title: A longitudinal examination of positive changes in quality-of-life after traumatic brain injury.
abstract: OBJECTIVE
  Most studies of quality-of-life (QoL) after traumatic brain injury (TBI) reveal a largely negative picture, yet some survivors show positive changes (PC). Understanding PC in QoL may assist clinicians in facilitating post-injury adjustment. This study aimed to prospectively explore changes in QoL from pre- to post-injury, identify those with PC and examine predictive and associated factors.
  
  
  METHODS
  Ninety-five participants, recruited from consecutive admissions to a rehabilitation hospital, were prospectively assessed at least once over the first 4 years post-injury. Measures of QoL, psychiatric disorders, coping style and psychosocial outcome were administered at each assessment.
  
  
  RESULTS
  Participants' mean QoL was in the average range pre-injury and at follow-up. A third demonstrated PC post-injury, which tended to remain stable. PC participants tended to rate their relatives as of greater importance than other participants, but did not rate their health as high. Group membership was not predicted by pre-injury demographic or injury factors, but it was significantly associated with psychosocial and functional outcome.
  
  
  CONCLUSIONS
  Even after a significant brain injury, some individuals show sustained improved QoL. Factors such as lack of 'good old days' bias and increased value placed on family may have important clinical utility.
authors.affiliation: Monash-Epworth Rehabilitation Research Centre, Epworth Hospital , Richmond, Victoria , Australia .
authors.forename: Kate R
authors.initials: KR
authors.lastname: Gould
authors.forename: Jennie L
authors.initials: JL
authors.lastname: Ponsford
mesh_terms: D000124:Achievement; D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D001930:Brain Injuries / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D011788:Quality of Life; D012959:Socioeconomic Factors; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data
keywords: Family; post-traumatic growth; psychiatric disorders; quality-of-life; response shift; traumatic brain injury