Morris Paul Graham, Prior Lindsay, Deb Shoumitro, Lewis Glyn, Mayle Wendy, Burrow Caroline E, Bryant Eleanor
Section of Clinical & Health Psychology, Old Medical School, Teviot Place, Edinburgh EH8 9AG, Scotland.
BMC Fam Pract. 2005 Jul 27;6:30. doi: 10.1186/1471-2296-6-30.
Head injuries are a common occurrence, with continuing care in the years following injury being provided by primary care teams and a variety of speciality services. The literature on outcome currently reflects areas considered important by health-care professionals, though these may differ in some respects from the views of head injured individuals themselves. Our study aimed to identify aspects of outcome considered important by survivors of traumatic head injury.
Thirty-two individuals were interviewed, each of whom had suffered head injury between one and ten years previously from which they still had residual difficulties. Purposive sampling was used in order to ensure that views were represented from individuals of differing age, gender and level of disability. These interviews were fully transcribed and analysed qualitatively by a psychologist, a sociologist and a psychiatrist with regular meetings to discuss the coding.
Aspects of outcome mentioned by head injury survivors which have received less attention previously included: specific difficulties with group conversations; changes in physical appearance due to scarring or weight change; a sense of loss for the life and sense of self that they had before the injury; and negative reactions of others, often due to lack of understanding of the consequences of injury amongst both family and general public.
Some aspects of outcome viewed as important by survivors of head injury may be overlooked by health professionals. Consideration of these areas of outcome and the development of suitable interventions should help to improve functional outcome for patients.
头部损伤很常见,受伤后的数年里由初级护理团队和各种专科服务提供持续护理。目前关于预后的文献反映了医疗保健专业人员认为重要的领域,尽管这些在某些方面可能与头部受伤个体自身的观点不同。我们的研究旨在确定创伤性脑损伤幸存者认为重要的预后方面。
对32名个体进行了访谈,他们每个人在一至十年前都遭受过头部损伤,目前仍有残留困难。采用目的抽样以确保不同年龄、性别和残疾程度的个体的观点都能得到体现。这些访谈进行了完整转录,并由一名心理学家、一名社会学家和一名精神科医生进行定性分析,他们定期开会讨论编码。
头部损伤幸存者提到的以前较少受到关注的预后方面包括:小组对话中的特定困难;因瘢痕或体重变化导致的外貌改变;对受伤前的生活和自我感觉的失落感;以及他人的负面反应,这通常是由于家人和公众对损伤后果缺乏了解。
头部损伤幸存者认为重要的一些预后方面可能被医疗专业人员忽视。考虑这些预后领域并制定合适的干预措施应有助于改善患者的功能预后。