title: Chronic stress and fatigue-related quality of life after mild to moderate traumatic brain injury.
abstract: OBJECTIVE
  To determine relationships among chronic stress, fatigue-related quality of life (QOL-F), and related covariates after mild to moderate traumatic brain injury (TBI).
  
  
  METHODS
  Observational and cross-sectional.
  
  
  METHODS
  A total of 84 community-dwelling individuals with mild to moderate TBI recruited from multiple out patient rehabilitation clinics assessed on average 15 months after injury.
  
  
  METHODS
  Self-report surveys and chart abstraction.
  
  
  METHODS
  Neurofunctional Behavioral Inventory, Perceived Stress Scale-14, Impact of Events Scale, McGill Pain Short-form Scale, and modified version of the Fatigue Impact Scale.
  
  
  RESULTS
  QOL-F was associated with somatic symptoms, perceived situational stress, but not with event-related stress (posttraumatic stress disorder symptoms) related to index TBI, preinjury demographic, or postinjury characteristics. Somatic symptoms and chronic situational stress accounted for 42% of the variance in QOL-F.
  
  
  CONCLUSIONS
  QOL-F in community-dwelling individuals with mild to moderate TBI is associated with chronic situational stress and somatic symptoms. Symptom management strategies may need to include general stress management to reduce fatigue burden and improve quality of life.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI 48108, USA. pdq@med.umich.edu
authors.forename: Esther
authors.initials: E
authors.lastname: Bay
authors.forename: Marita B
authors.initials: MB
authors.lastname: de-Leon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000150:complications / Q000523:psychology*; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012720:Severity of Illness Index; D013315:Stress, Psychological