Valitchka Lindsey, Turkstra Lyn S
Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, Wisconsin.
Semin Speech Lang. 2013 Aug;34(3):142-53. doi: 10.1055/s-0033-1358371. Epub 2013 Oct 28.
Many patients with acquired brain injury have acute impairments in declarative memory, the memory system responsible for learning facts and remembering events, whereas implicit memory for skills, habits, and emotional associations remains intact. The combination of impaired declarative memory and preserved implicit memory has implications for communicating with patients in inpatient rehabilitation, not only in therapy sessions but also in nontherapy interactions with rehabilitation staff. The aim of this study was to describe communication patterns among inpatients with declarative memory impairments and rehabilitation staff members during the early stage postinjury. Participants were five adults with acquired brain injury and declarative memory impairments. Each participant was observed for a full inpatient rehabilitation day. Results showed that staff and visitors frequently asked participants declarative questions to which answers were not verifiable (e.g., questions about preinjury events). Answers that could be verified often were incorrect but were accepted by staff as correct. Results suggest that acute rehabilitation staff may need training in communicating with patients with declarative memory impairments. We suggest strategies to create a more supportive communication environment for inpatients with memory impairment.
许多获得性脑损伤患者在陈述性记忆方面存在急性损伤,陈述性记忆是负责学习事实和记忆事件的记忆系统,而技能、习惯和情感联想的内隐记忆则保持完好。陈述性记忆受损和内隐记忆保留相结合,对住院康复患者的沟通产生影响,不仅在治疗过程中,而且在与康复工作人员的非治疗互动中也是如此。本研究的目的是描述损伤后早期陈述性记忆受损的住院患者与康复工作人员之间的沟通模式。研究对象是五名患有获得性脑损伤且有陈述性记忆障碍的成年人。对每位参与者进行了一整天的住院康复观察。结果显示,工作人员和访客经常向参与者提出无法核实答案的陈述性问题(例如,关于受伤前事件的问题)。经常能被核实的答案往往是错误的,但工作人员却将其视为正确答案而接受。结果表明,急性康复工作人员可能需要接受与陈述性记忆受损患者沟通方面的培训。我们提出了一些策略,为记忆受损的住院患者营造一个更具支持性的沟通环境。