Factors Explaining Quality of Life among People with Moderate to Severe Traumatic Brain Injury in Bangladesh: A Cross-Sectional Study
Keywords:Bangladesh, caregiver, depression, quality of life, social support, traumatic brain injury
Traumatic brain injury leads to mortality and disability with consequences for the poor quality of life of people. Little study regarding the quality of life of people with traumatic brain injury in Bangladesh exists. This cross-sectional study aims to examine the quality of life and its influencing factors among people with moderate to severe traumatic brain injury. The participants were 249 people with moderate to severe traumatic brain injury, and their caregivers recruited from three public hospitals in Bangladesh. Data were collected through questionnaires including socio-demographic, the Injury Related Illness and Injury Severity Score questionnaire, the Charlson Comorbidity Index, the Modified Barthel Index, the Patients Health Questionnaire-9, the MOS-Social Support Survey, the Quality of Life after Brain Injury (QOLIBRI), the caregiver socio-demographic, and the Caregiver Preparedness Scale. Data were analyzed using descriptive statistics, Pearson’s correlation test, and stepwise multiple regression model.
Results showed that majority of the people reported a poor quality of life. Stepwise multiple regression analysis revealed that social support, caregiver preparedness, depression, and income, were significant factors and could explain 37% variance of quality of life. To improve the quality of life among people with traumatic brain injury, nurses should seek significant resources to support them, perform emotional support to prevent depression and prepare their caregivers with knowledge and proper skills for patients’ care. Eventually, they can have healthy transition and obtain desirable health outcomes with good quality of life.
Zimmerman A, Fox S, Griffin R, Nelp T, Thomaz EB, Mvungi M, et al. An analysis of emergency care delays experienced by traumatic brain injury patients presenting to a regional referral hospital in a low-income country. Plos One. 2020;15(10). doi: 10.1371. e0240528. Epub 2020 Oct 12.
James SL, Theadom A, Ellenbogen RG, Bannick MS, Montjoy-Venning W, Lucchesi LR, et al. Global, regional,
and national burden of traumatic brain injury and spinal cord injury, 1990–2016: a systematic analysis for the
Global Burden of Disease Study 2016. Lancet Neurol. 2019; 18(1):56-87. doi: 10.1016/S1474-4422.
Dewan MC, Rattani A0, Gupta S, Baticulon RE, Hung YC, Punchak M, et al. Estimating the global incidence of
traumatic brain injury. J Neurosurg. 2018; 130(4):1080-97. doi: 10.3171/2017.10.JNS17352.
Islam M, Saha S, Elahy M, Islam K, Ahamed S. Factors influencing the outcome of patients with acute extradural haematomas undergoing surgery. Bangladesh J Medical Sci. 2011; 10(2):112 (Bangladesh local journal).
Mondol MA, Rahman N, Akther S, Ahmed B, Rahman A, Momen MA,et al. Sociodemographical and clinical presentation of traumatic brain injury patients. J Dhaka Med Coll. 2013;22 (1): 45-50 (Bangladesh local journal).
Gopaul R, Wei ZD, Yan J, Gong FY, Xiao SW. Clinical study of quality of life of traumatic brain injury patients after decompressive craniectomy and related influencing factors. Chin Neurosurg J.l 2016; 2(1): 33. doi: 10.1186/
s41016-016-0044-5. Epub 2016 Sep 22.
Andelic N, Howe EI, Hellstrøm T, Sanchez MF, Lu J, Lovstad M, et al. Disability and quality of life 20 years after traumatic brain injury. Brain Behav. 2018;8(7): e01018. doi: 10.1002/brb3.1018. Epub 2018 Jun 11.
Rauen K, Reichelt L, Probst P, Schäpers B, Müller F, Jahn K, Plesnila N. Quality of life up to 10 years after traumatic brain injury: a cross-sectional analysis. Health Qual Life Outcomes. 2020;18: 116. doi: 10.1186/s12955-020-01391-3. Epub 2020 Jun 4.
Songwatana P, Kitrungrote L, Anumas N, Nimitpan P. Predictive factors for health-related quality of life among Thai traumatic brain injury patients. J Beh Scie [Internet]. 2018 Jan 31 [cited 2021 Oct 24];13(1):82-92. Available from: https://so06.tci-thaijo.org/index.php/IJBS/article/view/81933
Abbasi SA, Ali T, Rozi S, Khan UR, Jooma R. Quality of life of road traffic injury survivors aged 15-44 years suffered from moderate and severe head injuries in Karachi, Pakistan. J Clin Res Bioeth 2019;10:335. doi: 10.35248/2155-9622.214.171.1245. Epub 2019 Jun 28.
Reddy RP, Rajeswaran J, Devi BI, Kandavel T. Cascade of traumatic brain injury: a correlational study of cognition, postconcussion symptoms, and quality of life. Indian J Psychol Med. 2017;39(1):32-9. doi: 10.4103/0253-7176.198940.
Grauwmeijer E, Heijenbrok-Kal MH, Peppel LD, Hartjes CJ, Haitsma IK, de Koning I, Ribbers GM. Cognition,
health-related quality of life, and depression ten years after moderate to severe traumatic brain injury: a prospective cohort study. J Neurotrauma. 2018;35(13):1543-51. doi: 10.1089/neu.2017.5404. Epub 2018 Apr 6.
von Steinbüchel N, Real RG, Sasse N, Wilson L, Otto C, Mullins R, et al. German validation of Quality of Life after Brain Injury (QOLIBRI) assessment and associated factors. Plos One. 2017;12(5): e0176668 doi: 10.1371/ journal.pone.0176668. Epub 2017 May 24.
Meleis AI. Transition theory: middle–range and situation–specific theories in nursing research and practice. New York: Springer Publishing Company; 2010.
World Health Organization. WHOQOL-BREF: introduction, administration, scoring and generic version of the assessment: field trial version, December 1996. World Health Organization; 1996. Available from: http://www.who.int/mental_health/ media/en/76.pdf
Von Steinbuechel N, Covic A, Polinder S, Kohlmann T, Cepulyte U, Poinstingl H,et al. Assessment of health-related quality of life after TBI: comparison of a disease-specific (QOLIBRI) with a generic (SF-36) instrument. Behav Neurol. 2016;2016:7928014. doi: 10.1155/2016/7928014. Epub 2016 Feb 1.
Gorgoraptis N, Zaw-Linn J, Feeney C, Tenorio-Jimenez C, Niemi M, Malik A, et al. Cognitive impairment and
health-related quality of life following traumatic braininjury. Neuro Rehabilitation. 2019;44(3): 32-31. doi:
Lieshout K, Oates J, Baker A, Unsworth CA. Cameron ID, Schmidt J, et al. Burden and preparedness amongst informal caregivers of adults with moderate to severe traumatic brain injury. Int J Environ Res Public Health. 2020;17(17),6386. doi: 10.3390/ijerph17176386. Epub 2020 Sep 2.
Leijdesdorff HA, Krijnen P, van Rooyen L, de Mheen PMV, Rhemrev S, Schipper IB. Reduced quality of life, fatigue, and societal participation after polytrauma. Int Surg. 2018;103(3-4): 158-66. doi.org/10.9738/INTSURG-D-
Xiong C, Hanafy S, Chan V, Hu ZJ, Sutton M, Escobar M, et al. Comorbidity in adults with traumatic brain injury and all-cause mortality: a systematic review. BMJ Open. 2019;9(11):e029072. doi: 10.1136/bmjopen-2019-029072. Epub 2019 Nov 7.
Stone K. Enhancing preparedness and satisfaction of caregivers of patients discharged from an inpatient rehabilitation facility using an interactive website. Rehabil Nurs. 2014;39(2):76-85. doi: 10.1002/rnj.123. Epub 2013 Aug 28.
Powell JM, Wise EK, Brockway JA, Fraser R, Temkin N, Bell KR. Characteristics and concerns of caregivers of adults with traumatic brain injury. J Head Trauma Rehabil. 2017;32(1),E33-E41. doi: 10.1097/HTR.0000000000000219. PMID: 27022956.
Hodkinson HM. Evaluation of a mental test score for assessment of mental impairment in the elderly. Age Ageing.1972;1(4):233-8. doi:10.1093/ageing/1.4.233.PMID: 4669880.
Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillside: Lawrence Erlbaum Associates,
Nolte, M. Disablement, context, and quality of life after brain injury: Measuring what matters [Dissertation Ph.D. Psychology].[Kingston, Ontario]: Queen’s Univesrity; 1999.
World Health Organization. Process of translation and adaptation of instruments. 2019 [cited 2019 December 26].Available from: https://www.who.int/substance_abuse/research_tools/translation/en/
Baker SP, O’Neill B, Haddon JW, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974;14(3),187-96. doi.org/10.1097/00005373-19740
Charlson ME, Pompei P, Ales KL, MacKenzie CRA. New method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373-83. doi: 10.1016/0021-9681(87)
Shah S, Vanclay F, Cooper B. Improving the sensitivity of the Barthel Index for stroke rehabilitation. J Clin Epidemiol. 1989;42(8):703-9. doi: 10.1016/0895-4356(89)90065-6. PMID: 2760661.
Spitzer RL, Kroenke K, Williams JW, Validation and utility of a self-report version of PRIME-MD The PHQ primary care study. Primary care evaluation of mental disorders. patient health questionnaire. JAMA. 1999;282(18):1737-44. doi: 10.1001/jama.282.18.1737. PMID:10568646.
Sherbourne CD, Stewart AL. The MOS social support survey. Soc Sci Med .1991; 32(6):705-14. doi: 10.1016/
von Steinbüchel N, Wilson L, Gibbons H, Hawthorne G, Höfer S, Schmidt S, et al. QOLIBRI Task Force. Quality
of Life after Brain Injury (QOLIBRI): scale development and metric properties. J Neurotrauma. 2010;27(7):
-85. doi: 10.1089/neu.2009.1076. PMID:20486801.
Wilson L, Marsden-Loftus I, Koskinen S, Bakx W, Bullinger M, Formisano R, et al. Interpreting Quality of Life after Brain Injury Scores: cross-walk with the Short Form-36. J. Neurotrauma. 2017;34(1): 59-65. doi: 10.1089/neu.
4287. Epub 2016 Jul 8.
Born K, Amsler F, Gross T. Prospective evaluation of the Quality of Life after Brain Injury (QOLIBRI) score: minor differences in patients with major versus no or mild traumatic brain injury at one-year follow up. Health Qual Life Outcomes. 2018;16(1):136. doi: 10.1186/s12955-018-0966-z. Epub 2018 Jul 9.
Archbold PG, Stewart BJ, Greenlick MR, Harvath T. Mutuality and preparedness as predictors of caregiver role
strain. Res Nurs Health. 1990;13(6):375-84. doi:10.1002/nur.4770130605.
Pucciarelli G, Savini S, Byun E, Simeone S, Barbaranelli C, Vela RJ, et al. Psychometric properties of the Caregiver Preparedness Scale in caregivers of stroke survivors. Heart Lung. 2014;43(6):555-60. doi: 10.1016/j.hrtlng.2014.08.004. Epub 2014 Sep 18.
Azman A, Jali NA, Singh PSJ, Abdullah JM, Ibrahim H. Family roles, challenges and needs in caring for traumatic brain injury (TBI) family members: a systematic review. J Health Res. 2020;34(6):495-504. doi: 10.1108/
Rasmussen MS, Arango-Lasprilla JC, Andelic N, Nordenmark TH, Soberg HL. Mental health and family functioning in patients and their family members after traumatic brain injury:a cross-sectional study. Brain Sci. 2020;10(10):670.doi: 10.3390/brainsci10100670. PMID: 32992808;PMCID: PMC7600942.Epub 2020 Sep 25.
How to Cite
Copyright: The Pacific Rim International Journal of Nursing Research, Thailand Nursing & Midwifery Council has exclusive rights to publish, reproduce and distribute the manuscript and all contents therein.