Psychosocial Quality of Life After Traumatic Brain Injury Among Children in Uganda 

Abstract

Background: Traumatic Brain Injury (TBI) is a leading cause of sudden death and disability amongst young people. About 28% of children managed for TBI in Uganda report some degree of physical disability one-year post-injury, but little is known about their psychosocial outcomes. We aimed to elucidate the psychosocial outcomes of children with TBI, and associated factors.Methods: A cross-sectional study carried out in the Neurosurgical Unit of Mulago National Referral Hospital (MNRH), Uganda. The Pediatric Quality of Life Inventory version 4.0 parent-proxy was administered to parents/guardians of children aged 6 to 17 years who were previously managed for TBI in MNRH more than a year post-injury; their medical records were also retrieved. Linear regression was used to determine factors associated with psychosocial outcomes.Results: A total of 116 children were recruited. The overall mean psychosocial functioning was 82 ± 22.74. Using a standard deviation below the mean score as a cut-off standard,85.7% of those children had good psychosocial functioning versus 14.3% with poor functioning. A long time of more than 2 years post-TBI (adjusted β = 1.36, p=0.012) and absence of associated injuries (adjusted β= 0.30, p=0.025) were associated with good psychosocial functioning, while TBI severity was negatively associated with poor psychosocial functioning (adjusted β= -0.36, p=0.041).Conclusion: Children managed for TBI continue to have psychosocial dysfunctioning after one year following injury, although continued improvement is observed even after 2 years. The severity of TBI and the presence of associated injuries are important determinants of the psychosocial quality of life of children. Multi-disciplinary supportive care should be very effective during the first 2 years following the injury to improve the quality of life of children with TBI.