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对重度创伤性脑损伤患者及其亲属进行的为期十二个月的前瞻性队列研究:应对方式、生活满意度和神经功能。

Twelve-month prospective cohort study of patients with severe traumatic brain injury and their relatives: Coping, satisfaction with life and neurological functioning.

作者信息

Haller Chiara S

机构信息

a Department of Psychology, Harvard University, Cambridge, MA, USA; Division of Public Psychiatry , Massachusetts Mental Health Center , Boston , MA , USA.

出版信息

Brain Inj. 2017;31(13-14):1903-1909. doi: 10.1080/02699052.2017.1346295. Epub 2017 Aug 22.

DOI:10.1080/02699052.2017.1346295
PMID:28829653
Abstract

BACKGROUND

To examine the associations between the functioning of patients with severe traumatic brain injury (TBI), and their relatives' coping style and quality of life across 12 months post-injury.

METHODS

Prospective, population-based cohort study assessing 188 patients with severe TBI (Abbreviated Injury Scale of the head region [HAIS] score >3), and their relatives, 3, 6 and 12 months post-injury. Data were drawn from a larger national study run in Switzerland (2007-2011). Patient assessment: Glasgow Coma Outcome Scale Extended (GOSE), Patient Competency Rating Scale for Neurorehabilitation (PCRS-NR). Relative assessment: Health-Related Quality of Life (HRQoL; 12-item short form health survey [SF-12]), Coping Inventory for Stressful Situations (CISS). Mixed linear models were run separately for ages >50 and ≤50 (i.e. bimodal distribution).

RESULTS

Patients' GOSE score was associated with relatives' reported mental SF-12 scores across age (ps < 0.01). Relatives' CISS was associated with patients' PCRS score (age > 50 years): Total and cognitive functioning decreased as emotion-oriented coping increased (ps = 0.01), while interpersonal functioning increased as task-oriented coping increased (p = 0.01) and decreased as avoidance-oriented coping increased (p = 0.02).

CONCLUSION

Patients' functioning and relatives' mental HRQoL and coping strategies are associated with each other.

摘要

背景

研究重度创伤性脑损伤(TBI)患者的功能与其亲属的应对方式及伤后12个月的生活质量之间的关联。

方法

基于人群的前瞻性队列研究,在伤后3、6和12个月对188例重度TBI患者(头部区域简明损伤量表[HAIS]评分>3)及其亲属进行评估。数据来自于在瑞士开展的一项更大规模的全国性研究(2007 - 2011年)。患者评估:格拉斯哥昏迷结局量表扩展版(GOSE)、神经康复患者能力评定量表(PCRS - NR)。亲属评估:健康相关生活质量(HRQoL;12项简短健康调查[SF - 12])、应激情境应对量表(CISS)。针对年龄>50岁和≤50岁(即双峰分布)分别进行混合线性模型分析。

结果

患者的GOSE评分与亲属报告的不同年龄段的精神SF - 12评分相关(p值<0.01)。亲属的CISS与患者的PCRS评分相关(年龄>50岁):随着以情绪为导向的应对方式增加,总体功能和认知功能下降(p值 = 0.01),而随着以任务为导向的应对方式增加,人际功能增强(p = 0.01),随着以回避为导向的应对方式增加,人际功能下降(p = 0.02)。

结论

患者的功能、亲属的精神HRQoL和应对策略之间相互关联。

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