Lindsay Sally, Hartman Laura R, Reed Nick, Gan Caron, Thomson Nicole, Solomon Beverely
Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario Canada; Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Ontario, Canada.
Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario Canada.
PLoS One. 2015 Apr 29;10(4):e0124679. doi: 10.1371/journal.pone.0124679. eCollection 2015.
We reviewed the literature on interventions that aimed to improve hospital-to-school reintegration for children and youth with acquired brain injury (ABI). ABI is the leading cause of disability among children and youth. A successful hospital-to-school reintegration process is essential to the rehabilitative process. However, little is known about the effective components of of such interventions.
Our research team conducted a systematic review, completing comprehensive searches of seven databases and selected reference lists for relevant articles published in a peer-reviewed journal between 1989 and June 2014. We selected articles for inclusion that report on studies involving: a clinical population with ABI; sample had an average age of 20 years or younger; an intentional structured intervention affecting hospital-to-school transitions or related components; an experimental design; and a statistically evaluated health outcome. Two independent reviewers applied our inclusion criteria, extracted data, and rated study quality. A meta-analysis was not feasible due to the heterogeneity of the studies reported. Of the 6933 articles identified in our initial search, 17 articles (reporting on 350 preadolescents and adolescents, aged 4-19, (average age 11.5 years, SD: 2.21) met our inclusion criteria. They reported on interventions varying in number of sessions (one to 119) and session length (20 minutes to 4 hours). The majority of interventions involved multiple one-to-one sessions conducted by a trained clinician or educator, homework activities, and parental involvement. The interventions were delivered through different settings and media, including hospitals, schools, and online. Although outcomes varied (with effect sizes ranging from small to large), 14 of the articles reported at least one significant improvement in cognitive, social, psychological, or behavioral functioning or knowledge of ABI.
Cognitive, behavioral, and problem-solving interventions have the potential to improve school reintegration for youth with ABI. However, more comprehensive interventions are needed to help link rehabilitation clinicians, educators, adolescents, and families.
我们回顾了旨在改善获得性脑损伤（ABI）儿童和青少年从医院重返学校情况的干预措施的相关文献。ABI是儿童和青少年残疾的主要原因。成功的从医院重返学校过程对康复进程至关重要。然而，对于此类干预措施的有效组成部分知之甚少。
我们的研究团队进行了一项系统综述，全面检索了七个数据库，并筛选了1989年至2014年6月期间发表在同行评审期刊上的相关文章的参考文献列表。我们选择纳入的文章需报告涉及以下内容的研究：患有ABI的临床人群；样本平均年龄为20岁或以下；一项影响从医院到学校过渡或相关组成部分的有意结构化干预；实验设计；以及经过统计学评估的健康结果。两名独立评审员应用我们的纳入标准，提取数据并对研究质量进行评级。由于所报告研究的异质性，无法进行荟萃分析。在我们初步检索中确定的6933篇文章中，有17篇（报告了350名4至19岁的青春期前儿童和青少年，平均年龄11.5岁，标准差：2.21）符合我们的纳入标准。这些文章报告的干预措施在疗程数量（1至119个）和疗程时长（20分钟至4小时）方面各不相同。大多数干预措施包括由训练有素的临床医生或教育工作者进行的多次一对一辅导、家庭作业活动以及家长参与。干预措施通过不同的场所和媒介实施，包括医院、学校和在线平台。尽管结果各不相同（效应大小从小到大都有），但其中14篇文章报告在认知、社交、心理或行为功能或对ABI的认知方面至少有一项显著改善。
认知、行为和解决问题的干预措施有可能改善ABI青少年重返学校的情况。然而，需要更全面的干预措施来帮助联系康复临床医生、教育工作者、青少年和家庭。
