Brown M, Vandergoot D
Department of Rehabilitation Medicine, The Mount Sinai Medical Center, New York, New York 10029, USA.
J Head Trauma Rehabil. 1998 Aug;13(4):1-23. doi: 10.1097/00001199-199808000-00002.
To provide a conceptual overview of approaches to quality of life (QOL) measurement and an extensive review of research relating to QOL after TBI; to document subjective QOL of individuals with traumatic brain injury (TBI); to explore how subjective QOL differs for people with TBI in comparison to individuals with no disability (ND) and those with spinal cord injury (SCI); and to document the perceptions of unmet important needs and the relationship between such perceptions and subjective QOL.
Interview-based data focusing on current perceptions of QOL and unmet important needs, obtained from individuals with TBI, SCI, or ND. Covariance and partial regression analyses were used to explore group differences and to document relationships between variables.
Individuals drawn from diverse communities across New York State.
TBI group: 430 individuals who identified themselves as having TBI; SCI group: 101 individuals with spinal cord injury; ND group: 187 people who identified themselves as having no disability. Participants were recruited through recruitment ads in general circulation newspapers and newsletters and through contacting a wide variety of community agencies.
Two summary QOL indicators: a Global QOL Measure based on two items tapping the individual's emotion-based view of QOL, and a summary score adapted from Flanagan"s Scale of Needs, reflecting the individual's perceptions of total unmet important needs.
Both summary QOL indicators were correlated with demographic characteristics. Unmet important needs were stronger in the TBI group than in the SCI and ND groups. Most areas of unmet important need were moderately correlated with the summary QOL indicators. Analyses of covariance showed that severity of injury was a more powerful modulator of post-TBI QOL judgments than the mere fact of TBI. For example, those with the most severe injury (ie, loss of consciousness [LOC] >1 month) rated their QOL similar to that in the ND group, whereas individuals who had experienced only a brief LOC (<20 minutes) viewed their QOL as significantly lower than that in the ND and SCI groups and lower than other TBI severity subgroups.
This exploration of subjective QOL strengthens the argument that after TBI, the insider"s reaction to injury varies greatly within the population. Thus, severity of injury strongly affects perceptions of QOL. The use of a multimethod approach for exploring the reactions and perceptions of QOL has proven useful in this study.
对生活质量（QOL）测量方法进行概念性概述，并广泛回顾与创伤性脑损伤（TBI）后生活质量相关的研究；记录创伤性脑损伤（TBI）患者的主观生活质量；探讨TBI患者与无残疾（ND）个体及脊髓损伤（SCI）个体相比主观生活质量的差异；记录未满足的重要需求的认知情况以及此类认知与主观生活质量之间的关系。
基于访谈的数据，聚焦于TBI、SCI或ND个体对当前生活质量和未满足的重要需求的认知。采用协方差分析和偏回归分析来探讨组间差异并记录变量之间的关系。
从纽约州不同社区招募个体。
TBI组：430名自认为患有TBI的个体；SCI组：101名脊髓损伤个体；ND组：187名自认为无残疾的个体。通过在大众发行的报纸和时事通讯上刊登招募广告以及联系各种社区机构来招募参与者。
两个生活质量综合指标：一个基于两项内容的总体生活质量测量指标，该指标挖掘个体基于情感的生活质量观；另一个是根据弗拉纳根需求量表改编的综合得分，反映个体对未满足的重要需求总量的认知。
两个生活质量综合指标均与人口统计学特征相关。TBI组未满足的重要需求比SCI组和ND组更强烈。未满足的重要需求的大多数领域与生活质量综合指标呈中度相关。协方差分析表明，损伤严重程度比单纯的TBI事实更能有力地调节TBI后生活质量的判断。例如，损伤最严重的个体（即意识丧失[LOC]>1个月）对其生活质量的评分与ND组相似，而仅经历短暂LOC（<20分钟）的个体认为其生活质量明显低于ND组和SCI组，且低于其他TBI严重程度亚组。
对主观生活质量的这一探索强化了这样一种观点，即TBI后，人群中个体对损伤的反应差异很大。因此，损伤严重程度强烈影响生活质量的认知。在本研究中，使用多方法途径来探索生活质量的反应和认知已被证明是有用的。
