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Arch Phys Med Rehabil. 2018 Jan 31. pii: S0003-9993(18)30043-1. doi: 10.1016/j.apmr.2017.11.018. [Epub ahead of print]

Responsiveness of the Traumatic Brain Injury-Quality of Life (TBI-QOL) Measurement System.

Author information

1
Brain Injury Research Center, TIRR Memorial Hermann, Houston, Texas. Electronic address: Julia.Poritz@memorialhermann.org.
2
Brain Injury Research Center, TIRR Memorial Hermann, Houston, Texas; Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas.
3
Center for Health Assessment Research and Translation, University of Delaware, Newark, Delaware.
4
Department of Biostatistics, University of Texas Health Science Center at Houston, School of Public Health, Houston, Texas.

Abstract

OBJECTIVE:

To assess the responsiveness of the Traumatic Brain Injury-Quality of Life (TBI-QOL) measurement system.

DESIGN:

Participants completed the 20 TBI-QOL item banks and the Participation Assessment with Recombined Tools-Objective (PART-O) Productivity Subscale at baseline and 6-month follow-up assessments. Participants were categorized into 4 groups (increased productivity, unchanged productivity, and decreased productivity) based on PART-O Productivity scores. Paired sample t tests were used to compare TBI-QOL scores at baseline and 6 months, and standardized response means and Cohen's d were computed to estimate effect sizes.

SETTING:

Three traumatic brain injury (TBI) Model Systems rehabilitation centers in the United States.

PARTICIPANTS:

Two hundred one community-dwelling adults with TBI.

INTERVENTIONS:

Not applicable.

MAIN OUTCOME MEASURES:

20 TBI-QOL item banks.

RESULTS:

As expected, given that there was no intervention, group mean TBI-QOL subdomain scores for the entire sample showed no change or small improvement over the 6-month study period. At the follow-up assessment, 72 participants reported increased productivity, 71 reported decreased productivity, and 58 reported the same level of productivity as they had 6 months prior. When compared with participants who reported unchanged or decreased productivity, participants who reported increased productivity on the PART-O subscale had clinically meaningful (d≥0.30) improvements on 7 TBI-QOL measures. The largest improvement was in the Independence subdomain (mean change, 7.06; df=0.84), with differences also observed in the Mobility, Positive Affect and Well-Being, Resilience, Grief/Loss, Ability to Participate, and Satisfaction with Participation subdomains.

CONCLUSIONS:

The 20 TBI-QOL item banks demonstrate responsiveness to change and measurement stability in a community-dwelling sample. Researchers may use the TBI-QOL to detect changes in HRQOL after a clinical intervention and clinicians may use it in their daily practices to monitor patient recovery.

KEYWORDS:

Health-related quality of life; Patient-reported outcome measure; Traumatic brain injury

PMID:
29407517
DOI:
10.1016/j.apmr.2017.11.018

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