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Factors Associated With High and Low Life Satisfaction 10 Years After Traumatic Brain Injury

Published:February 21, 2022DOI:https://doi.org/10.1016/j.apmr.2022.01.159

      Abstract

      Objective

      To identify correlates of life satisfaction at 10 years after moderate to severe traumatic brain injury (TBI) using an extreme phenotyping approach.

      Design

      Effect sizes were calculated in this observational cohort study to estimate relationships of 10-year postinjury extremely high, extremely low, and moderate life satisfaction with (1) pre-injury demographics, injury-related factors, and functional characteristics at inpatient rehabilitation admission and discharge; and (2) postinjury demographics and clinical and functional measures at 10 years postinjury.

      Setting

      Multicenter longitudinal database study.

      Participants

      People identified from the National Institute on Disability, Independent Living, and Rehabilitation Research TBI Database with life satisfaction data at 10 years post TBI (N=4800).

      Interventions

      Not applicable.

      Main Outcome Measure

      Satisfaction With Life Scale.

      Results

      Although few pre-injury factors or clinical and functional factors shortly after injury were associated with 10-year life satisfaction groups, the following 10-year postinjury factors were associated with extremely high vs extremely low life satisfaction group membership: greater independent functioning, less disability, more frequent community participation, being employed, and having fewer depressive and anxiety symptoms. Those with extremely high life satisfaction were distinctly different from those with moderate and extremely low satisfaction. Extremely high life satisfaction was underrepresented among non-Hispanic Black persons relative to non-Hispanic White persons. Relationships between life satisfaction and independent functioning, disability, and participation were attenuated among non-Hispanic Black persons.

      Conclusions

      Extreme phenotyping analysis complements existing knowledge regarding life satisfaction after moderate to severe TBI and may inform acute and postacute clinical service delivery by comparing extremely high and extremely low life satisfaction subgroups. Findings suggest little association among personal, clinical, and functional characteristics early post TBI and life satisfaction 10 years later. Contemporaneous correlates of extremely high life satisfaction exist at 10 years post TBI, although the positive relationship of these variables to life satisfaction may be attenuated for non-Hispanic Black persons.

      Keywords

      List of abbreviations:

      DRS (Disability Rating Scale), ES (effect size), GAD-7 (General Anxiety Disorder-7), GCS (Glasgow Coma Scale), GOS-E (Glasgow Outcome Scale-Extended), LST (life satisfaction trajectory), PART-O (Participation Assessment for Recombined Tools-Objective), PHQ-9 (Patient Health Questionnaire-9), SWLS (Satisfaction With Life Scale), TBI (traumatic brain injury), TBIMS (Traumatic Brain Injury Model Systems)
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