Quality of Life after Brain Injury (QOLIBRI): Scale Development and Metric Properties

Abstract

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.

Clinical study of quality of life of traumatic brain injury patients after decompressive craniectomy and related influencing factors

“…Extreme skewness can however create problems for analysis using correlations, reducing the probability that a scale will show strong relationships with other measures, and its reliability (or precision of measurement) of a scale. Skewness was checked but, however, some moderately skewed items were included, to capture a range of impairments [19]. Multivariate regression analyses were performed for the influence of sex, age, educational level, TBI to DC time, Worst GCS score, pupillary response, TBI to questionnaire time, whether performed cranioplasty, systolic blood pressure, diastolic blood pressure, temperature of patient, midline shift on computed tomography scan, fasting blood glucose, whether or not treated in a rehabilitation center, days of use of mannitol and use of barbiturate sedation to the 6 different QOLI-BRI domain scores and total score.…”

“…The test-retest reliability of the QOLIBRI scales was assessed using the intra-class correlation coefficient (ICC), calculated between the scale means on two occasions (retested on average 14 days after initial testing). The conventional interpretation of the ICC is that values of 0.40-0.75 are fair to good and values over 0.75 are excellent [19].…”

“…It can help to identify and set appropriate goals for therapy. Score shifts in individual domains may reflect areas of life where gains or drawbacks consequent to treatment are made [6,19,30].…”

“…QOLIBRI is a multidimensional view of HRQOL, encompassing well-being and functioning in physical, psychological (cognitive and emotional), social, and daily life domains, with the patient viewed as the best source of information on his or her subjective state [6,19]. The psychometric properties, correlations with neuropsychological tests and cross cultural validity of QOLIBRI have proved to overcome all the short comings in the previously present HRQOL instruments [20].…”

Yoga after Traumatic Brain Injury: Changes in Emotional Regulation and Health-Related Quality of Life in a Case-Study

“…The QOLIBRI is a 37-item questionnaire that includes a 5-point Likert scale with scoring from 1 "not at all satisfied" to 5 "very satisfied" [38]. Part one measures satisfaction level regarding cognition, feelings and emotions, autonomy and daily life, and social relationships.…”