The Association of Post-Concussion and Post-Traumatic Stress Disorder Symptoms with Health-Related Quality of Life, Health Care Use and Return-to-Work after Mild Traumatic Brain Injury

Vlegel, Marjolein van der; Polinder, Suzanne; Mikolić, Ana; Kaplan, Rana; Steinbüechel, Nicole von; Plass, Anne Marie; Zeldovich, Marina; Praag, Dominique Van; Bockhop, Fabian; Cunitz, Katrin; Mueller, Isabelle; Haagsma, Juanita A.

doi:10.3390/jcm10112473

Cited by 17 publications

(19 citation statements)

References 46 publications

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“…Nonetheless, we found significantly reduced functional level, higher symptom burden and lower quality of life in complicated mTBI compared to uncomplicated cases. This is in line with previous studies that consider complicated mTBI as a more severe brain injury than uncomplicated mTBI [ 1 , 2 , 4 ]. Indeed, Scandinavian guidelines for initial management of minimal, mild, and moderate TBI [ 28 ] recommend that patients with mTBI (GCS 13–15) who have intracranial findings on CT-scans should be managed as patients with moderate TBI.…”

Section: Discussionsupporting

confidence: 92%

“…A high number of patients experience prolonged symptoms, disabilities, and diminished health-related quality of life (HRQOL) after mild traumatic brain injury (mTBI) [ 1 , 2 ]. In the first six months after injury, patients with complicated mTBI (presence of intracranial injury on computed tomography, CT) report higher symptom burden, poorer functional outcomes and lower HRQOL than those with uncomplicated injury [ 1 , 3 – 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…In the first six months after injury, patients with complicated mTBI (presence of intracranial injury on computed tomography, CT) report higher symptom burden, poorer functional outcomes and lower HRQOL than those with uncomplicated injury [ 1 , 3 – 5 ]. A subgroup of patients with mTBI and extra-cranial injuries also report more symptoms and functional deficits [ 2 ]. These patients tend to have longer acute hospital stays and several different care pathways [ 6 ] and are often in need of regular follow-up and provision of acute and post-acute rehabilitation services [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Rehabilitation and outcomes after complicated vs uncomplicated mild TBI: results from the CENTER-TBI study

Howe

Zeldovich²,

Anđelić³

et al. 2022

BMC Health Serv Res

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Background Despite existing guidelines for managing mild traumatic brain injury (mTBI), evidence-based treatments are still scarce and large-scale studies on the provision and impact of specific rehabilitation services are needed. This study aimed to describe the provision of rehabilitation to patients after complicated and uncomplicated mTBI and investigate factors associated with functional outcome, symptom burden, and TBI-specific health-related quality of life (HRQOL) up to six months after injury. Methods Patients (n = 1379) with mTBI from the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) study who reported whether they received rehabilitation services during the first six months post-injury and who participated in outcome assessments were included. Functional outcome was measured with the Glasgow Outcome Scale – Extended (GOSE), symptom burden with the Rivermead Post Concussion Symptoms Questionnaire (RPQ), and HRQOL with the Quality of Life after Brain Injury – Overall Scale (QOLIBRI-OS). We examined whether transition of care (TOC) pathways, receiving rehabilitation services, sociodemographic (incl. geographic), premorbid, and injury-related factors were associated with outcomes using regression models. For easy comparison, we estimated ordinal regression models for all outcomes where the scores were classified based on quantiles. Results Overall, 43% of patients with complicated and 20% with uncomplicated mTBI reported receiving rehabilitation services, primarily in physical and cognitive domains. Patients with complicated mTBI had lower functional level, higher symptom burden, and lower HRQOL compared to uncomplicated mTBI. Rehabilitation services at three or six months and a higher number of TOC were associated with unfavorable outcomes in all models, in addition to pre-morbid psychiatric problems. Being male and having more than 13 years of education was associated with more favorable outcomes. Sustaining major trauma was associated with unfavorable GOSE outcome, whereas living in Southern and Eastern European regions was associated with lower HRQOL. Conclusions Patients with complicated mTBI reported more unfavorable outcomes and received rehabilitation services more frequently. Receiving rehabilitation services and higher number of care transitions were indicators of injury severity and associated with unfavorable outcomes. The findings should be interpreted carefully and validated in future studies as we applied a novel analytic approach. Trial registration ClinicalTrials.gov NCT02210221.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Rehabilitation and outcomes after complicated vs uncomplicated mild TBI: results from the CENTER-TBI study

Howe

Zeldovich²,

Anđelić³

et al. 2022

BMC Health Serv Res

Self Cite

View full text Add to dashboard Cite

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“…It has 20 items and can be used to assess the 20 symptoms of PSTD from the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition). A 5-point scale is used (0 = “Not at all” to 4 = “Extremely”) in the range of 0–80 (Blevins et al, 2015), with scores of 33 and above indicating PTSD (Stein et al, 2019; van der Vlegel et al, 2021). The content validity index of the questionnaire used in Indonesia is 0.96, and Cronbach's α value for the reliability test is 0.87 (Arnika, 2017).…”

Section: Methodsmentioning

confidence: 99%

Early Quality-of-Life Changes in Mild Traumatic Brain Injury: A Prospective Study

Mulyadi

Harianto

Tonapa

et al. 2023

Journal of Trauma Nursing

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“…Individuals with PTSD reported a decline in physical, mental, and social function, in addition to reduced quality of life. 5 PTSD was applied to cancer patients when the Fourth Edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) diagnostic criteria were expanded to a broader variety of traumatic events, including life-threatening disease. 6 Changes in DSM-5 diagnostic criteria for PTSD raise specific concerns on the evaluation of cancer-related PTSD, since they state that a life-threatening disease or debilitating medical condition is not necessarily considered a traumatic event.…”

Section: Introductionmentioning

confidence: 99%

The Role of Mental Adjustment in Mediating Post-Traumatic Stress Disorder Symptoms and Social Support in Chinese Ovarian Cancer Patients: A Cross-Sectional Study

Pang¹,

Li²,

Zhang³

2022

PRBM

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Background Post-traumatic stress disorder (PTSD) can manifest in individuals following a traumatic event. There is a paucity of studies focusing on PTSD symptoms in ovarian cancer (OC) patients. This study aimed to investigate the association of social support, mental adjustment and PTSD symptoms in Chinese OC patients with a view to exploring whether mental adjustment could mediate the relationship. Methods A cross-sectional study was conducted from January 2015 to December 2016. A total of 171 OC subjects were recruited and the effective response rate was 81.3%. The PTSD Checklist-Civilian Version (PCL-C), Mini-Mental Adjustment to Cancer scale (Mini-MAC) and Duke-UNC Functional Social Support Questionnaire were disseminated to the patients. The Chinese Mini-MAC was used in this study focusing on three components, namely negative emotion, positive attitude, and cognitive avoidance. Hierarchical linear regression analyses were employed to investigate the association of social support and PTSD symptoms, and the role of mental adjustment in their mediation. Results The prevalence of PTSD symptoms was 17.3% in OC patients. PTSD symptoms were negatively related with both social support and positive attitude, and positively associated with negative emotion and cognitive avoidance. Social support was negatively associated with negative emotion and cognitive avoidance, and positively related with positive attitude. In addition, negative emotion and positive attitude mediated the association between social support and PTSD symptoms. Conclusion PTSD symptoms in OC patients should be paid attention to. Social support and mental adjustment were positive resources associated with PTSD symptoms. Moreover, mental adjustment could mediate the relation between social support and PTSD symptoms in OC patients. Therefore, intervention management that focusing on improving perceived social support as well as strengthening mental adjustment, especially negative emotion and positive attitude, may be useful for reducing PTSD symptoms in this context.

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The Association of Post-Concussion and Post-Traumatic Stress Disorder Symptoms with Health-Related Quality of Life, Health Care Use and Return-to-Work after Mild Traumatic Brain Injury

Cited by 17 publications

References 46 publications

Rehabilitation and outcomes after complicated vs uncomplicated mild TBI: results from the CENTER-TBI study

Rehabilitation and outcomes after complicated vs uncomplicated mild TBI: results from the CENTER-TBI study

Early Quality-of-Life Changes in Mild Traumatic Brain Injury: A Prospective Study

The Role of Mental Adjustment in Mediating Post-Traumatic Stress Disorder Symptoms and Social Support in Chinese Ovarian Cancer Patients: A Cross-Sectional Study

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