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脑外伤后慢性期患者低强度门诊认知康复计划的有效性。

Effectiveness of a low intensity outpatient cognitive rehabilitation programme for patients in the chronic phase after acquired brain injury.

机构信息

Adelante Rehabilitation, Hoensbroek, The Netherlands.

出版信息

Neuropsychol Rehabil. 2010 Oct;20(5):760-77. doi: 10.1080/09602011.2010.484645. Epub 2010 Jun 1.

Abstract

The aim of this prospective cohort study was to examine the effectiveness of a low intensity outpatient cognitive rehabilitation programme for patients with acquired brain injury in the chronic phase. Twenty-seven patients with acquired brain injury (i.e., stroke, traumatic brain injury, subarachnoid haemorrhage; 52% male) with a mean age of 49.5 (SD 9.2) years and 25 relatives with a mean age of 48.8 (SD 8.8) years were recruited to the study. Mean time since injury in the patient group was 1.9 years (SD 2.0). The group programme consisted of 15 weekly sessions of 2.5 hours and included cognitive strategy training, social skills training, and psycho-education. Patients also received homework. Relatives were invited to attend twice. Repeated measurements were taken: prior to treatment (baseline, T0); directly after treatment (T1, 21 weeks); and at follow-up (T2, 45 weeks). Primary outcome measures were individualised goals (GAS), cognitive failures (CFQ), and quality of life (SA-SIP). Patients did improve significantly on individual goals (p < .05) between T0 and T1 and the level of attainment remained stable between T1 and T2. Goals were mostly set in the cognitive and behavioural domains. There were no significant differences between the measurements (T0-T1-T2) on the CFQ and the SA-SIP. The programme had a positive effect on the individual goals set by the patients. However, this did not result in a higher participation level or a better quality of life. This may be due to the low intensity and short duration of the programme.

摘要

本前瞻性队列研究旨在检验针对慢性期获得性脑损伤患者的低强度门诊认知康复计划的有效性。研究招募了 27 名获得性脑损伤患者(即中风、创伤性脑损伤、蛛网膜下腔出血;52%为男性),平均年龄为 49.5 岁(SD 9.2),25 名亲属,平均年龄为 48.8 岁(SD 8.8)。患者组的平均受伤时间为 1.9 年(SD 2.0)。小组方案包括 15 次每周 2.5 小时的认知策略训练、社交技能训练和心理教育。患者还需要完成家庭作业。亲属被邀请参加两次。进行了重复测量:治疗前(基线,T0);治疗后直接(T1,21 周);和随访时(T2,45 周)。主要的测量指标是个性化目标(GAS)、认知失误(CFQ)和生活质量(SA-SIP)。患者在 T0 和 T1 之间的个人目标(GAS)显著提高(p<0.05),并且在 T1 和 T2 之间的实现水平保持稳定。目标主要设定在认知和行为领域。在 CFQ 和 SA-SIP 上,测量值(T0-T1-T2)之间没有显著差异。该方案对患者设定的个人目标产生了积极影响。然而,这并没有导致更高的参与水平或更好的生活质量。这可能是由于该计划的强度低、持续时间短。

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