Impact assessment of functional disability associated with brain injury on the relationship between patient adjustment strategies and quality of life

Objective Brain injury, regardless of its origin, causes multiple damage (neurological, cognitive, behavioral, psychopathological). The resulting disability, as well as the adjustment strategies put in place by patients in order to cope with the difficulties they face, permanently affect their quality of life (QOL). The aim of our study is to evaluate the impact of functional disability on the relationship between patient adjustment strategies and QOL. Material/patients and methods Fifty patients were included in a week of neuropsychological assessment in a context of social and vocational rehabilitation. Patients filled a specific scale of QOL (QOLIBRI) and a generic scale evaluating five adjustment strategies (COPE Brief). Functional disability was assessed by the GOS score. The effects of the functional disability on the relationship between the different adjustment strategies and the different dimensions of quality of life were tested by linear regression analyzes. Results The results show that functional disability score moderates the relationship between 3 of 5 adjustment strategies and the QOL: distraction (escaping, daydreaming…) allows a better satisfaction with self-perception in patients with moderate disability. Problem solving allows for better satisfaction with social relationships and functioning of thinking in patients with good functional recovery. Finally, cognitive restructuring (humor, positive reinterpretation…) promotes relative satisfaction with the functioning of thinking in patients with a good GOS score. Discussion – conclusion These findings highlight the different effects that patient adjustment strategies can have on quality of life depending on the level of functional disability caused by brain injury. It therefore seems important to take into account these differences for the patient care of patients with brain injury in order to better assist them in their recovery process rehabilitation.