Ownsworth Tamara, Shum David
Applied Cognitive Neuroscience Research Centre and School of Psychology, Griffith University, Australia.
Disabil Rehabil. 2008;30(7):531-40. doi: 10.1080/09638280701355694.
Stroke occurs in many individuals of working age and can considerably disrupt their capacity for employment and other productive activities. Few studies have examined the relationship between loss of productivity and cognitive impairment, particularly deficits in executive function. The present study examined whether performance on tests of executive function is related to employment and productivity at 12-months follow-up.
Twenty-seven individuals (mean age = 47.3 years, SD = 10.7) on average 2.1 years (SD = 1.6) post-stroke were recruited from hospital and community rehabilitation services and administered a theory-driven battery of executive function tests (i.e. Health and Safety sub-test, FAS Test, Five-Point test, Key Search Test and Tinkertoy Test). A 12-month follow-up assessment of employment outcome ('employed' or 'unemployed') and productivity (measured by the Sydney Psychosocial Reintegration Scale) was conducted.
A series of between-group comparisons identified that a measure of purposive behaviour and self-regulation (i.e. the Tinkertoy Test) best distinguished between the employed and unemployed groups (p < 0.01) irrespective of time since injury and neglect. Level of post-stroke productivity was significantly correlated with measures of planning (p < 0.05), self-monitoring (p < 0.01) and self-regulation (p < 0.05), as well as time since injury (p < 0.05) and functional status (p < 0.01).
These findings highlight the importance of routinely assessing executive functions to guide cognitive rehabilitation interventions following stroke.
中风发生在许多工作年龄段的人群中，会严重扰乱他们的就业能力和其他生产活动。很少有研究探讨生产力丧失与认知障碍之间的关系，尤其是执行功能缺陷。本研究调查了执行功能测试的表现与12个月随访时的就业和生产力之间是否存在关联。
从医院和社区康复服务机构招募了27名中风后平均2.1年（标准差 = 1.6）的个体（平均年龄 = 47.3岁，标准差 = 10.7），并对他们进行了一系列理论驱动的执行功能测试（即健康与安全子测试、FAS测试、五点测试、钥匙搜索测试和积木测试）。对就业结果（“就业”或“失业”）和生产力（通过悉尼心理社会重新融入量表测量）进行了为期12个月的随访评估。
一系列组间比较发现，无论受伤时间和忽视情况如何，一项关于目的性行为和自我调节的测量（即积木测试）最能区分就业组和失业组（p < 0.01）。中风后的生产力水平与计划测量（p < 0.05）、自我监控（p < 0.01）和自我调节（p < 0.05）以及受伤时间（p < 0.05）和功能状态（p < 0.01）显著相关。
这些发现凸显了常规评估执行功能以指导中风后认知康复干预的重要性。
