Subjective complaints after acquired brain injury: presentation of the Brain Injury Complaint Questionnaire (BICoQ)

Abstract

The objective of the present study was to present a new complaint questionnaire designed to assess a wide range of difficulties commonly reported by patients with acquired brain injury.Patients (n 5 619) had been referred to a community re-entry service at a chronic stage after brain injury, mainly traumatic brain injury (TBI). The Brain Injury Complaint Questionnaire (BICoQ) includes 25 questions in the following domains: cognition, behavior, fatigue and sleep, mood, and somatic problems. A self and a proxy questionnaire were given. An additional question was given to the relative, about the patient's awareness of his difficulties. The questionnaires had a good internal coherence, as measured with Cronbach's alpha. The most frequent complaints were, in decreasing order, mental slowness, memory troubles, fatigue, concentration difficulties, anxiety, and dual tasking problems. Principal component analysis with varimax rotation yielded six underlying factors explaining 50.5% of total variance: somatic concerns, cognition, and lack of drive, lack of control, psycholinguistic disorders, mood, and mental fatigue/slowness. About 52% of patients reported fewer complaints than their proxy, suggesting lack of awareness. The total complaint scores were not significantly correlated with any injury severity measure, but were significantly correlated with disability and poorer quality of life (Note: only factor 2 [cognition/lack of drive] was significantly related to disability.) The BICoQ is a simple scale that can be used in addition to traditional clinical and cognitive assessment measures, and to assess awareness of everyday life problems.

A Detailed Overview of Long-Term Outcomes in Severe Traumatic Brain Injury Eight Years Post-injury

“…For the study, we created a questionnaire to assess the neurological and somatic impairments. Patients were asked the following question “What are the physical difficulties you have because of head trauma?.” Eleven of the most frequent deficiencies reported in previous studies were proposed with the possibility of classifying them as “none,” “moderate,” “severe.” Cognitive and behavioral complaints were investigated with the Brain Injury Complaint Questionnaire (BICoQ), after the following explanation “We will ask you questions about the problems you face in your everyday life since the TBI.” Twenty-five closed questions were given addressing frequently reported cognitive and behavioral complaints (19, 24). The same questions were asked to their relatives.…”

Self-awareness four years after severe traumatic brain injury: discordance between the patient’s and relative’s complaints. Results from the PariS-TBI study

“…This questionnaire has two versions, a patient version consisting of 25 questions, and a family (or close friend) version consisting of the same 25 questions along with a question on lack of awareness. 21 It consists of closed questions (yes/no) about cognitive processes (language, memory, attention and executive function), fatigue, mood, sleep, somatic disorders and behaviour (irritability/apathy). Examples of questions are 'Are you irritable?'…”

“…The questionnaire has been validated in a population of 619 patients with chronic acquired brain injury (mainly TBI or stroke); it has a good internal coherence (Cronbach alpha coefficients 0.84 and 0.83 for patient and proxy rating). 21 The unawareness index was calculated from the Brain Injury Complaint Questionnaire: it corresponds to the number of 'yes' responses by the relative when the patient rating was 'no'. This provided a measure of the discordance between the patient and relative, measuring the degree of under evaluation of difficulties by the patient, and avoiding the smoothing effect produced by a simple difference in scores.…”

CoCo - participation: The development and clinical use of a novel inventory measuring cognitive complaints in daily life

“…For instance, relatives have overestimated patients with ABI in their communication abilities (McClenahan, Johnston, & Densham, 1990, 1992Seel et al, 1997), or overall functioning (Cavallo, Kay, & Ezrachi, 1992;Cusick, Gerhart, & Mellick, 2000). Previous research shows that agreement tends to be lower for invisible symptoms (e.g., memory problems), but higher for observable symptoms (e.g., writing) (Hochstenbach et al, 2005;Vallat-Azouvi et al, 2018). Fatigue was probably more observable for relatives, hence patients and relatives reported a comparable level of fatigue.…”