Article
Quality of life one year after acute brain damage in patients and their spouses
Lebensqualität ein Jahr nach akuter Hirnschädigung bei Patienten und deren Partnern
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Published: | April 11, 2007 |
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Objective: Many studies have investigated the psychological adaptation of patients with brain-injury and the burden and health of family caregivers. However, the impact of family characteristics on the adaptation of brain-injured patients has received less attention. Recently, some studies have been conducted that focused on the role family factors play in the adaptation process. Most of these studies used a cross-sectional design. We conducted a prospective study that aimed at investigating the role of social factors in the adaptation process after traumatic brain injury (TBI) or subarachnoidal haemorrhage (SAH).
Methods: The first assessment took place as short as possible after the incident. One year later, patients and spouses were administered, among other instruments, the WHOQOL-BREF. This instrument is designed to measure the quality of life in the four domains physical, psychological, social, and environment. Additionally, a global score can be computed. Follow-up data for N=32 patients and N=42 spouses are available; ten patients were unable to provide data on the WHOQOL. Mean age of patients and spouses at time of injury was about 44 years. 48% of the patients had sustained a moderate and 52% a severe brain injury. 60% of the patiens were male.
Results: The comparison with the normative data on the WHOQOL revealed that neither the patients nor the spouses showed a marked reduction of their qualiy of life. Cross-sectional analyses showed significant associations primarily between anxiety and depression and the quality of life. Furthermore, longitudinal analyses provided hints for the importance of spouses' level of anxiety shortly after the incident and pre-injury family characteristics for the quality of life one year after brain injury.
Conclusions: The results indicate that there are couples who achieve and maintain an acceptable quality of life one year after brain injury. Anxiety symptoms seem to play a major role in determining quality of life. Furthermore, pre-injury couple and family functioning probably are of additional importance.