title: Evaluating clinically significant changes in health-related quality of life: A sample of relatives of patients with severe traumatic brain injury.
abstract: The objective of the study was to investigate change and predictors of change in health-related quality of life (HRQoL) in relatives of patients with severe traumatic brain injury (TBI) during rehabilitation, and to analyse associations between changes in HRQoL and symptoms of anxiety and depression. The Vitality (VT), Mental Health (MH), Social Function (SF) and the Role Emotional (RE) scales from the Short Form 36, and the anxiety and depression scales from the Symptom Checklist-90 - Revised were used. Of the 62 relatives, 24.6% experienced a reliable improvement on the VT scale, 53.2% on the MH scale, 27.4% on the SF scale and 16.1% on the RE scale. Of the relatives, 24.0% experienced clinically significant change (CSC) on the VT scale, 19.6% on the MH scale, 21.6% on the SF scale, and 19.2% on the RE scale. Relatives' age and higher patient Glasgow Coma Scale score predicted the experience of CSC in RE, and change on the Functional Independence Measure in patients predicted CSC on the MH scale. Improvements in VT as well as MH were associated with improvement in symptoms of anxiety and depression, and improvement in SF was associated with improvement in symptoms of depression. About one-fifth of the sample experienced a CSC on one of the four HRQoL measures. Relatives experiencing CSC tended to be related to patients who showed more improvement during rehabilitation. Improvements in HRQoL were associated with improvements in symptoms of anxiety and depression.
authors: a RUBRIC, Clinic of Neurorehabilitation, Traumatic Brain Injury Unit , Copenhagen University Hospital, Rigshospitalet , Copenhagen , Denmark.|b Department of Neurology , Copenhagen University Hospital, Rigshospitalet , Copenhagen , Denmark.
authors: Anne
authors: A
authors: Norup
authors: a RUBRIC, Clinic of Neurorehabilitation, Traumatic Brain Injury Unit , Copenhagen University Hospital, Rigshospitalet , Copenhagen , Denmark.
authors: Karin Spangsberg
authors: KS
authors: Kristensen
authors: a RUBRIC, Clinic of Neurorehabilitation, Traumatic Brain Injury Unit , Copenhagen University Hospital, Rigshospitalet , Copenhagen , Denmark.
authors: Ingrid
authors: I
authors: Poulsen
authors: c Institute of Public Health and Centre for Healthy Ageing , University of Copenhagen , Copenhagen , Denmark.
authors: Erik Lykke
authors: EL
authors: Mortensen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology*; D000070642:Brain Injuries, Traumatic / Q000534:rehabilitation*; D017028:Caregivers / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005190:Family / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D015599:Trauma Severity Indices; D055815:Young Adult
keywords: Clinically significant change; HRQoL; Reliable change index; Sub-acute rehabilitation; TBI; TBI-caregivers