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Core Indicators to Assess Quality of Life in Population with Brain Injury

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Abstract

Assessing quality of life of people with brain injury has a relevant role for developing strategies focused on personal outcomes that allow us to guide good practices and rehabilitation. So far, assessment of quality of life for this population has been restricted to an evaluation of personal outcomes from a health-related quality of life perspective. This approach it is mostly centered on physical health, however, quality of life needs to be addressed from a holistic and multidimensional perspective. The goal of this study is to identify core indicators of quality of life in brain injury based on a comprehensive theoretical model focused on the most relevant aspects of this population functioning. A Delphi study was carried out to obtain the specific core indicators of quality of life for this population. The methodology used to reach a consensus about the best indicators and items to measure quality of life involved four rounds and 14 experts on rehabilitation of people with brain injury. The Delphi study provided evidence of content validity for the field-test version of a new scale that will be applied to a wide sample in order to empirically check its suitability for this population.

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References

  • Alcedo Rodríguez, M., Aguado Díaz, A. L., Arias Martínez, B., González González, M., & Rozada Rodríguez, C. (2008). The Quality of Life Questionnaire (QLQ) for persons with disability who are ageing: Preliminary study. Psychosocial Intervention, 17(2), 153–167.

    Article  Google Scholar 

  • Andelic, N., Sigurdardottir, S., Schanke, A. K., Sandvik, L., Sveen, U., & Roe, C. (2010). Disability, physical health and mental health 1 year after traumatic brain injury. Disability and Rehabilitation, 32(13), 1122–1131. doi:10.3109/09638280903410722.

    Article  Google Scholar 

  • Arango-Lasprilla, J. C., Krch, D., Drew, A., De los Reyes Aragon, C. J., & Stevens, L. F. (2012). Health-related quality of life of individuals with traumatic brain injury in Barranquilla, Colombia. Brain Injury, 26(6), 825–833. doi:10.3109/02699052.2012.655364.

    Article  Google Scholar 

  • Arias, B., Gómez, L. E., Verdugo, M. A., & Navas, P. (2010). Evaluación de la calidad de vida en personas drogodependientes mediante el modelo de Rasch [Assessment of quality of life in people with drug dependences with Rasch model]. Revista Española de Drogodependencias, 35(1), 206–219.

    Google Scholar 

  • Balasubramanian, R., & Agarwal, D. (2013). Delphi Technique-A review. International Journal of Public Health Dentistry, 3(2), 16–25.

    Google Scholar 

  • Balboni, G., Coscarelli, A., Giunti, G., & Schalock, R. L. (2013). The assessment of the quality of life of adults with intellectual disability: The use of self-report and report of others assessment strategies. Research in Developmental Disabilities, 34(11), 4248–4254. doi:10.1016/j.ridd.2013.09.009.

    Article  Google Scholar 

  • Bangdiwala, K. (1987). Using SAS software graphical procedures for the observer agreement chart. Proceedings of the SAS User’s Group International Conference, 12, 1083–1088.

    Google Scholar 

  • Barroso, J., & Cabero, J. (2010). La investigación educativa en TIC. Visiones prácticas [Educational research in ICT. Practical insights]. Madrid: Síntesis.

  • Bilbao, A., & Díaz, J. L. (2008). Guía de manejo cognitivo y conductual de personas con daño cerebral adquirido [Cognitive and behavioral management guide for people with acquired brain injury]. Madrid: Instituto de Mayores y Servicios Sociales, Colección de Manuales y Guías, Serie Dependencia.

  • Carbó-Carreté, M., Guàrdia-Olmos, J., & Giné, C. (2015). Psychometric properties of the Spanish version of the Personal Outcomes Scale. International Journal of Clinical and Health Psychology, 15(3), 236–252. doi:10.1016/j.ijchp.2015.04.002.

    Article  Google Scholar 

  • Carlozzi, N. E., Tulsky, D. S., & Kisala, P. A. (2011). Traumatic brain injury patient-reported outcome measure: Identification of health-related quality-of-life issues relevant to individuals with traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 92(10), 52–60. doi:10.1016/j.apmr.2010.12.046.

    Article  Google Scholar 

  • Christie, C. A., & Barela, E. (2005). The Delphi technique as a method for increasing inclusion in the evaluation process. Canadian Journal of Program Evaluation, 20(1), 105–122.

    Google Scholar 

  • Cummins, R. A. (2005). Moving from the quality of life concept to a theory. Journal of Intellectual Disability Research, 49(10), 699–706. doi:10.1111/j.1365-2788.2005.00738.x.

    Article  Google Scholar 

  • Dalkey, N., & Helmer, O. (1963). An experimental application of the Delphi method to the use of experts. Management Science, 9(3), 458–467.

    Article  Google Scholar 

  • De Villiers, M. R., De Villiers, P. J., & Kent, A. P. (2005). The Delphi technique in health sciences education research. Medical Teacher, 27(7), 639–643. doi:10.1080/13611260500069947.

    Article  Google Scholar 

  • Delbecq, A. L., Van de Ven, A. H., & Gustafson, D. H. (1975). Group techniques for program planning: A guide to nominal group and Delphi processes. Glenview, IL: Scott Foresman.

    Google Scholar 

  • Dijkers, M. P. (2004). Quality of life after traumatic brain injury: A review of research approaches and findings. Archives of Physical Medicine and Rehabilitation, 85, 21–35. doi:10.1016/j.apmr.2003.08.119.

    Article  Google Scholar 

  • Felce, D., & Perry, J. (1995). Quality of life: Its definition and measurement. Research in Developmental Disabilities, 16(1), 51–74. doi:10.1016/0891-4222(94)00028-8.

    Article  Google Scholar 

  • Forslund, M. V., Roe, C., Sigurdardottir, S., & Andelic, N. (2013). Predicting health-related quality of life 2 years after moderate-to-severe traumatic brain injury. Acta Neurologica Scandinavica, 128(4), 220–227. doi:10.1111/ane.12130.

    Article  Google Scholar 

  • Gil-Gómez de Liaño, B., & Pascual-Ezama, D. (2012). La metodología Delphi como técnica de estudio de la validez de contenido [The Delphi method as a technique to study validity of content]. Anales de Psicología, 28(3), 1011–1020. doi:10.6018/analesps.28.3.156211.

    Google Scholar 

  • Gómez, L. E., Alcedo, M. A., Arias, B., Fontanil, Y., Arias, V. B., Monsalve, A., et al. (2016). A new scale for the measurement of quality of life in children with intellectual disability. Research in Developmental Disabilities, 53, 399–410. doi:10.1016/j.ridd.2016.03.005.

    Article  Google Scholar 

  • Gómez, L. E., Arias, B., Verdugo, M. A., & Navas, P. (2012). An outcomes-based assessment of quality of life in social services. Social Indicators Research, 106(1), 81–93. doi:10.1007/s11205-011-9794-9.

    Article  Google Scholar 

  • Gómez, L. E., Arias, B., Verdugo, M. A., Tassé, M. J., & Brown, I. (2015). Operationalisation of quality of life for adults with severe disabilities. Journal of Intellectual Disability Research, 59(10), 925–941. doi:10.1111/jir.12204.

    Article  Google Scholar 

  • Gómez Pastor, I. (2008). El daño cerebral sobrevenido: Un abordaje transdisciplinar dentro de los servicios sociales [Acquired brain injury: A transdisciplinary approach within social services]. Psychosocial Intervention, 17(3), 237–244.

    Article  Google Scholar 

  • Gómez, L. E., Peña, E., Alcedo, M. A., Monsalve, A., Fontanil, Y., Verdugo, M. A., et al. (2014). El constructo de calidad de vida en niños y adolescentes con discapacidades múltiples y profundas: Propuesta para su evaluación [The construct of quality of life concept in children and adolescents with profound and multiple Disabilities: A proposal for the assessment]. Siglo Cero, 45(1), 56–69.

    Google Scholar 

  • Gómez, L. E., Verdugo, M. A., Arias, B., & Arias, V. (2010). A comparison of alternative models of individual quality of life for social service recipients. Social Indicators Research, 101(1), 109–126. doi:10.1007/s11205-010-9639-y.

    Article  Google Scholar 

  • Gómez, L. E., Verdugo, M. A., Arias, B., Navas, P., & Schalock, R. L. (2013). The development and use of Provider Profiles at the organizational and systems level. Evaluation and Program Planning, 40, 17–26. doi:10.1016/j.evalprogplan.2013.05.001.

    Article  Google Scholar 

  • Grauwmeijer, E., Heijenbrok-Kal, M. H., & Ribbers, G. M. (2014). Health-related quality of life 3 years after moderate to severe traumatic brain injury: A prospective cohort study. Archives of Physical Medicine and Rehabilitation, 95(7), 1268–1276. doi:10.1016/j.apmr.2014.02.002.

    Article  Google Scholar 

  • Gray, J. A., & Truesdale, J. (2015). A Delphi study on staff Bereavement training in the intellectual and developmental disabilities field. Intellectual and Developmental Disabilities, 53(6), 394–405. doi:10.1352/1934-9556-53.6.394.

    Article  Google Scholar 

  • Guba, E. G., & Lincoln, Y. S. (1989). Fourth generation evaluation. Newbury Park, CA: Sage.

    Google Scholar 

  • Hasson, F., Keeney, S., & McKenna, H. (2000). Research guidelines for the Delphi survey technique. Journal of Advanced Nursing, 32(4), 1008–1015.

    Google Scholar 

  • Hawthorne, G., Gruen, R. L., & Kaye, A. H. (2009). Traumatic brain injury and long-term quality of life: Findings from an Australian study. Journal of Neurotrauma, 26(10), 1623–1633. doi:10.1089/neu.2008.0735.

    Article  Google Scholar 

  • Hsu, C. C., & Sandford, B. A. (2007). The Delphi technique: Making sense of consensus. Practical Assessment, Research and Evaluation, 12(10), 1–8.

    Google Scholar 

  • Hu, X. B., Feng, Z., Fan, Y. C., Xiong, Z. Y., & Huang, Q. W. (2012). Health-related quality-of-life after traumatic brain injury: A 2-year follow-up study in Wuhan, China. Brain Injury, 26(2), 183–187. doi:10.3109/02699052.2011.648707.

    Article  Google Scholar 

  • Jacobsson, L. J., Westerberg, M., & Lexell, J. (2010). Health-related quality-of-life and life satisfaction 6-15 years after traumatic brain injuries in northern Sweden. Brain Injury, 24(9), 1075–1086. doi:10.3109/02699052.2010.494590.

    Article  Google Scholar 

  • Keeney, S. (2009). The Delphi Technique in: The Research Process in Nursing (Eds. K. Gerrish & A. Lacey) (6th Ed.). London: Blackwell Publishing.

  • Kennedy, H. P. (2004). Enhancing Delphi research: methods and results. Journal of Advanced Nursing, 45(5), 504–511. doi:10.1046/j.1365-2648.2003.02933.x.

    Article  Google Scholar 

  • Lakeman, R. (2010). Mental health recovery competencies for mental health workers: A Delphi study. Journal of Mental Health, 19(1), 62–74. doi:10.3109/09638230903469194.

    Article  Google Scholar 

  • Landeta, J. (2006). Current validity of the Delphi method in social sciences. Technological Forecasting and Social Change, 73(5), 467–482. doi:10.1016/j.techfore.2005.09.002.

    Article  Google Scholar 

  • León, O. G., & Montero, I. (2003). Métodos de investigación en psicología y educación (3rd ed.) [Research methods in psychology and education (3rd ed.]. Madrid: McGraw-Hill.

  • Ludwig, B. (1997). Predicting the future: Have you considered using the Delphi methodology? Journal of Extension, 35(5), 1–4.

    Google Scholar 

  • Machamer, J., Temkin, N., & Dikmen, S. (2013). Health-related quality of life in traumatic brain injury: Is a proxy report necessary? Journal of Neurotrauma, 30(22), 1845–1851. doi:10.1089/neu.2013.2920.

    Article  Google Scholar 

  • Nestvold, K., & Stavem, K. (2009). Determinants of health-related quality of life 22 years after hospitalization for traumatic brain injury. Brain Injury, 23(1), 15–21. doi:10.1080/02699050802530540.

    Article  Google Scholar 

  • Okoli, C., & Pawlowski, S. D. (2004). The Delphi method as a research tool: An example, design considerations and applications. Information & Management, 42(1), 15–29. doi:10.1016/j.im.2003.11.002.

    Article  Google Scholar 

  • Petry, K., Maes, B., & Vlaskamp, C. (2005). Domains of quality of life of people with profound multiple disabilities: The perspective of parents and direct support staff. Journal of Applied Research in Intellectual Disabilities, 18(1), 35–46. doi:10.1111/j.1468-3148.2004.00209.x.

    Article  Google Scholar 

  • Popham, W. J. (2003). The seductive allure of data. Educational Leadership, 60(5), 48–51.

    Google Scholar 

  • Powell, C. (2003). The Delphi technique: Myths and realities. Journal of Advanced Nursing, 41(4), 376–382.

    Article  Google Scholar 

  • Quezada, M. (2011). El daño cerebral adquirido (DCA) en España: principales resultados a partir de la encuesta EDAD-2008 [Acquired brain injury (ABI) in Spain: Main results from the 2008 survey EDAD]. Boletín del Observatorio Estatal de la Discapacidad, 3, 39–59.

    Google Scholar 

  • Rubial-Álvarez, S., & Veiga-Suárez, M. (2012). Perfil del sujeto con daño cerebral adquirido en fase crónica en un recurso de atención sociosanitaria [The profile of the subject with acquired brain injury in a chronic phase in a care resource sociosanitary]. Revista de Neurología, 55, 392–398.

    Google Scholar 

  • Sasse, N., Gibbons, H., Wilson, L., Martínez, R., Sehmisch, S., von Wild, K., et al. (2014). Coping strategies in individuals after traumatic brain injury: Associations with health-related quality of life. Disability and Rehabilitation, 36(25), 2152–2160. doi:10.3109/09638288.2014.893029.

    Article  Google Scholar 

  • Schalock, R. L., Bonham, G. S., & Verdugo, M. A. (2008). The conceptualization and measurement of quality of life: Implications for program planning and evaluation in the field of intellectual disabilities. Evaluation and Program Planning, 31(2), 181–190. doi:10.1016/j.evalprogplan.2008.02.001.

    Article  Google Scholar 

  • Schalock, R. L., Gardner, J. F., & Bradley, V. J. (2007). Quality of life for persons with intellectual and other developmental disabilities: Applications across individuals, organizations, communities, and systems. Washington, DC: American Association on Intellectual and Developmental Disabilities.

    Google Scholar 

  • Schalock, R. L., & Verdugo, M. A. (2002). Handbook on quality of life for human service practitioners. Washington, DC: American Association on Mental Retardation.

    Google Scholar 

  • Schalock, R. L., & Verdugo, M. A. (2007). El concepto de calidad de vida en los servicios y apoyos para personas con discapacidad intelectual [The concept of quality of life in support services for people with intellectual disability]. Siglo Cero, 38, 21–36.

    Google Scholar 

  • Schalock, R. L., & Verdugo, M. A. (2008). Quality of life conceptual and measurement frameworks: From concept to application in the field of intellectual disabilities. Evaluation and Program Planning, 31(2), 181–190.

    Article  Google Scholar 

  • Schalock, R. L., & Verdugo, M. A. (2012). A Leadership Guide to Redefining Intellectual and Developmental Disabilities Organizations: Eight Successful Change Strategies. Baltimore, MD: Brookes.

    Google Scholar 

  • Schalock, R. L., Verdugo, M. A., & Gómez, L. E. (2011). Evidence-Based practices in the field of intellectual and developmental disabilities: An international consensus approach. Evaluation and Program Planning, 34(3), 273–282. doi:10.1016/j.evalprogplan.2010.10.0.

    Article  Google Scholar 

  • Schalock, R. L., Verdugo, M. A., Gómez, L. E., & Reinders, H. S. (2016). Moving us toward a theory of individual quality of life. American Journal on Intellectual and Developmental Disabilities, 121(1), 1–12. doi:10.1352/1944-7558-121.1.1.

    Article  Google Scholar 

  • Schalock, R. L., Verdugo, M. A., Jenaro, C., Wang, M., Wehmeyer, M., Xu, J., et al. (2005). A cross-cultural study of quality of life indicators. American Journal on Mental Retardation, 110, 298–311.

    Article  Google Scholar 

  • Scholten, A. C., Haagsma, J. A., Andriessen, T. M. J. C., Vos, P. E., Steyerberg, E. W., Van Beeck, E. F., et al. (2015). Health-related quality of life after mild, moderate and severe traumatic brain injury: Patterns and predictors of suboptimal functioning during the first year after injury. Injury, 46(4), 616–624. doi:10.1016/j.injury.2014.10.064.

    Article  Google Scholar 

  • Soberg, H. L., Røe, C., Anke, A., Arango-Lasprilla, J. C., Skandsen, T., Sveen, U., et al. (2013). Health-related quality of life 12 months after severe traumatic brain injury: A prospective nationwide cohort study. Journal of Rehabilitation Medicine, 45(8), 785–791.

    Article  Google Scholar 

  • Teasdale, T. W., Christensen, A. L., Willmes, K., Deloche, G., Braga, L., Stachowiak, F., et al. (1997). Subjective experience in brain-injured patients and their close relatives: A European Brain Injury Questionnaire study. Brain Injury, 11(8), 543–563. doi:10.1080/026990597123250.

    Article  Google Scholar 

  • Teasdale, T. W., & Engberg, A. W. (2005). Subjective well-being and quality of life following traumatic brain injury in adults: A long-term population-based follow-up. Brain Injury, 19(12), 1041–1048. doi:10.1080/02699050500110397.

    Article  Google Scholar 

  • Truelle, J. L., Koskinen, S., Hawthorne, G., Sarajuuri, J., Formisano, R., von Wild, K., et al. (2010). Quality of life after traumatic brain injury: The clinical use of the QOLIBRI, a novel disease-specific instrument. Brain Injury, 24(11), 1272–1291. doi:10.3109/02699052.2010.506865.

    Article  Google Scholar 

  • Ulfarsson, T., Lundgren-Nilsson, Å., Blomstrand, C., & Nilsson, M. (2014). A history of unemployment or sick leave influences long-term functioning and health-related quality-of-life after severe traumatic brain injury. Brain Injury, 28(3), 328–335. doi:10.3109/02699052.2013.865274.

    Article  Google Scholar 

  • Van Loon, J. H., Bonham, G. S., Peterson, D. D., Schalock, R. L., Claes, C., & Decramer, A. E. (2013). The use of evidence-based outcomes in systems and organizations providing services and supports to persons with intellectual disability. Evaluation and Program Planning, 36(1), 80–87. doi:10.1016/j.evalprogplan.2012.08.002.

    Article  Google Scholar 

  • Verdugo, M. A., Arias, B., Gómez, L. E., & Schalock, R. L. (2010). Development of an objective instrument to assess quality of life in social services: Reliability and validity in Spain. International Journal of Clinical and Health Psychology, 10(1), 105–123.

    Google Scholar 

  • Verdugo, M. A., Gómez, L. E., Arias, B., Navas, P., & Schalock, R. L. (2014). Measuring quality of life in people with intellectual and multiple disabilities: Validation of the San Martín Scale. Research in Developmental Disabilities, 35(1), 75–86. doi:10.1016/j.ridd.2013.10.025.

    Article  Google Scholar 

  • Verdugo, M. A., Gómez, L. E., Arias, B., Santamaría, M., Clavero, D., & Tamarit, J. (2013). Escala INICO-FEAPS. Evaluación integral de la calidad de vida de personas con discapacidad intelectual o del desarrollo [Assessment of quality of life in persons with intellectual disability: INICO-FEAPS Scale]. Salamanca: Universidad de Salamanca, Publicaciones del INICO.

  • Wang, M., Schalock, R. L., Verdugo, M. A., & Jenaro, C. (2010). Examining the factor structure and hierarchical nature of the quality of life construct. American Journal on Intellectual and Developmental Disabilities, 115(3), 218–233. doi:10.1352/1944-7558-115.3.218.

    Article  Google Scholar 

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Acknowledgements

We gratefully acknowledge the support of the Spanish Ministry of Economy and Competitiveness (Grant PSI2015-65193-P [MINECO/FEDER, UE]), and of two predoctoral’s fellowships (BES-2013-065113; FPU14/01468 – Spanish Ministry of Economy and Competitiveness and Ministry of Education, Culture and Sport respectively). We also gratefully acknowledge the support of the Centro de Referencia Estatal de Atención al Daño Cerebral Adquirido (CEADAC, Spain), who have partially funded the research, and the Federación Española de Daño Cerebral (FEDACE, Spain). Finally, the authors would especially like to thank the organizations, professionals, people with brain injury, and families for completing the questionnaires and for their support on this project.

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Correspondence to María Fernández.

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Fernández, M., Verdugo, M.Á., Gómez, L.E. et al. Core Indicators to Assess Quality of Life in Population with Brain Injury. Soc Indic Res 137, 813–828 (2018). https://doi.org/10.1007/s11205-017-1612-6

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