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急性脑损伤康复中的知识转化:整合与应用认知交流干预证据的模型。

Knowledge translation in ABI rehabilitation: A model for consolidating and applying the evidence for cognitive-communication interventions.

作者信息

MacDonald Sheila, Wiseman-Hakes Catherine

机构信息

Sheila MacDonald & Associates, Guelph, Ontario, Canada.

出版信息

Brain Inj. 2010;24(3):486-508. doi: 10.3109/02699050903518118.

DOI:10.3109/02699050903518118
PMID:20184406
Abstract

PRIMARY OBJECTIVES

(1) To propose a model for consolidating and disseminating existing evidence relevant to cognitive-communication interventions after ABI. (2) To present the Cognitive-Communication Intervention Review Framework (CCIRF). (3) To outline future considerations for applying evidence to clinical practice.

RESEARCH DESIGN

Employment of a model for knowledge translation.

METHODS AND PROCEDURES

Application of evidence requires synthesis and dissemination of information in an accessible format for end users. A literature search identified 20 systematic reviews (1997-2007) with a complex array of 72 practice recommendations relevant to cognitive-communication interventions. The CCIRF was used to synthesize the evidence within 11 intervention categories. Reviews were analysed according to: organization, population, intervention, comparison and outcome, with a focus on communication outcomes.

MAIN OUTCOMES AND RESULTS

Consolidated evidence revealed support for interventions relating to: social communication, behavioural regulation, verbal formulation, attention, external memory aids, executive functions and communication partner training. Research gaps were noted in the areas of comprehension (auditory/reading), written expression and vocational communication interventions. Similar recommendations emerge across reviews.

CONCLUSIONS

Implementation of the growing body of evidence for cognitive-communication interventions is challenged by variability in study populations, interventions, and research focus on communication. The CCIRF provides a means of promoting consistency in knowledge translation and application.

摘要

主要目标

(1)提出一个整合和传播与获得性脑损伤后认知-沟通干预相关的现有证据的模型。(2)介绍认知-沟通干预综述框架(CCIRF)。(3)概述将证据应用于临床实践的未来考量。

研究设计

采用知识转化模型。

方法与步骤

证据的应用需要以终端用户易于获取的形式综合和传播信息。文献检索确定了20项系统评价(1997 - 2007年),其中包含一系列与认知-沟通干预相关的72条实践建议。CCIRF被用于综合11个干预类别的证据。根据组织、人群、干预、对照和结果对综述进行分析,重点关注沟通结果。

主要结果

综合证据表明对以下干预措施有支持:社交沟通(social communication)、行为调节(behavioural regulation)、言语表达(verbal formulation)、注意力(attention)、外部记忆辅助工具(external memory aids)、执行功能(executive functions)和沟通伙伴培训(communication partner training)。在理解(听觉/阅读)、书面表达和职业沟通干预领域发现了研究空白。各综述中出现了类似的建议。

结论

认知-沟通干预的证据越来越多,但在研究人群、干预措施以及对沟通的研究重点方面存在差异,这给证据的实施带来了挑战。CCIRF提供了一种促进知识转化和应用一致性的方法。

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