DA005 - Preinjury History Questionnaire Instructions

DA005	Instructions for Administration of the Pre-Injury History Interview/Questionnaire
Review Committee: Data	Start Date: 2/17/2004
Attachments: None	Last Revised Date: 1/1/2013
Forms: DAF102 – Form 1 Pre-Injury History Interview; DAF103 – Form 1 Pre-Injury History Questionnaire	Last Reviewed Date: 2/11/2020

Introduction:

The Form 1 data collection of the TBIMS National Database requires the use of the Pre-Injury History Interview/Questionnaire to be collected from the patient and/or family as soon as it is possible after the participant has been enrolled into the TBIMS.

Purpose:

To institute a standardized method for collecting pre-injury history items on the TBIMS Form 1.

Scope:

All current TBIMS centers collecting Form 1 data.

Responsibilities:

All current TBIMS staff who collect pre-injury history information.

Procedural steps:

The Pre-Injury History Interview or Questionnaire should be used to collect relevant data for the TBIMS National Database Form 1. Exact wording of questions is provided. The Pre-Injury History Interview and Questionnaire forms are available on the NDSC website. Centers should not be using their own data collection methods or forms.

The pre-injury history information is to be collected as soon as possible after injury, whether from the person with TBI or from a family member/significant other. The objective is to get accurate information, from the most reliable source. If information cannot be obtained during inpatient rehabilitation, continue to attempt to collect this information up until the Form 2 year 1 data collection window closes, taking care to distinguish the difference between pre-injury occurrences and occurrences during the follow-up period.

Form 1 demographic questions are included in the questionnaire because, with the exception of date of birth, it is preferable to collect this information from the patient or a well-informed significant other rather than from medical records. Asking these easy-to-answer demographic questions also helps to establish rapport with the respondent prior to the more sensitive questions.

The Pre-Injury History Interview can be used for in-person interviews or phone interviews. The Pre-Injury History Questionnaire can be used as a self-administered questionnaire, or it can be mailed to the person with brain injury and/or family member. The Pre-Injury History Interview or Questionnaire should be given to the person who, based on the clinician/data collector's opinion, can supply the most accurate information.

Family members or patients may be unsure of their answers to some questions (e.g., drug and alcohol use/abuse). Do not encourage individuals to guess at answers; but do encourage them to answer all questions. When coding data later, enter the appropriate code to indicate that the question was asked but not answered (e.g. "unknown"). [We deliberately chose not to list a "don't know" or "unknown" response alternative on the questionnaire. Past experience indicates that such alternatives substantially increase the rate of unusable responses.]

For prospective data collection, information collected using this questionnaire should be entered into the database as part of the Form 1. For retrospective data collection, information collected using this questionnaire should be updated on the Form 1 already entered into the database.

Training requirements:

The Pre-Injury History Interview/Questionnaire is discussed at the Data Collectors conferences as well as a possible topic for the quarterly Data Collectors teleconferences.

Compliance:

All collaborating centers utilizing the TBIMS National Database are responsible for adhering to this policy and its procedures. The NDSC will determine if the questionnaire is used as part of the Quality Support Visits.

References:

None.

History:

Date	Action
2/17/2004	Version of inclusion criteria used to create this SOP
9/16/2008	Transferred to SOP template and approved by SOP Review Committee
12/12/2008	Revised definition with approval of Planning Committee and Project Directors
1/1/2013	Updated Pre-morbid to Pre-Injury; Updated language to include Pre-Injury Interview and Questionnaire
09/08/2014	SOP Reviewed
2/11/2020	SOP Reviewed

Review schedule:

At least every 5 years.