von Steinbuechel Nicole, Krenz Ugne, Bockhop Fabian, Koerte Inga K, Timmermann Dagmar, Cunitz Katrin, Zeldovich Marina, Andelic Nada, Rojczyk Philine, Bonfert Michaela Veronika, Berweck Steffen, Kieslich Matthias, Brockmann Knut, Roediger Maike, Lendt Michael, Buchheim Anna, Muehlan Holger, Holloway Ivana, Olabarrieta-Landa Laiene
Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany.
cBRAIN/Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital, Ludwig-Maximilian University, Nussbaumstrasse 5, 80336 Munich, Germany.
J Clin Med. 2023 Jun 7;12(12):3895. doi: 10.3390/jcm12123895.
In the field of pediatric traumatic brain injury (TBI), relationships between pre-injury and injury-related characteristics and post-TBI outcomes (functional recovery, post-concussion depression, anxiety) and their impact on disease-specific health-related quality of life (HRQoL) are under-investigated. Here, a multidimensional conceptual model was tested using a structural equation model (SEM). The final SEM evaluates the associations between these four latent variables. We retrospectively investigated 152 children (8-12 years) and 148 adolescents (13-17 years) after TBI at the recruiting clinics or online. The final SEM displayed a fair goodness-of-fit (SRMR = 0.09, RMSEA = 0.08 with 90% CI [0.068, 0.085], GFI = 0.87, CFI = 0.83), explaining 39% of the variance across the four latent variables and 45% of the variance in HRQoL in particular. The relationships between pre-injury and post-injury outcomes and between post-injury outcomes and TBI-specific HRQoL were moderately strong. Especially, pre-injury characteristics (children's age, sensory, cognitive, or physical impairments, neurological and chronic diseases, and parental education) may aggravate post-injury outcomes, which in turn may influence TBI-specific HRQoL negatively. Thus, the SEM comprises potential risk factors for developing negative post-injury outcomes, impacting TBI-specific HRQoL. Our findings may assist healthcare providers and parents in the management, therapy, rehabilitation, and care of pediatric individuals after TBI.
在小儿创伤性脑损伤（TBI）领域，损伤前和损伤相关特征与TBI后结果（功能恢复、脑震荡后抑郁、焦虑）之间的关系及其对特定疾病的健康相关生活质量（HRQoL）的影响尚未得到充分研究。在此，使用结构方程模型（SEM）对一个多维概念模型进行了测试。最终的SEM评估了这四个潜在变量之间的关联。我们在招募诊所或通过网络对152名儿童（8 - 12岁）和148名青少年（13 - 17岁）TBI后情况进行了回顾性调查。最终的SEM显示出较好的拟合优度（SRMR = 0.09，RMSEA = 0.08，90%置信区间[0.068, 0.085]，GFI = 0.87，CFI = 0.83），解释了四个潜在变量中39%的方差，特别是HRQoL中45%的方差。损伤前和损伤后结果之间以及损伤后结果与TBI特异性HRQoL之间的关系中等强度。特别是，损伤前特征（儿童年龄、感觉、认知或身体损伤、神经和慢性疾病以及父母教育程度）可能会加重损伤后结果，进而可能对TBI特异性HRQoL产生负面影响。因此，SEM包含了导致损伤后负面结果的潜在风险因素，影响TBI特异性HRQoL。我们的研究结果可能有助于医疗保健提供者和家长对小儿TBI患者进行管理、治疗、康复和护理。
