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Views on Quality of Life Differ Between Alcohol Related Brain Damaged Individuals and Their Healthcare Professionals

Abstract

Measuring quality of life (QoL) in alcohol related brain damaged individuals (ARBDs) is challenging, mostly because patients are characterized by important cognitive impairments and are generally unaware of their defects. However, quality of life assessments are essential to help inform care and rehabilitative settings; thus introducing and including views from healthcare professionals on ARBDs’ quality of life is a reasonable approach. We examine QoL and the perception of cognitive defects among ARBDs and compare them to expert appraisals by acquainted healthcare professionals. We hypothesize that ARBDs self-assessments outscore QoL expert-ratings by professionals and demonstrate an unawareness of their cognitive deficits, with anosognosia being related to the QoL domains of interest. Six domains of QoL and the occurrence of cognitive problems in 14 detoxified alcoholics are investigated by means of self-ratings and expert-ratings from two acquainted healthcare professionals. Anosognosia is assessed by using difference scores between self- and expert-ratings on the manifestation of everyday executive dysfunctions. We find that ARBDs experience anosognosia (ps < .001) and outscore systematically expert-ratings on the investigated QoL domains (ps < .03). Complex patterns of relationships between self-/expert-rated QoL relate mostly negatively and moderately with anosognosia, confirming some of our assumptions and informing others. ARBDs are characterized by anosognosia and differ largely from expert’s views on patient QoL. Professionals relate compromised patient QoL to the inability of the patient to have insight of his/her dysfunctions; whereas among patients, QoL relates less strongly to anosognosia. Remaining doubts on the validity of QoL self-/expert-ratings in ARBDs are discussed.

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Acknowledgments

Authors are grateful to the patients, their families and nursing staff for participating and their support during the study. We thank Dr. Salvador Rivas (University of Luxembourg, Luxembourg) for his valuable time and for proofreading the manuscript. We thank Dr. Giovanni Ottoboni (University of Bologna, Italy) for discussions during the preparation of the manuscript.

Conflict of Interest

The work was supported by continuous funding from the Fondation Ste Zithe whose support is gratefully acknowledged. The supporting source had no involvement in the study conception, data collection, data analysis, interpretation of the data, the writing of the report, or the decision to submit the report for publication.

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Correspondence to Jean-Paul Steinmetz.

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Steinmetz, JP., Theisen-Flies, C. & Federspiel, C. Views on Quality of Life Differ Between Alcohol Related Brain Damaged Individuals and Their Healthcare Professionals. Applied Research Quality Life 11, 239–251 (2016). https://doi.org/10.1007/s11482-014-9365-8

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Keywords

  • Quality of life
  • Alcohol related brain damage
  • Korsakoff’s syndrome
  • Anosognosia
  • Self-rating
  • Expert-rating