasgow Outcome Scale (GOSE) score. Participants had severe (24%), moderate (11%) and mild (56%) injuries as assessed on the GCS, 3 months to 15 years post-injury. The QOLIBRI uses 37 items to measure “satisfaction” in the areas of “Cognition”, “Self”, “Daily Life and Autonomy”, and “Social Relationships”, and “feeling bothered” by “Emotions”and “Physical Problems”. The scales meet standard psychometric criteria (α = .84 to .96; intra-class correlation—ICC = .72 to .91). ICCs (0.68 to 0.90) and αs (.83 to .96) were also good in a subgroup of participants with lower cognitive performance. The six-subscale structure of the international sample was reproduced for the German version using confirmatory factor analyses and Rasch analysis. Scale validity was supported by systematic relationships observed between the QOLIBRI and the GOSE, Patient Competency Rating Scale for Neurorehabilitation (PCRS-NR), Hospital Anxiety and Depression Scale (HADS), Profile of Mood States (POMS), Short Form 36 (SF-36), and Satisfaction with Life Scale (SWLS). The German QOLIBRI contains novel information not provided by other currently available measures and has good psychometric criteria. It is potentially useful for clinicians and researchers, in post-acute and rehabilitation studies, on a group and individual level.

The psychometric validation of the Dutch version of the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) after Traumatic Brain Injury (TBI)

“…Further, TBI severity was rated using the Glascow Coma Scale (GCS), with scores between 3-8 indicating severe, 9-12 moderate, and 13-15 mild TBI (20–24). The GCS was administered within the first 24 hours after the brain injury occurred.…”

Critical Care Management of Traumatic Brain Injury

“…The resulting score gives a measure of QOL out of a total possible score of 100. Other popular HRQOL indices used for TBI patients are Short Form 36 (SF-36), 81 Glasgow Outcome Scale -Extended (GOS-E), 82 quality of life after Brain Injury (QOLIBRI) 83 and Telephone Interview for Cognitive Status and Brain Injury Grief Inventory (BIGI). 84…”

Cognition and Intervention in Traumatic Brain Injury

“…Taken together, the evidence implies that the cognitive-emotion condition of TBI patient is hazardous from the point of view of health and well-being, particularly with to the mild, moderate and severe levels of infirmity [32]. Despite the cognitive impairments arising from limited-to-substantial connectivity with white and gray matter that result in widespread disharmony among essential network systems, the potential for promising interventional therapies seems both efficacious and technologically innovative, such as at synaptic sites of neural plasticity [33].…”