{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T06:43:22Z","timestamp":1779000202187,"version":"3.51.4"},"reference-count":71,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T00:00:00Z","timestamp":1686096000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Dr. Senckenbergische Stiftung"},{"name":"Clementine Kinderhospital Dr. Christ\u2018sche Stiftungen"},{"name":"Uniscientia Stiftung"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>In the field of pediatric traumatic brain injury (TBI), relationships between pre-injury and injury-related characteristics and post-TBI outcomes (functional recovery, post-concussion depression, anxiety) and their impact on disease-specific health-related quality of life (HRQoL) are under-investigated. Here, a multidimensional conceptual model was tested using a structural equation model (SEM). The final SEM evaluates the associations between these four latent variables. We retrospectively investigated 152 children (8\u201312 years) and 148 adolescents (13\u201317 years) after TBI at the recruiting clinics or online. The final SEM displayed a fair goodness-of-fit (SRMR = 0.09, RMSEA = 0.08 with 90% CI [0.068, 0.085], GFI = 0.87, CFI = 0.83), explaining 39% of the variance across the four latent variables and 45% of the variance in HRQoL in particular. The relationships between pre-injury and post-injury outcomes and between post-injury outcomes and TBI-specific HRQoL were moderately strong. Especially, pre-injury characteristics (children\u2019s age, sensory, cognitive, or physical impairments, neurological and chronic diseases, and parental education) may aggravate post-injury outcomes, which in turn may influence TBI-specific HRQoL negatively. Thus, the SEM comprises potential risk factors for developing negative post-injury outcomes, impacting TBI-specific HRQoL. Our findings may assist healthcare providers and parents in the management, therapy, rehabilitation, and care of pediatric individuals after TBI.<\/jats:p>","DOI":"10.3390\/jcm12123895","type":"journal-article","created":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T02:02:28Z","timestamp":1686189748000},"page":"3895","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A Multidimensional Approach to Assessing Factors Impacting Health-Related Quality of Life after Pediatric Traumatic Brain Injury"],"prefix":"10.3390","volume":"12","author":[{"given":"Nicole","family":"von Steinbuechel","sequence":"first","affiliation":[{"name":"Institute of Medical Psychology and Medical Sociology, University Medical Center G\u00f6ttingen, Waldweg 37A, 37073 G\u00f6ttingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0518-8781","authenticated-orcid":false,"given":"Ugne","family":"Krenz","sequence":"additional","affiliation":[{"name":"Institute of Medical Psychology and Medical Sociology, University Medical Center G\u00f6ttingen, Waldweg 37A, 37073 G\u00f6ttingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8892-896X","authenticated-orcid":false,"given":"Fabian","family":"Bockhop","sequence":"additional","affiliation":[{"name":"Institute of Medical Psychology and Medical Sociology, University Medical Center G\u00f6ttingen, Waldweg 37A, 37073 G\u00f6ttingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1281-9286","authenticated-orcid":false,"given":"Inga K.","family":"Koerte","sequence":"additional","affiliation":[{"name":"cBRAIN\/Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital, Ludwig-Maximilian University, Nussbaumstrasse 5, 80336 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dagmar","family":"Timmermann","sequence":"additional","affiliation":[{"name":"Institute of Medical Psychology and Medical Sociology, University Medical Center G\u00f6ttingen, Waldweg 37A, 37073 G\u00f6ttingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5530-8190","authenticated-orcid":false,"given":"Katrin","family":"Cunitz","sequence":"additional","affiliation":[{"name":"Institute of Medical Psychology and Medical Sociology, University Medical Center G\u00f6ttingen, Waldweg 37A, 37073 G\u00f6ttingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0172-9904","authenticated-orcid":false,"given":"Marina","family":"Zeldovich","sequence":"additional","affiliation":[{"name":"Institute of Medical Psychology and Medical Sociology, University Medical Center G\u00f6ttingen, Waldweg 37A, 37073 G\u00f6ttingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nada","family":"Andelic","sequence":"additional","affiliation":[{"name":"Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Department of Health and Society, University of Oslo, 0316 Oslo, Norway"},{"name":"Department of Physical Medicine and Rehabilitation, Oslo University Hospital, 0424 Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9813-3690","authenticated-orcid":false,"given":"Philine","family":"Rojczyk","sequence":"additional","affiliation":[{"name":"cBRAIN\/Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital, Ludwig-Maximilian University, Nussbaumstrasse 5, 80336 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0995-9050","authenticated-orcid":false,"given":"Michaela Veronika","family":"Bonfert","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, Dr. von Hauner Children\u2019s Hospital, LMU University Hospital, Haydnstr. 5, 80336 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steffen","family":"Berweck","sequence":"additional","affiliation":[{"name":"Specialist Center for Paediatric Neurology, Neurorehabilitation and Epileptology, Schoen Klinik, Krankenhausstra\u00dfe 20, 83569 Vogtareuth, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Kieslich","sequence":"additional","affiliation":[{"name":"Department of Paediatric Neurology, Hospital of Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Knut","family":"Brockmann","sequence":"additional","affiliation":[{"name":"Interdisciplinary Pediatric Center for Children with Developmental Disabilities and Severe Chronic Disorders, Department of Pediatrics and Adolescent Medicine, University Medical Center, Robert-Koch-Str. 40, 37075 G\u00f6ttingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maike","family":"Roediger","sequence":"additional","affiliation":[{"name":"Department of Pediatric Intensive Care Medicine and Neonatology, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Lendt","sequence":"additional","affiliation":[{"name":"Neuropediatrics, St. Mauritius Therapeutic Clinic, Str\u00fcmper Stra\u00dfe 111, 40670 Meerbusch, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1339-5246","authenticated-orcid":false,"given":"Anna","family":"Buchheim","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Psychologie, Universit\u00e4t Innsbruck, Innrain 52 f, 6020 Innsbruck, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8048-5682","authenticated-orcid":false,"given":"Holger","family":"Muehlan","sequence":"additional","affiliation":[{"name":"Department of Health and Prevention, University of Greifswald, Robert-Blum-Str. 13, 17487 Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9542-883X","authenticated-orcid":false,"given":"Ivana","family":"Holloway","sequence":"additional","affiliation":[{"name":"Institute of Medical Psychology and Medical Sociology, University Medical Center G\u00f6ttingen, Waldweg 37A, 37073 G\u00f6ttingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8305-8720","authenticated-orcid":false,"given":"Laiene","family":"Olabarrieta-Landa","sequence":"additional","affiliation":[{"name":"Departamento de Ciencias de la Salud, Universidad P\u00fablica de Navarra, Campus de Arrosad\u00eda, 31006 Pamplona, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1016\/S1474-4422(17)30371-X","article-title":"Traumatic Brain Injury: Integrated Approaches to Improve Prevention, Clinical Care, and Research","volume":"16","author":"Maas","year":"2017","journal-title":"Lancet Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/j.ijdevneu.2011.12.005","article-title":"Depression in Children and Adolescents in the First 6 Months after Traumatic Brain Injury","volume":"30","author":"Max","year":"2012","journal-title":"Int. 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