Quality of Life after Traumatic Brain Injury

The Quality of Life after TBI (QOLIBRI) questionnaire was designed specifically to measure the quality of life of those who have sustained a TBI (Truelle et al. 2010). Prior to the creation of the scale, the following items were reviewed: Quality of Life of the TBI, The Profile de la Qualite de la View Subjective, The Brain Injury Community Rehabilitation Outcome scale, and the European Brain Injury Questionnaire. All items from each of the questionnaires were reviewed. Following a review of the items and an assessment of their psychometric properties, a preliminary QOLIBRI was developed which consisted of 49 items arranged into eight subscales (von Steinbuchel et al. 2010).

The final QOLIBRI consists of 37 items in six subscales including cognition (7 items), self (7 items), daily life and autonomy (7 items) and social relationships (6 items), emotions (5 items) and physical problems (5 items). The first four subscales are coded on a 1 to 5 scale where 1 is not at all satisfied and 5 is very satisfied. The responses to the last two subscales (emotion and physical problems) are reverse scored to correspond with the satisfaction items. Here 1 is very bothered and 5 is not at all bothered. Responses for each subscale are summed to give a total, which is then divided by the number of responses to give the scale a mean score. The scale means have a maximum possible range of 1 to 5. The mean can be computed when there are some missing responses, but should not be calculated if more than one third of responses on the scale are missing. In a similar manner the QOLIBRI total score is calculated by summing all the responses, and then dividing by the actual number of responses. Again, a total score should not be calculated if more than one third of responses are missing (www.qolibrinet.com). The scales have also been translated into seven languages and have been tested with each language cohort. The test is available for no cost at http://www.qolibrinet.com/registration.htm.

Table: Characteristics of the Quality of Life after Traumatic Brain Injury

Advantages. This scale was designed specifically for the ABI population and has been translated into six other languages. To date, this is the only scale designed specifically for those who have sustained either an ABI or a TBI. The composite measure has the advantage of covering both functional outcomes post ABI and Health-Related QoL (HRQoL) post ABI.

Limitations. Like so many other scales measuring quality of life, the important limitation is the complexity of HRQoL, as it remains virtually impossible to capture and define an individual’s view of the future, the concept of individuality, and the experience of intimacy (Truelle et al. 2010). The conclusions of the study are based on the approach to recruitment. Subjects where subjects were chosen at various times across a multitude of settings (convenience sampling), and therefore the sample was scale orientated, not patient focused (Truelle et al. 2010).

 

Summary- Quality of Life after Traumatic Brain Injury

Interpretability: Results are easy to interpret, with lower scores indicating a better QoL.

Acceptability: The scale, available in seven languages, is a self-report of how well the individual perceives themselves as doing. 

Feasibility: The scale is now available and ready for more regular use. It is easy to use, available in a variety of languages and there is no fee for its use.

 

Table: Quality of Life after Traumatic Brain Injury Evaluation Summary

Reliability

Validity

Responsiveness

Rigor

Results

Rigor

Results

Rigor

Results

Floor/ceiling

+++

+++ (TR)

+++(IC)

+++

 

++

N/A

N/A

N/A

NOTE: +++=Excellent; ++=Adequate; +=Poor; N/A=insufficient information; TR=Test re-test; IC=Internal Consistency; IO=Interobserver; Varied (re. floor/ceiling effects; mixed results).