Objectives: Several studies indicate that injury-related variables and measures of physical and cognitive impairment are poor predictors of quality of life (QOL) after traumatic brain injury (TBI).1-3 Objective measures of functional activity also show a weak relationship with QOL.4,5 This study investigated the potential contribution of subjective self-appraisal measures to predicting QOL. Hypothesis: Activity-related satisfaction with functioning and measures of perceived cognitive, emotional, and social self-efficacy will make sig-nificant incremental contributions to global QOL when considered with demographic, injury-related, and functional measures. Participants: Convenience sample of 100 patients with documented moderate or severe TBI, living in the community an average of 5 years after injury. The study sample included both participants recruited from the community and referrals for postacute rehabilitation. All participants provided written in-formed consent. Methods: Separate regressions on demographic and injury-related variables; com-munity integration (Community Integration Questionnaire); activity-related satisfaction (QCIQ) and perceived self-efficacy (SE) to determine which variables showed significant relation with global QOL (PQOL). Significant variables were retained and entered into a 3-stage forward regression to investigate the relative and overall prediction of PQOL. Results: Gender and time postinjury made small, significant contributions to PQOL (R² = 0.10). Productivity made a modest additional contribution to PQOL (incremental R² = 0.12) as did satisfaction with productivity (incremental R² = 0.13). Perceived cognitive SE made the largest single contribution to PQOL (incremental R² = 0.39). Overall, the model accounted for 79% of the variance associated with PQOL. Conclusions: Perceived self-efficacy makes a significant contribution to global QOL after TBI, and may reflect the person's belief in his or her ability to reduce discrepancies between expectations and achievements. The investigation of additional aspects of subjective self-appraisal is warranted to increase our understanding of QOL, and potentially to inform therapies toward improving QOL after TBI.

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