The consequences of traumatic brain injury (TBI) for health-related quality of life (HRQoL) are poorly investigated, and a TBI-specific instrument has not previously been available. The cross-cultural development of a new measure to assess HRQoL after TBI is described.An international TBI Task Force derived a conceptual model from previous work, constructed an initial item bank of 148 items, and then reduced the item set through two successive multi-centre validation studies. The first study with eight language versions of the QOLIBRI recruited 1528 participants with TBI and the second with six language versions 921 participants. The data from 795 participants from the second study who had complete GCS and GOS data were used to finalise the instrument.The final version of the QOLIBRI consists of 37 items in six scales. Satisfaction is assessed in the areas of "Cognition", "Self", "Daily life and Autonomy", and "Social Relationships" and feeling bothered by "Emotions "and "Physical Problems". The QOLIBRI scales meet standard psychometric criteria (internal consistency, = .75 to .89, test-retest reliability, r tt = .78 to .85). Test-retest reliability (r tt = 0.68 to 0.87) as well as internal consistency ( = .81 to .91) was also good in a subgroup of participants with lower cognitive performance. Although there is one strong HRQoL factor, a six scale structure explaining additional variance was validated by exploratory and confirmatory factor analyses and with Rasch modelling.The QOLIBRI is a new cross-culturally developed instrument for assessing HRQoL after TBI that fulfils standard psychometric criteria. It is potentially useful for clinicians and researchers conducting clinical trials, assessing the impact of rehabilitation or other interventions, or carrying out epidemiological surveys.
The authors found no difference in time to tracheal intubation between awake FFI and awake MVL intubation performed by experienced anesthesiologists in patients with anticipated difficult airway.
Results are reported from an international project the aim of which has been to develop and validate a wide-ranging questionnaire suitable for administration to brain-injured patients and their relatives. A self-report questionnaire concerning subjective experience of cognitive, emotional and social difficulties (The European Brain Injury Questionnaire, EBIQ) was administered to a group of 905 brain-injured patients, and close relatives to these competed a parallel version of the questionnaire concerning the brain-injured person. The sample was drawn from seven European countries together with Brazil. The same questionnaire was also administered to a group of 203-non-brain-injured controls, similarly in self-report and relative-report versions. Scales relating to eight specific areas of functioning, together with a global scale, are derived from the questionnaire and their internal reliability was estimated in the present data. Analyses of the 63 items of the questionnaire showed consistently greater levels of problems for the brain-injured group, especially as indicated by relatives. This pattern was substantially replicated among the nine scales. The scales discriminated well between stroke patients and those who had suffered a traumatic brain injury. There was also a tendency for reported problems to be greater for patients who were surveyed later post-injury (> or = 19 months) rather than earlier. Comparison of sets of controls derived from two countries (France and Brazil) showed small but important differences. It is concluded that the questionnaire has an acceptable reliability and validity, but that it will be necessary to obtain culturally relevant non-brain-injured control data when employing it in different countries.
A cohort of 33 people at risk for Huntington's disease (HD), applying for genetic testing, were tested with a battery of neuropsychological tests covering attentional, visuospatial, learning, memory, and planning functions. A psychiatric rating scale, SCL-90R, was also applied, mainly as a control, since cognitive dysfunction could be ascribed to functional disorders as well as neurodegenerative processes.Self-rating did not indicate any psychiatric symptoms in carriers or noncarriers. However, significantly inferior cognitive functioning in the gene carriers was disclosed by the neuropsychological tests. Primarily, attentional, learning, and planning functions were affected. It is concluded that premorbid cognitive decline occurs in HD. concerning the presence of neuropsychological dysfunction. However, one of the most recent studies found "evidence of presymptomatic cognitive decline in HD"." Closely related to the neuropsychological studies is the issue ofpresymptomatic and early psychiatric symptoms.'3-" The main finding in this area is that depression is common, but that severe psychiatric morbidity is seldom present in these stages of HD.In our study, a battery of neuropsychological tests covering basic as well as more complex cognitive functions related to different parts of the brain was used. A self-rating scale for psychiatric symptoms was added mainly as a control, as neuropsychological dysfunction could be ascribed to psychiatric illness as well as neurodegenerative processes. Materials and methodsThe first Danish persons at risk for HD attending for genetic testing were consecutively included in a cohort of 40 subjects. The recommendations for procedure of genetic testing programmes were followed."6 The study was SELF-RATING SCALEThe Symptom Checklist-90 items revised (SCL-90R), a self-rating scale providing quality and intensity of psychopathology, was used. Ninety items are rated from 0 (= not at all) through 1 (=a little bit), 2 (=moderately), and 3 (= quite a bit) to 4 (=extremely) and clustered to dimensions of psychopathology."7 600 on 9 May 2018 by guest. Protected by copyright.
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