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创伤性脑损伤患者自我意识受损的管理。

Management of impaired self-awareness in persons with traumatic brain injury.

作者信息

Cheng S K W, Man D W K

机构信息

Occupational Therapy Department, MacLehose Medical Rehabilitation Centre, Hospital Authority, Hong Kong, PR China.

出版信息

Brain Inj. 2006 Jun;20(6):621-8. doi: 10.1080/02699050600677196.

DOI:10.1080/02699050600677196
PMID:16754287
Abstract

AIM

To develop and evaluate a systematic intervention programme for the management of impaired self-awareness (ISD) in people with traumatic brain injury.

METHODS

This study adopted a pre-test-post-test control group design. Twenty-one patients with traumatic brain injury were randomly assigned to an experimental group and a control group according to their admission sequence. The groups joined a newly developed Awareness Intervention Programme (AIP) and a conventional rehabilitation programme respectively for 4 weeks. Pre- and post-intervention outcome measures taken from the two groups were compared. Wilcoxon Signed-Ranks Tests were conducted to compare the within-group changes of the outcome measures of the Self-Awareness of Deficits Interview (SADI), the Functional Independence Measure (FIM) and the Lawton Instrumental Activities of Daily Living Score (Lawton IADL) in the control and experimental groups. Mann Whitney U-tests were conducted to compare the across-group differences of improvements of outcome measures between the participants in the two groups.

RESULTS

After AIP training, the participants in the experimental group demonstrated significant improvement in their level of awareness as compared to the control group. However, the functional outcomes of the participants in experimental group did not show significant differences.

CONCLUSION

The AIP can promote improvement in the level of self-awareness of people with traumatic brain injury. This new programme can be further developed to extend a better carryover treatment effect to functional improvement in daily activities.

摘要

目的

制定并评估一项针对创伤性脑损伤患者自我意识受损(ISD)管理的系统干预方案。

方法

本研究采用前后测对照组设计。21名创伤性脑损伤患者根据入院顺序被随机分为实验组和对照组。两组分别参加新制定的意识干预方案(AIP)和传统康复方案,为期4周。比较两组干预前后的结果指标。采用Wilcoxon符号秩检验比较对照组和实验组中缺陷访谈自我意识(SADI)、功能独立性测量(FIM)和洛顿日常生活活动能力评分(Lawton IADL)结果指标的组内变化。采用曼-惠特尼U检验比较两组参与者结果指标改善情况的组间差异。

结果

经过AIP训练,与对照组相比,实验组参与者的意识水平有显著提高。然而,实验组参与者的功能结局并无显著差异。

结论

AIP可促进创伤性脑损伤患者自我意识水平的提高。这一新方案可进一步开发,以将更好的延续治疗效果扩展至日常活动的功能改善。

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