对神经功能障碍患者基于小组的记忆康复益处的定性探索：对康复服务提供与评估的启示
Qualitative exploration of the benefits of group-based memory rehabilitation for people with neurological disabilities: implications for rehabilitation delivery and evaluation.
作者信息
Chouliara Niki, Lincoln Nadina B
机构信息
NIHR Collaboration of Leadership in Applied Health Research and Care, Institute of Mental Health, University of Nottingham, Nottingham, UK.
Department of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Queen's Medical Centre, Nottigham, UK.
出版信息
BMJ Open. 2016 Sep 19;6(9):e011225. doi: 10.1136/bmjopen-2016-011225.
OBJECTIVE
To identify patient-perceived benefits of memory rehabilitation and draw transferrable lessons for the delivery and evaluation of similar interventions for people with neurological disabilities.
METHODS
A qualitative study was conducted as part of a pragmatic randomised controlled trial comparing 2 memory rehabilitation approaches with a self-help control group. Postintervention interviews were conducted with 20 participants with a diagnosis of traumatic brain injury, multiple sclerosis or stroke. Data were analysed using a qualitative content analysis approach.
RESULTS
Participants receiving memory rehabilitation reported that the sessions responded to previously unmet needs for information on brain injury and memory function and developed their insight along with a sense of self-efficacy and control over the management of their memory problems. Although they did not experience major improvements in their memory function per se, they reported that rehabilitation gave them the skills to effectively cope with the residual deficits. Respondents in the control groups did not report similar benefits. The opportunities for interaction offered by the group setting were greatly valued by all respondents. Mixed aetiology groups were received positively; however, marked differences in cognitive performance were frustrating for some participants.
CONCLUSIONS
The study highlighted important patient-perceived outcomes that should be considered by researchers and rehabilitation professionals when evaluating the effects of memory rehabilitation. The use of domain-specific outcome measures which reflect these areas is recommended. Qualitative changes in the use of memory aids may be achieved which cannot be captured by frequency indices alone. The benefits of the group-based rehabilitation approach were stressed by participants, suggesting that a combination of group and individual sessions might be a good practice.
TRIAL REGISTRATION NUMBER
ISRCTN92582254; Results.
目的
确定患者所感知到的记忆康复的益处，并为针对神经功能障碍患者的类似干预措施的实施和评估汲取可借鉴的经验教训。
方法
作为一项实用随机对照试验的一部分开展了一项定性研究，该试验将两种记忆康复方法与一个自助对照组进行比较。对20名被诊断为创伤性脑损伤、多发性硬化症或中风的参与者进行了干预后访谈。采用定性内容分析法对数据进行分析。
结果
接受记忆康复的参与者报告称，这些课程满足了他们此前在脑损伤和记忆功能信息方面未得到满足的需求，增强了他们的洞察力，同时培养了自我效能感以及对记忆问题管理的掌控感。尽管他们本身并未在记忆功能方面有显著改善，但他们表示康复训练赋予了他们有效应对残余缺陷的技能。对照组的受访者未报告类似的益处。所有受访者都非常重视小组环境所提供的互动机会。病因混合的小组受到了积极评价；然而，认知表现上的显著差异让一些参与者感到沮丧。
结论
该研究突出了患者所感知到的重要结果，研究人员和康复专业人员在评估记忆康复效果时应予以考虑。建议使用反映这些领域的特定领域结果指标。可能会实现记忆辅助工具使用方面的定性变化，而这是仅靠频率指数无法捕捉到的。参与者强调了基于小组的康复方法的益处，这表明小组和个体课程相结合可能是一种良好做法。
试验注册号
ISRCTN92582254；结果。
Zotero 插件