Development and validation of a revised trauma-specific quality of life instrument. Issue 4 (April 2020)

• Record Type: Journal Article
• Authors: Herrera-Escobar, Juan Pablo; deRoon-Cassini, Terri; Brasel, Karen; Nehra, Deepika; Al Rafai, Syeda Sanam; Toppo, Alexander; Kasotakis, George; Velmahos, George; Salim, Ali; Haider, Adil Hussain
• Is Part Of: Journal of trauma and acute care surgery. Volume 88:Issue 4(2020)
• Publication Date: 2020-04
• Subjects: Trauma -- quality of life -- measurement tool -- long-term outcomes; Surgical intensive care -- Periodicals; Surgical emergencies -- Periodicals; Wounds and injuries -- Surgery -- Periodicals; 617.026
• DOI: 10.1097/TA.0000000000002505
• Languages: English
• ISSNs: 2163-0755

Abstract

Abstract : BACKGROUND: The National Academies of Science has called for routine collection of long-term outcomes after injury. One of the main barriers for this is the lack of practical trauma-specific tools to collect such outcomes. The only trauma-specific long-term outcomes measure that applies a biopsychosocial view of patient care, the Trauma Quality-of-Life (T-QoL), has not been adopted because of its length, lack of composite scores, and unknown validity. Our objective was to develop a shorter version of the T-QoL measure that is reliable, valid, specific, and generalizable to all trauma populations. METHODS: We used two random samples selected from a prospective registry developed to follow long-term outcomes of adult trauma survivors (Injury Severity Score ≥9) admitted to three level I trauma centers. First, we validated the original T-QoL instrument using the 12-Item Short-Form Health Survey (SF-12) version 2.0 and Breslau post-traumatic stress disorder screening (B-PTSD) tools. Second, we conducted a confirmatory factor analysis to reduce the length of the original T-QoL instrument, and using a different sample, we scored and performed internal consistency and validity assessments of the revised T-QoL (RT-QoL) components. RESULTS: All components of the original T-QoL were significantly correlated negatively with the B-PTSD and positively with the SF-12 mental and physical composite scores. After confirmatory factor analysis, a three-component structure using 18 items (six items/component) most appropriately represented the data. Each component in the revised instrument demonstrated a high level of internal consistency (Cronbach's α ≥0.8) and correlated negatively with the B-PTSD and positively with the SF-12, demonstrating concurrent validity. In addition, each of the RT-QoL components was able to distinguish between individuals based on their work status, with those who have returned to work reporting better health. CONCLUSION: This more practical RT-QoL measure greatly increases the ability to evaluate long-term outcomes in trauma more efficiently and meaningfully, without sacrificing the validity and psychometric properties of the original instrument. LEVEL OF EVIDENCE: Prognostic and epidemiological, level III. Abstract : Supplemental digital content is available in the text.