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研究不同患者出院信息中诊断术语对预期轻度创伤性脑损伤结果的影响。

CE the effect of varying diagnostic terminology within patient discharge information on expected mild traumatic brain injury outcome.

机构信息

Clinical Neuropsychology Research Group, School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia.

出版信息

Clin Neuropsychol. 2013;27(5):762-78. doi: 10.1080/13854046.2013.795245. Epub 2013 May 10.

Abstract

This study aimed to determine if systematic variation of the diagnostic terminology embedded within written discharge information (i.e., concussion or mild traumatic brain injury, mTBI) would produce different expected symptoms and illness perceptions. We hypothesized that compared to concussion advice, mTBI advice would be associated with worse outcomes. Sixty-two volunteers with no history of brain injury or neurological disease were randomly allocated to one of two conditions in which they read a mTBI vignette followed by information that varied only by use of the embedded terms concussion (n = 28) or mTBI (n = 34). Both groups reported illness perceptions (timeline and consequences subscale of the Illness Perception Questionnaire-Revised) and expected Postconcussion Syndrome (PCS) symptoms 6 months post injury (Neurobehavioral Symptom Inventory, NSI). Statistically significant group differences due to terminology were found on selected NSI scores (i.e., total, cognitive and sensory symptom cluster scores (concussion > mTBI)), but there was no effect of terminology on illness perception. When embedded in discharge advice, diagnostic terminology affects some but not all expected outcomes. Given that such expectations are a known contributor to poor mTBI outcome, clinicians should consider the potential impact of varied terminology on their patients.

摘要

本研究旨在确定书面出院信息中(即脑震荡或轻度创伤性脑损伤,mTBI)嵌入的诊断术语的系统变化是否会产生不同的预期症状和疾病认知。我们假设与脑震荡建议相比,mTBI 建议会与更糟糕的结果相关。62 名没有脑损伤或神经病史的志愿者被随机分配到两种情况之一,他们阅读 mTBI 小插曲,然后阅读信息,这些信息仅通过嵌入的术语变化,分别是脑震荡(n = 28)或 mTBI(n = 34)。两组均报告疾病认知(修订后的疾病认知问卷的时间线和后果子量表)和预期的脑震荡后综合征(PCS)症状,在受伤后 6 个月(神经行为症状清单,NSI)。由于术语的选择,在特定的 NSI 评分上发现了统计学上显著的组间差异(即总评分、认知和感觉症状群评分(脑震荡>mTBI)),但术语对疾病认知没有影响。当嵌入出院建议时,诊断术语会影响一些但不是所有的预期结果。鉴于这种期望是 mTBI 结果不佳的已知因素,临床医生应考虑不同术语对患者的潜在影响。

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