title: Predictors of health-related quality-of-life following traumatic brain injury.
abstract: OBJECTIVE
  To examine the predictive associations of family satisfaction, functional impairment, pain, and depression on health-related quality-of-life (HRQoL) among persons with traumatic brain injury (TBI) through structural equation modelling (SEM).
  
  
  METHODS
  Participants were part of a larger longitudinal study of adjustment following TBI. Direct and indirect effects of predictor variables on HRQoL were analyzed through SEM.
  
  
  METHODS
  The sample included 131 participants with TBI (89 men, 42 women) who had been discharged from an acute care hospital. The Sickness Impact Profile was administered to measure HRQoL at or beyond 24 months post-discharge. Predictor variable measures included the Functional Independence Measure, Family Satisfaction Scale and single items assessing the presence of pain and depression.
  
  
  RESULTS
  SEM revealed direct effects of functional impairment (p < 0.001), family satisfaction (p < 0.01), depression (p < 0.05) and pain (p < 0.01) on HRQoL. Indirect effects from functional impairment (p < 0.05) and pain (p < 0.05) to HRQoL through depression were also present.
  
  
  CONCLUSIONS
  The presence of pain and depression, greater functional impairment and lower family satisfaction were predictively associated with lower HRQoL. Depression further mediated the effects of pain and functional impairment on HRQoL. The present study advances understanding of the ways in which pain, depression and functional impairment predict HRQoL.
authors.affiliation: Department of Educational Psychology, Texas A&M University, College Station, TX, USA. mcmeredithcampbell@gmail.com
authors.forename: Meredith L C
authors.initials: ML
authors.lastname: Williamson
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Elliott
authors.forename: Jack W
authors.initials: JW
authors.lastname: Berry
authors.forename: Andrea T
authors.initials: AT
authors.lastname: Underhill
authors.forename: Despina
authors.initials: D
authors.lastname: Stavrinos
authors.forename: Philip R
authors.initials: PR
authors.lastname: Fine
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001930:Brain Injuries / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data; D003863:Depression / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation; D006233:Persons with Disabilities / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008137:Longitudinal Studies; D008297:Male; D010146:Pain / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation; D010351:Patient Discharge; D010549:Personal Satisfaction; D011788:Quality of Life; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D013997:Time Factors