Skidmore Elizabeth R, Swafford Melissa, Juengst Shannon B, Terhorst Lauren
Elizabeth R. Skidmore, PhD, OTR/L, is Professor and Chair, Department of Occupational Therapy and Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA;
Melissa Swafford, MOT, OTR/L, is K. Leroy Irvis Fellow, Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA.
Am J Occup Ther. 2018 Jan/Feb;72(1):7201345010p1-7201345010p5. doi: 10.5014/ajot.2018.023556.
Poor self-awareness co-occurs with cognitive impairments after stroke and may influence independence in daily activities. Strategy training promotes independence after stroke, but poor awareness may attenuate treatment response. We examined the degree to which awareness status affected changes in independence attributed to strategy training.
We conducted a secondary analysis of 30 participants with cognitive impairments after acute stroke randomized to strategy training or attention control in addition to typical inpatient rehabilitation. We measured awareness with the Self-Awareness of Deficits Interview and independence with the FIM™. Data were analyzed using general linear models.
Poor awareness attenuated improvements in independence over time, F(3, 55) = 3.04, p = .038. Strategy training promoted greater improvements in independence over time relative to attention control, F(3, 55) = 5.93, p = .002. However, the interaction between awareness and intervention was not significant, F(1, 19) = 0.025, p = .877.
Awareness status may not affect the response to strategy training, indicating that strategy training may benefit people with poor awareness.
自我意识差与中风后的认知障碍同时出现，可能会影响日常活动的独立性。策略训练可促进中风后的独立性，但意识差可能会削弱治疗反应。我们研究了意识状态对策略训练所致独立性变化的影响程度。
我们对30名急性中风后有认知障碍的参与者进行了二次分析，这些参与者除接受典型的住院康复治疗外，还被随机分配至策略训练组或注意力控制组。我们用缺陷访谈的自我意识来测量意识，并用FIM™来测量独立性。使用一般线性模型对数据进行分析。
随着时间的推移，意识差会削弱独立性的改善，F(3, 55) = 3.04，p = .038。与注意力控制相比，策略训练随着时间的推移能促进更大程度的独立性改善，F(3, 55) = 5.93，p = .002。然而，意识与干预之间的交互作用并不显著，F(1, 19) = 0.025，p = .877。
意识状态可能不会影响对策略训练的反应，这表明策略训练可能对意识差的人有益。
