German validation of Quality of Life after Brain Injury (QOLIBRI) assessment and associated factors

PLoS One. 2017 May 24;12(5):e0176668. doi: 10.1371/journal.pone.0176668. eCollection 2017.

Abstract

The consequences of traumatic brain injury (TBI) for health-related quality of life (HRQoL) are still poorly understood, and no TBI-specific instrument has hitherto been available. This paper describes in detail the psychometrics and validity of the German version of an internationally developed, self-rated HRQoL tool after TBI-the QOLIBRI (Quality of Life after Brain Injury). Factors associated with HRQoL, such as the impact of cognitive status and awareness, are specifically reported. One-hundred seventy-two participants after TBI were recruited from the records of acute clinics, most of whom having a Glasgow Coma Scale (GCS) 24-hour worst score and a Glasgow Outcome Scale (GOSE) score. Participants had severe (24%), moderate (11%) and mild (56%) injuries as assessed on the GCS, 3 months to 15 years post-injury. The QOLIBRI uses 37 items to measure "satisfaction" in the areas of "Cognition", "Self", "Daily Life and Autonomy", and "Social Relationships", and "feeling bothered" by "Emotions"and "Physical Problems". The scales meet standard psychometric criteria (α = .84 to .96; intra-class correlation-ICC = .72 to .91). ICCs (0.68 to 0.90) and αs (.83 to .96) were also good in a subgroup of participants with lower cognitive performance. The six-subscale structure of the international sample was reproduced for the German version using confirmatory factor analyses and Rasch analysis. Scale validity was supported by systematic relationships observed between the QOLIBRI and the GOSE, Patient Competency Rating Scale for Neurorehabilitation (PCRS-NR), Hospital Anxiety and Depression Scale (HADS), Profile of Mood States (POMS), Short Form 36 (SF-36), and Satisfaction with Life Scale (SWLS). The German QOLIBRI contains novel information not provided by other currently available measures and has good psychometric criteria. It is potentially useful for clinicians and researchers, in post-acute and rehabilitation studies, on a group and individual level.

Publication types

  • Multicenter Study
  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bacterial Proteins
  • Brain Injuries / diagnosis*
  • Brain Injuries / psychology*
  • Factor Analysis, Statistical
  • Female
  • Germany
  • Glasgow Outcome Scale
  • Humans
  • Interviews as Topic
  • Male
  • Membrane Proteins
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Phosphotransferases
  • Principal Component Analysis
  • Psychometrics
  • Quality of Life*
  • Reproducibility of Results
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Bacterial Proteins
  • Membrane Proteins
  • Phosphotransferases
  • TeiR protein, Comamonas testosteroni

Grants and funding

This project was funded by the ZNS – Hannelore Kohl Foundation (project number 2008014; www.hannelore-kohl-stiftung.de), the German Research Foundation, and the Open Access Publication Funds of the Göttingen University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.