Article

OBJECTIVE: To examine the level of agreement between patients and their proxies
on a measure of health-related quality of life (HRQL) 1 year after traumatic
brain injury (TBI). DESIGN:
A cross-sectional study.
SETTING: Four hospitals in
Taipei. PARTICIPANTS: Participants (N=176) were patients with TBI (n=88)
identified from discharge records of 4 hospitals in Taiwan and family members or
friends (n=88) who could answer questions regarding the patient's health and HRQL
1 year after the injury. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES:
A health profile of the brief Taiwanese version of the World Health Organization
Quality of Life (WHOQOL-BREF) and 2 health utility measures of the time tradeoff
(TTO) and standard gamble (SG). RESULTS: Compared with proxy responses, patients
provided higher ratings on the domains of the WHOQOL-BREF and lower ratings on
the TTO and SG. Intraclass correlation coefficients between patient and proxy
ratings varied among the 4 domains of the WHOQOL-BREF, in which levels of
agreement were moderate or good for physical capacity (.69) and low for
psychological well-being (.45), social relationships (.24), and the environment
(.32). Levels of agreement were extremely low for the TTO (0.0) and SG (.10). A
profile analysis showed that patients' ratings on the WHOQOL-BREF, on average,
were significantly greater than those of their proxies (mean difference, 3.07),
with a similar distribution of scatter responses (mean difference, .002) and
shape agreement (mean difference, .57). Greater variations in the patient-proxy
level of agreement appeared in patients who were younger and had more severe
injuries, and also with parent and child proxies. CONCLUSIONS: To assess the HRQL
of patients with a TBI, the level of patient-proxy agreement was adequate for the
physical domain but was lower for the social and environmental domains, and the
agreement was very low for the TTO and SG. Furthermore, a patient's age and
injury severity, and the patient-proxy' relationship may affect the agreement.
CI - Copyright (c) 2017 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS