Schönberger Michael, Humle Frank, Zeeman Peter, Teasdale Thomas W
Center for Rehabilitation of Brain Injury, University of Copenhagen, Copenhagen, Denmark.
Neuropsychol Rehabil. 2006 Oct;16(5):561-78. doi: 10.1080/09602010500263084.
The purpose of the present study was to investigate the relationship between patients' compliance and awareness and outcome of brain injury rehabilitation. Subjects were 98 patients who underwent a holistic neuropsychological outpatient rehabilitation programme. Patients had suffered a traumatic brain injury (n = 26), a cerebrovascular accident (n = 58), or another neurological insult (n = 14).
Two staff members, a neuropsychologist and a physiotherapist, retrospectively and separately rated patients' awareness and their compliance. Outcome was measured with the d2 test of concentration, measures of oxygen uptake, strength endurance, running speed, and patients' and relatives' ratings of patients' cognitive, physical, and overall problems on the European Brain Injury Questionnaire (EBIQ). The discrepancy between patients' and relatives' ratings on the EBIQ was incorporated as a second measure of patients' awareness.
The neuropsychologist's compliance ratings were significantly related to measures of insight, improvement of d2 performance accuracy and stability, improvement of oxygen uptake, and reduction of cognitive and overall problems as reported by the patients, while the physiotherapist's compliance ratings were related to measures of insight, improvement of d2 performance speed, improvement of oxygen uptake and strength endurance, and all three EBIQ patient scales.
The results suggest a differential relationship between situation-specific compliance and outcome.
本研究的目的是调查患者的依从性、意识与脑损伤康复结果之间的关系。研究对象为98名接受全面神经心理学门诊康复计划的患者。这些患者曾遭受创伤性脑损伤（n = 26）、脑血管意外（n = 58）或其他神经损伤（n = 14）。
两名工作人员，一名神经心理学家和一名物理治疗师，分别对患者的意识和依从性进行回顾性评估。康复结果通过注意力的d2测试、摄氧量测量、力量耐力、跑步速度，以及患者和亲属在欧洲脑损伤问卷（EBIQ）上对患者认知、身体和整体问题的评分来衡量。患者和亲属在EBIQ上评分的差异被纳入作为患者意识的第二项测量指标。
神经心理学家的依从性评分与洞察力指标、d2测试表现准确性和稳定性的提高、摄氧量的提高以及患者报告的认知和整体问题的减少显著相关，而物理治疗师的依从性评分与洞察力指标、d2测试表现速度的提高、摄氧量和力量耐力的提高以及EBIQ患者的所有三个量表相关。
结果表明特定情境下的依从性与康复结果之间存在差异关系。
