Takada Kaoruko, Sashika Hironobu, Wakabayashi Hidetaka, Hirayasu Yoshio
a Department of Rehabilitation Medicine.
b Department of Psychiatry , Yokohama City University , Yokohama City , Kanagawa , Japan.
Brain Inj. 2016;30(13-14):1590-1598. doi: 10.1080/02699052.2016.1199901. Epub 2016 Sep 14.
To investigate the quality-of-life (QoL) and social participation of patients with traumatic brain injury (TBI) living in the community in Japan.
A mixed-methods study of 29 post-TBI patients and 12 family members was conducted. Objective scales were used to evaluate QoL (Short Form Health Survey SF-36), depression (Zung Self-rating Depression Scale) and psychosocial function (Sydney Psychosocial Reintegration Scale, 2 edition). Subjective views of changes in social functioning, participation and suitability of family support were obtained by a semi-structured interview. Participants were classified into 'change' and 'no-change' groups for social participation and between-group comparisons of QoL and determinant factors of QoL were evaluated.
The SF-36 social role component was significantly associated with the suitability of family support, followed by their understanding. However, QoL was not significantly associated with changes in social participation. Social participation was particularly influenced by the absence of rehabilitation support for low-skill labourers and housewives, whether they lost their employment or not.
Advances in rehabilitation services are required, particularly to meet the specific needs of housewives and low-skill labourers. Families should receive sufficient education and short- and long-term strategies for providing suitable support to patients and their families should be implemented.
调查日本社区中创伤性脑损伤(TBI)患者的生活质量(QoL)和社会参与情况。
对29名TBI后患者和12名家庭成员进行了混合方法研究。使用客观量表评估生活质量(简短健康调查问卷SF-36)、抑郁(zung自评抑郁量表)和心理社会功能(悉尼心理社会重新融入量表,第2版)。通过半结构化访谈获得社会功能变化、参与情况和家庭支持适宜性的主观观点。参与者被分为社会参与的“变化”组和“无变化”组,并评估了生活质量的组间比较和生活质量的决定因素。
SF-36社会角色成分与家庭支持的适宜性显著相关,其次是他们的理解。然而,生活质量与社会参与的变化没有显著关联。社会参与尤其受到低技能劳动者和家庭主妇缺乏康复支持的影响,无论他们是否失去工作。
需要推进康复服务,特别是要满足家庭主妇和低技能劳动者的特殊需求。家庭应接受充分的教育,并应实施为患者提供适当支持的短期和长期策略。