创伤性脑损伤后认知康复的INCOG指南：方法与概述。
INCOG guidelines for cognitive rehabilitation following traumatic brain injury: methods and overview.
作者信息
Bayley Mark Theodore, Tate Robyn, Douglas Jacinta Mary, Turkstra Lyn S, Ponsford Jennie, Stergiou-Kita Mary, Kua Ailene, Bragge Peter
机构信息
Brain and Spinal Cord Rehabilitation Program (Dr Bayley), Toronto Rehabilitation Institute/University Health Network (Dr Kua), Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (Dr Bayley); Centre for Rehabilitation Research, Kolling Institute, Sydney Medical School-Northern, University of Sydney, Royal Rehabilitation Centre, Sydney, New South Wales, Australia (Dr Tate); Department of Human Communication Sciences, La Trobe University, Melbourne, Victoria, Australia (Dr Douglas); Department of Communication Sciences and Disorders, University of Wisconsin-Madison (Dr Turkstra); School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia (Dr Ponsford); Toronto Rehabilitation Institute, Toronto, Ontario, Canada (Dr Stergiou-Kita); Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada (Dr Stergiou-Kita); and National Trauma Research Institute & Monash University, Melbourne, Victoria, Australia (Dr Bragge).
出版信息
J Head Trauma Rehabil. 2014 Jul-Aug;29(4):290-306. doi: 10.1097/HTR.0000000000000070.
INTRODUCTION
Traumatic brain injury results in complex cognitive sequelae. However, clinicians have difficulty implementing the available evidence. An international group of researchers and clinicians (known as INCOG) convened to develop clinical practice guidelines for cognitive rehabilitation posttraumatic brain injury.
METHODS
The Guidelines Adaptation and Development cycle was used to derive the recommendations. Previously published cognitive rehabilitation recommendations were identified and tabulated. An expert panel met to select appropriate recommendations. Afterward, the team enhanced the recommendations by reviewing available literature. To address shortfalls of previous guidelines, the team developed decision algorithms incorporating the recommendations based on inclusion and exclusion criteria of published trials and expert opinion. The team then prioritized the recommendations for implementation and developed audit criteria to evaluate adherence to best practice.
RESULTS
The team recommends that individuals have detailed assessments of cognition after resolution of posttraumatic amnesia. Cognitive assessment and rehabilitation should be tailored to the patient's neuropsychological profile, premorbid cognitive characteristics, and goals for life activities and participation. Clinical algorithms and audit tools to evaluate current practice are provided.
CONCLUSION
Cognitive rehabilitation should be offered to select individuals with traumatic brain injury. These guidelines provide assistance to clinicians who want to provide evidence-based care.
引言
创伤性脑损伤会导致复杂的认知后遗症。然而，临床医生在应用现有证据时存在困难。一个国际研究人员和临床医生小组（称为INCOG）召开会议，制定创伤性脑损伤后认知康复的临床实践指南。
方法
采用指南改编与制定周期来得出建议。识别并列出先前发表的认知康复建议。一个专家小组开会挑选合适的建议。之后，团队通过查阅现有文献强化这些建议。为解决先前指南的不足，团队根据已发表试验的纳入和排除标准以及专家意见，制定了纳入这些建议的决策算法。然后，团队对实施建议进行优先排序，并制定审核标准以评估对最佳实践的遵循情况。
结果
该团队建议，在创伤后遗忘症解决后，对个体进行详细的认知评估。认知评估和康复应根据患者的神经心理学特征、病前认知特点以及生活活动和参与目标进行调整。提供了评估当前实践的临床算法和审核工具。
结论
应为选定的创伤性脑损伤个体提供认知康复。这些指南为希望提供循证护理的临床医生提供了帮助。
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