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美国军人创伤性脑损伤生活质量量表(TBI-QOL)的临床效用和心理测量特性

Clinical Utility and Psychometric Properties of the Traumatic Brain Injury Quality of Life Scale (TBI-QOL) in US Military Service Members.

作者信息

Lange Rael T, Brickell Tracey A, Bailie Jason M, Tulsky David S, French Louis M

机构信息

Defense and Veterans Brain Injury Center, Bethesda, Maryland (Drs Lange, Brickell, Bailie, and French); Walter Reed National Military Medical Center, Bethesda, Maryland (Drs Lange, Brickell, and French); University of British Columbia, Vancouver, British Columbia, Canada (Dr Lange); Uniformed Services University of the Health Sciences, Bethesda, Maryland (Drs Brickell and French); Department of Physical Therapy and Center on Assessment Research and Translation, University of Delaware, Newark, Delaware (Dr Tulsky); Kessler Foundation Research Center, West Orange, New Jersey (Dr Tulsky); Center for Neuroscience and Regenerative Medicine, Bethesda, Maryland (Drs Lange, Brickell, and French); Naval Medical Center San Diego, San Diego, California (Dr Bailie).

出版信息

J Head Trauma Rehabil. 2016 Jan-Feb;31(1):62-78. doi: 10.1097/HTR.0000000000000149.

Abstract

OBJECTIVE

To examine the clinical utility and psychometric properties of the Traumatic Brain Injury Quality of Life (TBI-QOL) scale in a US military population.

PARTICIPANTS

One hundred fifty-two US military service members (age: M = 34.3, SD = 9.4; 89.5% men) prospectively enrolled from the Walter Reed National Military Medical Center and other nationwide community outreach initiatives. Participants included 99 service members who had sustained a mild traumatic brain injury (TBI) and 53 injured or noninjured controls without TBI (n = 29 and n = 24, respectively).

PROCEDURE

Participants completed the TBI-QOL scale and 5 other behavioral measures, on average, 33.8 months postinjury (SD = 37.9).

MAIN OUTCOME MEASURES

Fourteen TBI-QOL subscales; Neurobehavioral Symptom Inventory; Posttraumatic Stress Disorder Checklist-Civilian version; Alcohol Use Disorders Identification Test; Combat Exposure Scale.

RESULTS

The internal consistency reliability of the TBI-QOL scales ranged from α = .91 to α = .98. The convergent and discriminant validity of the 14 TBI-QOL subscales was high. The mild TBI group had significantly worse scores on 10 of the 14 TBI-QOL subscales than the control group (range, P < .001 to P = .043). Effect sizes ranged from medium to very large (d = 0.35 to d = 1.13). The largest differences were found on the Cognition-General Concerns (d = 1.13), Executive Function (d = 0.94), Grief-Loss (d = 0.88), Pain Interference (d = 0.83), and Headache Pain (d = 0.83) subscales.

CONCLUSION

These results support the use of the TBI-QOL scale as a measure of health-related quality of life in a mild TBI military sample. Additional research is recommended to further evaluate the clinical utility of the TBI-QOL scale in both military and civilian settings.

摘要

目的

在美国军人人群中检验创伤性脑损伤生活质量(TBI-QOL)量表的临床效用和心理测量特性。

参与者

152名美国军人(年龄:M = 34.3,标准差 = 9.4;89.5%为男性),他们是从沃尔特里德国家军事医疗中心及其他全国性社区外展项目中前瞻性招募而来的。参与者包括99名遭受轻度创伤性脑损伤(TBI)的军人以及53名未受伤或无TBI的对照者(分别为29名和24名)。

程序

参与者在受伤后平均33.8个月(标准差 = 37.9)完成了TBI-QOL量表及其他5项行为测量指标。

主要测量指标

14个TBI-QOL分量表;神经行为症状量表;创伤后应激障碍检查表(平民版);酒精使用障碍识别测试;战斗暴露量表。

结果

TBI-QOL量表的内部一致性信度范围为α = 0.91至α = 0.98。14个TBI-QOL分量表的聚合效度和区分效度都很高。轻度TBI组在14个TBI-QOL分量表中的10个上得分显著低于对照组(范围为P < .001至P = .043)。效应大小从中度到非常大(d = 0.35至d = 1.13)不等。在认知-一般担忧(d = 1.13)、执行功能(d = 0.94)、悲伤-丧失(d = 0.88)、疼痛干扰(d = 0.83)和头痛疼痛(d = 0.83)分量表上发现的差异最大。

结论

这些结果支持将TBI-QOL量表用作轻度TBI军人样本中与健康相关生活质量的测量工具。建议进一步开展研究,以在军事和民用环境中进一步评估TBI-QOL量表的临床效用。

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