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脑损伤应对技能小组:针对脑损伤患者及其照护者的预防干预措施。

Brain injury coping skills group: a preventative intervention for patients with brain injury and their caregivers.

机构信息

Department of Neuropsychology, Rehabilitation Hospital of Indiana, Indianapolis, IN 46268, USA.

出版信息

Arch Phys Med Rehabil. 2010 Jun;91(6):840-8. doi: 10.1016/j.apmr.2010.03.015.

Abstract

OBJECTIVE

To determine whether training in coping strategies will improve psychologic functioning and self-efficacy in survivors of brain injury (BI) and caregivers.

DESIGN

Randomized controlled pilot study with measurements at baseline, postintervention, and 3-month follow-up.

SETTING

Postacute rehabilitation clinic.

PARTICIPANTS

Survivors of BI (n=20) and caregivers (n=20).

INTERVENTIONS

The Brain Injury Coping Skills Group is a 12-session, manualized, cognitive-behavioral treatment (CBT) group providing psychoeducation, support, and coping skills training. Effects of this preventative intervention were examined on emotional functioning and perceived self-efficacy (PSE).

MAIN OUTCOME MEASURES

Brief Symptom Inventory-18 (BSI-18) and Brain Injury Coping Skills Questionnaire.

RESULTS

Analyses revealed that the Brain Injury Coping Skills group showed significantly improved PSE compared with the control group immediately posttreatment (F=14.16; P=.001) and maintained this over time. PSE assessed posttreatment predicted global distress at 3-month follow-up across groups (rho=-.46). No differences between treatment and control groups were apparent on the BSI-18 posttreatment. However, the control group showed increased emotional distress at 3-month follow-up while the Brain Injury Coping Skills group remained stable over time.

CONCLUSIONS

Few CBT studies have included survivors of BI and caregivers together in group treatment or included a control group. No prior studies have examined the role of PSE specifically. Prior intervention studies show inconsistent effects on emotional functioning, raising questions regarding the role of intervening variables. This study offers a new conceptualization that PSE may moderate longer-term emotional adjustment after brain injury. Results indicate that PSE is an important and modifiable factor in helping persons better adjust to BI.

摘要

目的

确定应对策略培训是否会改善脑损伤(BI)幸存者和照顾者的心理功能和自我效能。

设计

随机对照试点研究,在基线、干预后和 3 个月随访时进行测量。

地点

急性后期康复诊所。

参与者

BI 幸存者(n=20)和照顾者(n=20)。

干预措施

脑损伤应对技能小组是一个 12 节的、手册化的认知行为治疗(CBT)小组,提供心理教育、支持和应对技能培训。检查了这种预防性干预对情绪功能和感知自我效能(PSE)的影响。

主要观察指标

简短症状清单-18(BSI-18)和脑损伤应对技能问卷。

结果

分析表明,脑损伤应对技能组在治疗后即刻与对照组相比,自我效能感显著提高(F=14.16;P=.001),并保持了这种状态。治疗后评估的自我效能感预测了 3 个月随访时所有组的总体困扰(rho=-.46)。治疗后,BSI-18 两组之间无差异。然而,对照组在 3 个月随访时表现出情绪困扰增加,而脑损伤应对技能组则保持稳定。

结论

很少有 CBT 研究将 BI 幸存者和照顾者一起纳入小组治疗,也没有对照组。以前没有研究专门检查自我效能感的作用。先前的干预研究显示对情绪功能的影响不一致,这对干预变量的作用提出了质疑。本研究提供了一个新的概念,即自我效能感可能会调节脑损伤后的情绪适应。结果表明,自我效能感是帮助人们更好地适应 BI 的一个重要和可调节的因素。

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