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疲劳对社区居住的创伤性脑损伤成年人残疾的独特贡献。

Unique contribution of fatigue to disability in community-dwelling adults with traumatic brain injury.

机构信息

Department of Occupational Therapy, School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA, USA.

出版信息

Arch Phys Med Rehabil. 2013 Jan;94(1):74-9. doi: 10.1016/j.apmr.2012.07.025. Epub 2012 Aug 9.

Abstract

OBJECTIVE

To examine the unique contribution of fatigue to self-reported disability in community-dwelling adults with traumatic brain injury (TBI).

DESIGN

A cross-sectional cohort design.

SETTING

Community dwellings.

PARTICIPANTS

Adults (N=50) with a history of mild to severe TBI were assessed.

INTERVENTION

Not applicable.

MAIN OUTCOME MEASURES

This study assessed the contribution of fatigue (Modified Fatigue Impact Scale) to disability (Mayo-Portland Adaptability Inventory), controlling for executive functions (Frontal Systems Behavior Scale), depression status (major depression in partial remission/current major depression/depressive symptoms or no history of depression), and initial injury severity (uncomplicated mild, complicated mild, moderate, or severe).

RESULTS

Fatigue was found to contribute uniquely to the variance in self-reported disability (β=.47, P<.001) after controlling for injury severity, executive functions, and depression status. The overall model was significant (F(4,45)=17.32, P<.001) and explained 61% of the variance in self-reported disability, with fatigue alone accounting for 12% of the variance in self-reported disability (F(1,45)=13.97, P<.001).

CONCLUSIONS

Fatigue contributes uniquely to disability status among community-dwelling adults with chronic TBI, independent of injury severity, executive functions, and depression. Addressing fatigue through targeted interventions may help to improve self-perceived disability in this population.

摘要

目的

研究社区居住的创伤性脑损伤(TBI)成年人中,疲劳对自我报告残疾的独特贡献。

设计

横断面队列设计。

地点

社区住宅。

参与者

评估了有轻度至重度 TBI 病史的成年人(N=50)。

干预

不适用。

主要观察指标

本研究评估了疲劳(改良疲劳影响量表)对残疾(Mayo-Portland 适应能力量表)的贡献,控制了执行功能(额叶系统行为量表)、抑郁状态(部分缓解/当前重度抑郁/抑郁症状或无抑郁史)和初始损伤严重程度(单纯轻度、复杂轻度、中度或重度)。

结果

在控制损伤严重程度、执行功能和抑郁状态后,发现疲劳对自我报告残疾的方差有独特的贡献(β=.47,P<.001)。整体模型具有统计学意义(F(4,45)=17.32,P<.001),解释了自我报告残疾方差的 61%,疲劳单独解释了自我报告残疾方差的 12%(F(1,45)=13.97,P<.001)。

结论

在社区居住的慢性 TBI 成年人中,疲劳对残疾状况有独特的贡献,与损伤严重程度、执行功能和抑郁无关。通过针对性干预来解决疲劳问题可能有助于改善该人群的自我感知残疾状况。

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