Predictive Factors of Self-Reported Quality of Life in Acquired Brain Injury: One-Year Follow-Up
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Participants
2.2. Measures
2.2.1. CAVIDACE Scale
2.2.2. Patient Health Questionnaire-9 (PHQ9)
2.2.3. Patient Competency Rating Scale (PCRS)
2.2.4. Community Integration Questionnaire (CIQ)
2.2.5. Connor–Davidson Resilience Scale (CD-RISC)
2.2.6. Social Support Questionnaire-6 (SSQ6)
2.3. Procedure
2.4. Statistical Analysis
3. Results
3.1. Patient Sample
3.2. Changes in QoL from Baseline to One-Year Follow-Up
3.3. Changes in Other Variables from the Baseline to One-Year Follow-Up
3.4. Factors Related to QoL: Independent t-Tests and ANOVAs
3.5. Predictors of QoL at One-Year: Regressions
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Sociodemographic and Clinical Variables | Patients with 12 Months Follow-Up (n = 203) | Patients without Complete Follow-Up (n = 402) | |
---|---|---|---|
n (%) | n (%) | ||
Gender | 203 | 400 | χ² = 1.87 |
Male | 130 (64%) | 243 (60.8%) | |
Female | 73 (36%) | 157 (39.3%) | |
Age (years) | 203 | 396 | t394 = −0.12 |
Mean (SD) | 53.01 (14.44) | 54.83 (14.47) | |
Range | 18–86 | 18–91 | |
Civil status | 198 | 391 | χ² = 2.46 |
Single/separated/divorced/window(er) | 107 (54%) | 196 (50.1%) | |
Married/cohabitating | 91 (46%) | 195 (49.9%) | |
Educational level | 190 | 369 | χ² = 1.02 |
Without education/none | 14 (7.4%) | 30 (8.1%) | |
Primary education | 60 (31.6%) | 116 (31.4%) | |
Secondary education | 64 (33.7%) | 117 (31.7%) | |
Higher education | 52 (27.4%) | 106 (28.7%) | |
Prior employment status | 200 | 383 | χ² = 2.58 |
Not active/unemployed | 63 (31.5%) | 135 (25.2%) | |
Employed/student | 137 (68,5%) | 248 (64.8%) | |
Current employment status | 203 | 386 | χ² = 0.65 |
Not active/unemployed | 199 (98%) | 376 (97.4%) | |
Employed/student | 4 (2%) | 10 (2.6%) | |
Type of home | 122 | 251 | χ² = 0.90 |
Independent flat | 12 (9.8%) | 29 (11.6%) | |
Residential center | 18 (14.8%) | 39 (15.5%) | |
Family home/sheltered flat | 92 (75.4%) | 183 (72.9%) | |
Level support | 189 | 355 | χ² = 9.24 * |
Intermittent | 20 (10.6%) | 42 (11.6%) | |
Limited | 12 (6.3%) | 38 (10.5%) | |
Extensive | 50 (26.5%) | 98 (27.0%) | |
Generalized | 107 (56.6%) | 185 (51.0%) | |
Loss of legal capacity | 191 | 369 | χ² = 3.91 |
No | 127 (66.5%) | 262 (71%) | |
Yes | 64 (33.5%) | 107 (29%) | |
Dependence recognized | 194 | 370 | χ² = 0.00 |
No | 44 (22.7%) | 84 (22.7%) | |
Yes | 150 (77.3%) | 286 (77.3%) | |
Degree of dependence | 153 | 276 | χ² = 1.97 |
Grade I moderate dependency | 24 (15.2%) | 40 (14.5%) | |
Grade II severe dependency | 51 (33.3%) | 102 (37.0%) | |
Grade III major dependency | 78 (51%) | 134 (48.6%) | |
Time since the injury (years) | 194 | 373 | t371 = 10.95 ** |
Mean (SD) | 8.25 (7.83) | 7.20 (6.98) | |
Range | 0.5–47.5 | 0.5–47.5 | |
Location of the injury | 191 | 358 | χ² = 4.90 * |
One hemisphere | 121 (63.4%) | 245 (68.4%) | |
Both hemispheres | 70 (36.6%) | 113 (31.6%) | |
Etiology of the injury | 201 | 390 | χ² = 24.30 *** |
Stroke | 112 (55.7%) | 239 (61.3%) | |
Traumatic brain injury | 66 (32.8%) | 93 (23.8%) | |
Cerebral anoxia | 10 (5%) | 16 (4.1%) | |
Cerebral tumors | 6 (3%) | 17 (4.4%) | |
Infection diseases | 2 (1%) | 8 (2.1%) | |
Other | 5 (2.5%) | 17 (4.4%) | |
Comorbidity (health conditions) | 203 | 393 | t400 = −2.12 |
Mean (SD) | 5.35 (2.49) | 5.01 (2.44) | |
Range | 0–12 | 0–12 | |
Type of center | 171 | 313 | χ² = 23.36 *** |
Day center | 101 (59.1%) | 146 (46.6%) | |
Rehabilitation center | 70 (40.9%) | 167 (53.4%) |
Statistics | EW | IR | MW | PD | PW | SD | SI | RI | Total QoL Index |
---|---|---|---|---|---|---|---|---|---|
No. items | 5 | 5 | 5 | 5 | 5 | 5 | 5 | 5 | 40 |
Mean | 11.23 | 10.25 | 12.33 | 9.55 | 10.93 | 10.26 | 9.27 | 12.06 | 105.11 |
SD | 2.83 | 3.65 | 3.36 | 3.39 | 3.10 | 3.75 | 3.65 | 2.90 | 15.51 |
Range of scores | 1–15 | 0–15 | 0–15 | 0–15 | 0–15 | 0–15 | 0–15 | 3–15 | 71–135 |
Skewness | −0.71 | −0.35 | −1.57 | −0.37 | −0.38 | −0.46 | −0.20 | −0.94 | 0.07 |
Kurtosis | 0.26 | −0.68 | 2.26 | −0.44 | −0.32 | −0.75 | −0.42 | 0.22 | −0.60 |
Domain | ABI 3 Years Ago or Less (n = 63) | ABI More Than 3 Years Ago (n = 131) | ||||||
---|---|---|---|---|---|---|---|---|
t | Effect Size | Baseline | One- Year Follow-Up | t | Effect size | Baseline | One- Year Follow-Up | |
EW | t(57) = −9.42 ** | 0.14 | 10.48 (3.29) | 11.72 (2.88) | t(95) = −0.05 | 0.00 | 10.98 (2.84) | 11.01 (2.81) |
IR | t(54) = 0.46 | 0.01 | 11.29 (3.09) | 10.96 (3.31) | t(97) = −1.17 | 0.01 | 9.55 (3.68) | 9.92 (3.63) |
MW | t(56) = −0.07 | 0.00 | 12.28 (2.80) | 12.40 (3.31) | t(96) = −2.82 | 0.03 | 11.88 (3.05) | 12.38 (3.37) |
PD | t(57) = −1.35 | 0.02 | 9.22 (3.52) | 9.81 (3.65) | t(98) = −3.86 * | 0.04 | 8.82 (2.98) | 9.39 (3.31) |
PW | t(57) = −0.01 | 0.00 | 11.31 (2.93) | 11.36 (3.21) | t(92) = 0.00 | 0.00 | 10.61 (2.81) | 10.60 (3.10) |
SD | t(55) = 0.04 | 0.00 | 11.02 (3.01) | 10.91 (3.97) | t(95) = −1.79 | 0.02 | 9.38 (3.89) | 9.87 (3.60) |
SI | t(57) = −0.51 | 0.01 | 8.74 (4.04) | 9.19 (3.65) | t(97) = −1.64 | 0.02 | 8.93 (3.97) | 9.40 (3.51) |
RI | t(55) = 0.29 | 0.00 | 12.64 (2.49) | 12.39 (3.42) | t(95) = −0.01 | 0.00 | 11.85 (2.76) | 11.88 (2.63) |
Total | t(33) = 0.03 | 0.00 | 103.44 (14.14) | 102.91 (14.65) | t(95) = −1.79 | 0.03 | 101.91 (14.73) | 103.80 (15.48) |
EW | IR | MW | PD | PW | SD | SI | RI | Total QoL Index | |
---|---|---|---|---|---|---|---|---|---|
Sociodemographic Variables | |||||||||
Gender | |||||||||
Age 0 = ≤50 1 = >50 | η2 = 0.03 * 10.96 (3.25) 9.74 (4.02) | ||||||||
Civil status 0 = Single/separated/divorced 1 = Married/cohabitating | η2 = 0.03 * 10.76 (2.77) 11.69 (2.84) | ||||||||
Educational level 1 = Without education/none 2 = Primary education 3 = Secondary education 4 = Higher education | η2 = 0.05 * 8.17 (3.41) 9.57 (3.89) 10.41 (3.48) 11.23 (3.88) | ||||||||
Prior employment | |||||||||
Type of home 1 = Independent flat 2 = Residential center 3 = Family/sheltered | η2 = 0.15 *** 12.82 (1.89) 8.87 (3.91) 12.66 (3.63) | η2 = 0.08 * 12.64 (1.69) 9.93 (3.81) 12.24 (2.85) | |||||||
Injury-related variables | |||||||||
Level of support | |||||||||
Loss of legal capacity 0 = No 1 = Yes | η2 = 0.03 * 10.69 (3.40) 9.26 (4.02) | η2 = 0.06 ** 10.11 (3.29) 8.28 (3.44) | |||||||
Degree of dependency 1 = Grade I moderate dependency 2 = Grade II severe dependency 3 = Grade I major dependency | η2 = 0.02 * 11.81 (3.03) 9.29 (3.69) 9.23 (3.85) | η2 = 0.02 ** 116.28 (14.34) 102.58 (14.82) 100.68 (15.15) | |||||||
Time since injury | |||||||||
Location of the injury 0 = Unilateral 1 = Bilateral | η2 = 0.03 * 10.71 (3.56) 9.54 (3.44) | η2 = 0.04 * 9.98 (3.46) 8.63 (3.12) | η2 = 0.03 * 9.82 (3.63) 8.47 (3.27) | ||||||
Etiology of the injury | |||||||||
Comorbidity 0 = ≤5 1 = >5 | η2 = 0.04 ** 11.70 (2.55) 10.52 (3.09) | η2 = 0.04 ** 10.14 (3.18) 8.69 (3.54) | η2 = 0.04 * 10.83 (3.63) 9.40 (3.79) | η2 = 0.04 ** 9.89 (3.67) 8.37 (3.45) | η2 = 0.04 * 107.79 (15.00) 101.77 (15.61) | ||||
Rehabilitation variable | |||||||||
Type of center 0 = Day center 1 = Rehabilitation center | η2 = 0.05 ** 9.49 (3.93) 11.12 (3.22) | ||||||||
Personal and social variables (baseline) | |||||||||
Self-awareness | |||||||||
Depression 1 = Low 2 = Intermediate 3 = High | η2 = 0.14 *** 12.13 (2.59) 11.56 (2.27) 9.18 (3.33) | η2 = 0.06 ** 10.34 (3.37) 9.54 (3.21) 7.85 (3.70) | η2 = 0.06 * 107.23 (15.12) 106.48 (17.80) 96.95 (13.32) | ||||||
Resilience 1 = Low 2 = Intermediate 3 = High | η2 = 0.06 * 10.40 (2.57) 11.14 (2.79) 12.25 (2.62) | η2 = 0.07 ** 8.63 (4.02) 10.34 (3.21) 11.27 (3.77) | η2 = 0.04 * 11.09 (3.97) 12.69 (2.67) 12.62 (3.74) | η2 = 0.05 * 8.15 (3.29) 9.74 (3.19) 10.14 (3.55) | η2 = 0.12 *** 94.81 (12.00) 105.87 (13.05) 110.03 (18.93) | ||||
Social support 1 = Low 2 = Intermediate 3 = High | η2 = 0.05 * 9,45 (4.32) 10.30 (3.50) 11.54 (2.96) | η2 = 0.05 * 11.21 (3.27) 11.91 (3.08) 12.92 (2.17) | |||||||
Satisfaction with social support 1 = Low 2 = Intermediate 3 = High | η2 = 0.10 ** 9.64 (2.43) 11.13 (2.78) 12.08 (2.79) | η2 = 0.08 ** 8.92 (3.31) 9.48 (3.61) 11.31 (3.33) | η2 = 0.08 ** 10.44 (4.24) 12.17 (2.88) 13.08 (3.06) | η2 = 0.06 * 9.54 (3.01) 10.58 (2.97) 11.65 (3.16) | η2 = 0.05 * 7.81 (3.42) 8.92 (3.67) 9.95 (3.74) | η2 = 0.15 *** 10.35 (3.06) 11.51 (2.97) 13.25 (2.42) | η2 = 0.09 ** 95.61 (14.72) 104.36 (16.63) 109.02 (13.65) | ||
Community integration 1 = Low 2 = Intermediate 3 = High | η2 = 0.09 ** 8.50 (4.20) 10.49 (3.08) 11.32 (3.23) | η2 = 0.06 ** 11.20 (3.96) 12.58 (3.26) 13.20 (2.31) | η2 = 0.13 *** 8.14 (3.37) 9.26 (3.26) 11.24 (2.43) | η2 = 0.14 *** 8.89 (3.66) 9.83 (3.84) 12.36 (2.70) | η2 = 0.14 *** 8.89 (3.66) 9.83 (3.84) 12.36 (2.70) | η2 = 0.13 *** 7.34 (3.71) 9.47 (3.39) 10.80 (3.11) | |||
Personal and social variables (one-year) | |||||||||
Self-awareness | |||||||||
Depression 1 = Low 2 = Intermediate 3 = High | η2 = 0.17 *** 12.16 (2.50) 11.24 (2.66) 8.65 (3.01) | η2 = 0.08 ** 11.20 (3.66) 10.00 (3.93) 8.15 (3.23) | η2 = 0.08 * 106.00 (16.78) 108.37 (14.40) 97.15 (9.60) | ||||||
Resilience 1 = Low 2 = Intermediate 3 = High | η2 = 0.11 ** 10.14 (2.87) 10.82 (2.90) 12.62 (2.44) | η2 = 0.08 * 10.59 (4.00) 12.30 (3.06) 13.27 (2.99) | η2 = 0.28 *** 6.90 (3.49) 9.13 (2.87) 12.00 (2.60) | η2 = 0.11 ** 8.14 (3.97) 9.97 (3.37) 11.69 (3.28) | η2 = 0.17 *** 7.33 (3.10) 9.27 (3.06) 11.53 (3.70) | η2 = 0.05 * 11.19 (3.08) 11.73 (2.89) 13.03 (3.06) | η2 = 0.10 * 96.29 (12.28) 106.10 (14.09) 110.71 (17.17) | ||
Social support | |||||||||
Satisfaction with social support 1 = Low 2 = Intermediate 3 = High | η2 = 0.06 * 10.07 (3.13) 10.88 (2.70) 11.98 (2.73) | η2 = 0.15 *** 6.88 (3.56) 10.03 (3.91) 11.30 (3.44) | η2 = 0.14 ** 9.81 (2.97) 9.80 (3.19) 12.16 (2.75) | η2 = 0.16 *** 9.25 (3.32) 11.85 (2.85) 12.79 (2.47) | η2 = 0.08 * 96.46 (16.27) 106.42 (14.79) 108.72 (14.12) | ||||
Community integration 1 = Low 2 = Intermediate 3 = High | η2 = 0.13 *** 8.47 (3.96) 10.35 (3.82) 11.76 (2.63) | η2 = 0.08 * 11.11 (4.17) 12.68 (3.27) 13.30 (2.04) | η2 = 0.17 *** 8.06 (3.42) 8.73 (3.04) 11.16 (2.74) | η2 = 0.11 ** 8.63 (3.32) 10.35 (3.46) 11.51 (3.57) | η2 = 0.07 * 8.38 (4.14) 9.22 (3.38) 10.57 (3.02) | η2 = 0.07 * 10.82 (3.49) 11.56 (3.05) 12.77 (2.47) |
Dependent Variables | Variables (Final Model) | Unstandardized Coefficients | Standardized Coefficients | 95 CI Lower/Upper Bound | t | p | F Change | Change Adjusted R2 | |
---|---|---|---|---|---|---|---|---|---|
B | S.E. | Beta | |||||||
EW | Civil status | 1.31 | 0.55 | 0.24 | 0.21/2.42 | 2.38 | 0.020 | 4.97 * | 0.05 |
Depression baseline | −1.27 | 0.39 | −0.33 | −2.05/−0.49 | −0.33 | 0.002 | 16.06 *** | 0.17 | |
Resilience 12 m | 1.34 | 0.41 | 0.34 | 0.52/2.17 | 3.26 | 0.002 | 10.63 ** | 0.10 | |
Total | 0.32 | ||||||||
IR | IR baseline | 0.47 | 0.09 | 0.48 | 0.30/0.64 | 5.57 | <0.001 | 55.14 *** | 0.38 |
Satisfaction with social support 12 m | 1.14 | 0.42 | 0.23 | 0.31/1.98 | 2.72 | 0.008 | 9.39 ** | 0.06 | |
Community integration 12 m | 1.00 | 0.38 | 0.38 | 0.24/1.77 | 2.62 | 0.011 | 6.85 * | 0.04 | |
Total | 0.48 | ||||||||
MW | Community integration 12 m | 1.67 | 0.64 | 0.36 | 0.38/2.96 | 2.60 | 0.012 | 6.77 * | 0.11 |
Total | 0.11 | ||||||||
PD | Loss of legal capacity | −1.19 | 0.58 | −0.16 | −2.35/−0.04 | −2.05 | 0.043 | 7.51 ** | 0.06 |
Community integration baseline | 1.08 | 0.36 | 0.25 | 0.36/1.79 | 3.00 | 0.004 | 16.83 *** | 0.13 | |
Resilience 12 m | 2.29 | 0.42 | 0.45 | 1.46/3.12 | 5.47 | <0.001 | 29.94 *** | 0.18 | |
Total | 0.37 | ||||||||
PW | PW baseline | 0.47 | 0.10 | 0.43 | 0.27/0.67 | 4.69 | <0.001 | 28.55 *** | 0.23 |
Satisfaction with social support 12 m | 0.98 | 0.40 | 0.23 | 0.19/1.77 | 2.45 | 0.016 | 6.09 * | 0.05 | |
Total | 0.28 | ||||||||
SD | SD baseline | 0.27 | 0.09 | 0.27 | 0.09/0.45 | 2.93 | 0.004 | 20.42 *** | 0.16 |
Educational level | 1.00 | 0.34 | 0.26 | 0.34/1.67 | 3.00 | 0.003 | 7.96 ** | 0.06 | |
Community integration baseline | 0.92 | 0.44 | 0.20 | 0.05/1.79 | 2.10 | 0.039 | 6.32 * | 0.04 | |
Resilience 12 m | 1.03 | 0.47 | 0.20 | 0.10/1.96 | 2.19 | 0.031 | 4.79 * | 0.03 | |
Total | 0.29 | ||||||||
SI | SI baseline | 0.32 | 0.07 | 0.35 | 0.18/0.47 | 4.40 | <0.001 | 23.80 *** | 0.16 |
Comorbidity | −1.21 | 0.58 | −0.17 | −2.36/−0.06 | −2.09 | 0.039 | 6.62 * | 0.05 | |
Resilience 12 m | 1.74 | 0.43 | 0.33 | 0.90/2.58 | 4.09 | <0.001 | 16.72 *** | 0.10 | |
Total | 0.31 | ||||||||
RI | Satisfaction with social support baseline | 1.89 | 0.53 | 0.47 | 0.83/2.95 | 3.60 | 0.001 | 16.14 *** | 0.27 |
Community integration baseline | 1.22 | 0.58 | 0.28 | 0.06/2.39 | 2.12 | 0.041 | 4.49 * | 0.06 | |
Total | 0.33 | ||||||||
Total QoL Index | Total baseline | 0.55 | .11 | 0.53 | 0.33/0.76 | 5.00 | <0.001 | 25.03 *** | 0.17 |
Dependency level | −8.27 | 2.01 | −0.39 | −12.27/−4.27 | −4.11 | <0.001 | 15.61 *** | 0.15 | |
Depression baseline | −5.63 | 2.26 | −0.24 | −10.14/−1.13 | −2.49 | 0.015 | 8.12 ** | 0.07 | |
Satisfaction with social support baseline | 4.50 | 2.04 | 0.21 | 0.43/8.57 | 2.20 | 0.031 | 4.84 * | 0.04 | |
Total | 0.43 |
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Aza, A.; Verdugo, M.Á.; Orgaz, M.B.; Amor, A.M.; Fernández, M. Predictive Factors of Self-Reported Quality of Life in Acquired Brain Injury: One-Year Follow-Up. Int. J. Environ. Res. Public Health 2021, 18, 927. https://doi.org/10.3390/ijerph18030927
Aza A, Verdugo MÁ, Orgaz MB, Amor AM, Fernández M. Predictive Factors of Self-Reported Quality of Life in Acquired Brain Injury: One-Year Follow-Up. International Journal of Environmental Research and Public Health. 2021; 18(3):927. https://doi.org/10.3390/ijerph18030927
Chicago/Turabian StyleAza, Alba, Miguel Á. Verdugo, María Begoña Orgaz, Antonio M. Amor, and María Fernández. 2021. "Predictive Factors of Self-Reported Quality of Life in Acquired Brain Injury: One-Year Follow-Up" International Journal of Environmental Research and Public Health 18, no. 3: 927. https://doi.org/10.3390/ijerph18030927