LeBlanc Joanne, de Guise Elaine, Champoux Marie-Claude, Couturier Céline, Lamoureux Julie, Marcoux Judith, Maleki Mohammed, Feyz Mitra
McGill University Health Centre-Montreal General Hospital , Montreal , Canada.
Int J Speech Lang Pathol. 2014 Dec;16(6):582-93. doi: 10.3109/17549507.2013.871335. Epub 2014 Jan 21.
This study looked at performance on the conversational discourse checklist of the Protocole Montréal d'évaluation de la communication (D-MEC) in 195 adults with TBI of all severity hospitalized in a Level 1 Trauma Centre. To explore validity, results were compared to findings on tests of memory, mental flexibility, confrontation naming, semantic and letter category naming, verbal reasoning, and to scores on the Montreal Cognitive Assessment. The relationship to outcome as measured with the Disability Rating Scale (DRS), the Extended Glasgow Outcome Scale (GOS-E), length of stay, and discharge destinations was also determined. Patients with severe TBI performed significantly worse than mild and moderate groups (χ(2)(KW2df) = 24.435, p = .0001). The total D-MEC score correlated significantly with all cognitive and language measures (p < .05). It also had a significant moderate correlation with the DRS total score (r = -.6090, p < .0001) and the GOS-E score (r = .539, p < .0001), indicating that better performance on conversational discourse was associated with a lower disability rating and better global outcome. Finally, the total D-MEC score was significantly different between the discharge destination groups (F(3,90) = 20.19, p < .0001). Thus, early identification of conversational discourse impairment in acute care post-TBI was possible with the D-MEC and could allow for early intervention in speech-language pathology.
本研究观察了195名在一级创伤中心住院的不同严重程度的成年创伤性脑损伤（TBI）患者在《蒙特利尔交流评估协议》（D-MEC）对话语篇检查表上的表现。为了探究有效性，将结果与记忆测试、心理灵活性测试、对物命名测试、语义和字母类别命名测试、言语推理测试的结果以及蒙特利尔认知评估的得分进行了比较。还确定了其与用残疾评定量表（DRS）、扩展格拉斯哥预后量表（GOS-E）、住院时间和出院去向所衡量的预后之间的关系。重度TBI患者的表现明显比轻度和中度组差（χ(2)(KW2df)=24.435，p = .0001）。D-MEC总分与所有认知和语言测量指标均显著相关（p < .05）。它与DRS总分（r = -.6090，p < .0001）和GOS-E得分（r = .539，p < .0001）也有显著的中度相关性，表明对话语篇表现更好与较低的残疾评定和更好的整体预后相关。最后，出院去向组之间的D-MEC总分存在显著差异（F(3,90)=20.19，p < .0001）。因此，使用D-MEC可以在TBI后的急性护理中早期识别对话语篇障碍，并可在言语病理学方面进行早期干预。
