Assessing Quality of Life in Survivors of Brain Injury from Intimate Partner Violence: A Systematic Review

Background and Purpose: It is estimated about 1 in 3 women, and 1 in 10 men, will experience intimate partner violence (IPV) in their lifetime. IPV includes many forms of abuse, with physical violence, including trauma to the head and strangulation, being the most prevalent, thereby increasing the risk of sustaining a brain injury (BI). Survivors of IPV-related BI are a unique population, who often have complex biological, psychological, and social circumstances. This calls for a comprehensive means of evaluating health and wellbeing. Quality of life (QoL) is a multidimensional concept that holistically assesses wellbeing, offering insights necessary to develop clinically meaningful interventions. Measuring QoL in survivors of IPV-related BI, both in practice and research, requires instruments that have been validated for this specific population. This systematic review sought to explore and discuss instruments used to measure QoL in survivors of BI resulting from IPV.

Methods: Following PRISMA guidelines for systematic reviews, we searched six databases for studies that measured QoL in survivors of IPV-related BI using Boolean search terms. At each phase of this review, an expert in BI research, and a front-line worker with survivors of IPV were consulted. This review was conducted as part of the Supporting Survivors of Abuse and Brain Injury Through Research, or SOAR, initiative. Articles had to include a measure of QoL, and be in English. There were no inclusion or exclusion criteria based on sex, gender, race, ethnicity, socioeconomic status, or geographical location of participants. All articles were exported to RefWorks, duplicates were removed, and the studies were evaluated by two authors.

Results: The initial search revealed no studies evaluated QoL specifically among survivors of IPV-related BI. The inclusion and exclusion criteria were therefore modified to include studies that measured QoL in participants who had survived either IPV with a report of physical abuse, or BI among individuals with a heightened risk of experiencing IPV. The subsequent search produced five studies that met the revised eligibility criteria and were included in this review. Among the five articles reviewed, four involved a sample of IPV survivors and one involved a sample with BI survivors. In four studies, the Medical Outcomes Study Short-Form was validated among both populations, showing good reliability and internal consistency.

Conclusion and Implications: This systematic review revealed no studies measured QoL in survivors of IPV-related BI, suggesting a significant gap in the literature. Understanding the full picture of health and wellbeing among survivors of IPV-related BI is essential for providing effective services. While there is an overall lack of validation of QoL instruments in this population, there are some promising measures that could be considered. For example, the Medical Outcomes Study Short-Form has been used in studies with participants who have survived either IPV or BI and may be adaptable for survivors of IPV-related BI. Future research should examine the validity and reliability of QoL instruments among survivors of IPV-related BI to promote a strengths-based research agenda and inform meaningful interventions.