Pierobon A, Callegari S, Mastretta E
Servizio di Psicologia, Fondazione Salvatore Maugeri, Clinica del Lavoro e della Riabilitazione, IRCCS, Istituto Scientifico di Montescano (PV) Pavia, Italy.
G Ital Med Lav Ergon. 2006 Jul-Sep;28(3 Suppl 2):119-22.
WHO recommends that the biopsychosocial model be adopted in the rehabilitation and, particularly, in the multidisciplinary care of Traumatic Brain Injury (TBI) patients. The neuropsychological, psychological, and Quality of Life (QoL) assessment of TBI patients follows the evolution of their clinical conditions. The following evaluation battery is administered in our Unit: Specific Neuropsicological Tests, Wechsler Adult Intelligence Scales Revised (WAIS-R), and the Short Form-36 (SF-36) and Satisfaction Profile (SAT-P), two generic questionnaires measuring respectively health status and subjective aspects of QoL. Mauro is an 18-year old patient with TBI, complicated after one and a half years by epilepsy. The clinical report is divided into three phases (3, 5 and 18 months post-TBI)--ranging from the first psychological-neuropsychological assessment to the patient's socio-educational re-integration--and includes self-reports by the patient and/or his mother, a discussion of the QoL and neuropsychological data, and a presentation of the work carried out in the cognitive behavioural rehabilitation. The psychological topics that emerged are: memories of the traumatic event and the hospitalization period, enthusiasm about the "return to life", and difficulties and suffering due to the fact of "being different". This paper offers an example of both the assessment and treatment of TBI patients--following its course from where it begins in the Rehabilitation Center to its continuation in the patient's social environment. The purpose of such a global clinical management is to effectuate a psychosocial re-integration that is adequate in terms of the patient's cognitive resources and residual behavioural abilities.
世界卫生组织建议在康复过程中，尤其是在创伤性脑损伤（TBI）患者的多学科护理中采用生物心理社会模型。TBI患者的神经心理学、心理学和生活质量（QoL）评估会随着其临床状况的变化而进行。我们科室采用了以下评估组合：特定神经心理学测试、韦氏成人智力量表修订版（WAIS-R），以及简短健康调查问卷36项版本（SF-36）和满意度概况问卷（SAT-P），这两份通用问卷分别用于测量健康状况和生活质量的主观方面。毛罗是一名18岁的TBI患者，受伤一年半后并发癫痫。临床报告分为三个阶段（TBI后3个月、5个月和18个月），从首次心理-神经心理学评估到患者的社会教育重新融入，包括患者和/或其母亲的自我报告、生活质量和神经心理学数据的讨论，以及认知行为康复所开展工作的介绍。出现的心理主题有：创伤事件和住院期间的记忆、对“回归生活”的热情，以及因“与众不同”而产生的困难和痛苦。本文提供了一个TBI患者评估和治疗的实例——展示了从康复中心开始到在患者社会环境中持续进行的整个过程。这种全面临床管理的目的是实现与患者认知资源和残余行为能力相适应的心理社会重新融入。
