title: 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 here. 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 multicenter validation studies. The first study, with eight language versions of the QOLIBRI, recruited 1528 participants with TBI, and the second with six language versions, recruited 921 participants. The data from 795 participants from the second study who had complete Glasgow Coma Scale (GCS) and Glasgow Outcome Scale (GOS) data were used to finalize the instrument. The final version of the QOLIBRI consists of 37 items in six scales (see Appendix ). 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, alpha = 0.75-0.89, test-retest reliability, r(tt) = 0.78-0.85). Test-retest reliability (r(tt) = 0.68-0.87) as well as internal consistency (alpha = 0.81-0.91) were 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 modeling. The QOLIBRI is a new cross-culturally developed instrument for assessing HRQoL after TBI that fulfills standard psychometric criteria. It is potentially useful for clinicians and researchers conducting clinical trials, for assessing the impact of rehabilitation or other interventions, and for carrying out epidemiological surveys.
authors.affiliation: Department of Medical Psychology and Medical Sociology, Georg-August-University, Goettingen, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: von Steinbüchel
authors.forename: Lindsay
authors.initials: L
authors.lastname: Wilson
authors.forename: Henning
authors.initials: H
authors.lastname: Gibbons
authors.forename: Graeme
authors.initials: G
authors.lastname: Hawthorne
authors.forename: Stefan
authors.initials: S
authors.lastname: Höfer
authors.forename: Silke
authors.initials: S
authors.lastname: Schmidt
authors.forename: Monika
authors.initials: M
authors.lastname: Bullinger
authors.forename: Andrew
authors.initials: A
authors.lastname: Maas
authors.forename: Edmund
authors.initials: E
authors.lastname: Neugebauer
authors.forename: Jane
authors.initials: J
authors.lastname: Powell
authors.forename: Klaus
authors.initials: K
authors.lastname: von Wild
authors.forename: George
authors.initials: G
authors.lastname: Zitnay
authors.forename: Wilbert
authors.initials: W
authors.lastname: Bakx
authors.forename: Anne-Lise
authors.initials: AL
authors.lastname: Christensen
authors.forename: Sanna
authors.initials: S
authors.lastname: Koskinen
authors.forename: Jaana
authors.initials: J
authors.lastname: Sarajuuri
authors.forename: Rita
authors.initials: R
authors.lastname: Formisano
authors.forename: Nadine
authors.initials: N
authors.lastname: Sasse
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Truelle
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000150:complications* / Q000503:physiopathology / Q000523:psychology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards; D055815:Young Adult