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脑损伤后激越行为的监测:发作、持续时间、强度及护理班次差异

Monitoring Agitated Behavior After acquired Brain Injury: Onset, Duration, Intensity, and Nursing Shift Variation.

作者信息

Aadal Lena, Mortensen Jesper, Nielsen Jørgen Feldbaek

机构信息

Hammel Neurorehabilitation and Research Centre, Hammel, Denmark.

出版信息

Rehabil Nurs. 2016 Sep;41(5):289-97. doi: 10.1002/rnj.251. Epub 2015 Nov 6.

Abstract

PURPOSE

To describe the onset, duration, intensity, and nursing shift variation of agitated behavior in patients with acquired brain injury (ABI) at a rehabilitation hospital.

DESIGN

Prospective descriptive study.

METHODS

A total of 11 patients with agitated behavior were included. Agitated behavior was registered with the Agitated Behavior Scale (ABS). The nurse or therapist allocated the individual patient assessed ABS during each shift. Intensity of agitated behavior was tested using exact test. A within-subject shift effect was analyzed with repeated-measure ANOVA.

FINDINGS

The onset of agitated behavior was at a median of 14 (1-28) days from admission. Seven patients remained agitated beyond 3 weeks from onset. Severe intensity of agitation was observed in 86 of 453 nursing shifts. Differences in agitated behavior between day, evening, and night shifts were found, F(2.20) = 7.90, p = .008, with tendencies of increased agitated behavior in day and evening shifts compared to night shifts.

CONCLUSION

Agitated behavior had a late onset, was severe, and long-lasting in the present sample of patients.

CLINICAL RELEVANCE

The study increases awareness on the potential challenge of agitated behavior in patients with ABI.

摘要

目的

描述康复医院中获得性脑损伤(ABI)患者激越行为的发作时间、持续时间、强度及护理班次差异。

设计

前瞻性描述性研究。

方法

共纳入11例有激越行为的患者。采用激越行为量表(ABS)记录激越行为。护士或治疗师在每个班次对个体患者进行ABS评估。使用精确检验测试激越行为的强度。采用重复测量方差分析分析受试者内班次效应。

结果

激越行为发作时间中位数为入院后14(1 - 28)天。7例患者激越行为发作后持续超过3周。在453个护理班次中有86次观察到严重激越强度。发现日班、晚班和夜班之间激越行为存在差异,F(2.20) = 7.90,p = .008,与夜班相比,日班和晚班激越行为有增加趋势。

结论

在本患者样本中,激越行为发作较晚,严重且持续时间长。

临床意义

该研究提高了对ABI患者激越行为潜在挑战的认识。

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