Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark.
J Clin Nurs. 2010 Nov;19(21-22):2959-69. doi: 10.1111/j.1365-2702.2010.03330.x.
To identify the effect of early rehabilitation of patients with post-traumatic amnesia in patients with traumatic brain injury, to review and critically assess evidence related to the timing of intervention and to identify the effect on outcome of a specific neurological rehabilitation in acute care.
Up to 70% of patients with traumatic brain injury will experience post-traumatic amnesia. Although duration of post-traumatic amnesia is correlated negatively with outcome for patients with traumatic brain injury, there is limited evidence relating to what influence timing and effect may have on enhancing early rehabilitation patient outcomes.
A critical literature review.
Searches for systematic reviews were undertaken in Medline, CINAHL, Cochrane, PSYC INFO and Neurotraume databases. The efficacy of intervention and timing was classified based on a hierarchy of study designs for questions about health care interventions based on soundness of design.
Six reviews and 11 original studies were included and comprised the review. Many studies used weak designs and small sample size, thus limiting their ability to control confusing variables and outcomes. Few studies included papers with the information about timing and effect of early post-traumatic amnesia intervention. Only one study showed an effect of a reality orientation programme in acute care. Although there was no significant detail reported on the possibility of reducing the post-traumatic amnesia period, the study showed clinical relevance.
This review highlights the limited evidence of the effect of early rehabilitation of patients with post-traumatic amnesia. Future research should be conducted to identify the effectiveness of early intervention.
Although nurses are treating patients with post-traumatic amnesia without systematic assessment, the limited evidence available does little to direct nurses as to the best approach to start early rehabilitation of post-traumatic amnesia to promote good outcomes.
确定创伤性脑损伤患者中创伤后失忆症患者早期康复的效果，回顾和批判性评估与干预时机相关的证据，并确定急性护理中特定神经康复对结局的影响。
多达 70%的创伤性脑损伤患者会经历创伤后失忆症。尽管创伤后失忆症的持续时间与创伤性脑损伤患者的结局呈负相关，但与时间和效果对增强早期康复患者结局的影响相关的证据有限。
文献批判性回顾。
在 Medline、CINAHL、Cochrane、PSYC INFO 和 Neurotraume 数据库中进行了系统评价搜索。根据基于健康护理干预措施的设计合理性的研究设计层次结构，对干预措施和时机的疗效进行分类。
纳入了 6 篇综述和 11 篇原始研究，这些研究构成了本次综述。许多研究使用了较弱的设计和小样本量，因此限制了它们控制混杂变量和结局的能力。很少有研究包括有关早期创伤后失忆症干预时机和效果的信息的论文。只有一项研究显示急性护理中现实定向计划有效果。虽然没有报告关于减少创伤后失忆症期间的可能性的详细信息，但该研究显示出了临床相关性。
本综述强调了早期康复对创伤后失忆症患者效果的证据有限。未来的研究应该确定早期干预的有效性。
尽管护士在没有系统评估的情况下治疗创伤后失忆症患者，但现有的有限证据几乎没有指导护士如何开始早期康复创伤后失忆症以促进良好结局。
