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苏格拉底反馈提高后天性脑损伤患者缺陷意识的效果和可行性:四项单病例实验设计(SCED)研究。

Effectiveness and feasibility of Socratic feedback to increase awareness of deficits in patients with acquired brain injury: Four single-case experimental design (SCED) studies.

机构信息

Department of Brain Injury Rehabilitation, Adelante Rehabilitation Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, Netherlands.

Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands.

出版信息

Neuropsychol Rehabil. 2020 May;30(4):591-612. doi: 10.1080/09602011.2018.1485110. Epub 2018 Jun 29.

Abstract

OBJECTIVE

To investigate the effectiveness and feasibility of a Socratic feedback programme to improve awareness of deficits in patients with acquired brain injury (ABI).

SETTING

Rehabilitation centre.

PARTICIPANTS

Four patients with ABI with awareness problems.

DESIGN

A series of single-case experimental design studies with random intervention starting points (A-B + maintenance design).

MAIN MEASURES

Rate of trainer-feedback and self-control behaviour on everyday tasks, patient competency rating scale (PCRS), self-regulating skills interview (SRSI), hospital anxiety and depression scale.

RESULTS

All patients needed less trainer feedback, the change was significant in 3 out of 4. One patient increased in overt self-corrective behaviour. SRSI performance increased in all patients (medium to strong effect size), and PCRS performance increased in two patients (medium and strong effect size). Mood and anxiety levels were elevated in one patient at the beginning of the training and decreased to normal levels at the end of the training. The feasibility of the programme was scored 9 out of 10.

CONCLUSIONS

The Socratic feedback method is a promising intervention for improving awareness of deficits in patients with ABI. Controlled studies with larger populations are needed to draw more solid conclusions about the effect of this method.

摘要

目的

探讨苏格拉底反馈方案对提高获得性脑损伤(ABI)患者意识缺陷的效果和可行性。

环境

康复中心。

参与者

4 名存在意识问题的 ABI 患者。

设计

一系列具有随机干预起点的单病例实验设计研究(A-B+维持设计)。

主要措施

日常任务中的培训师反馈率和自我控制行为、患者能力评定量表(PCRS)、自我调节技能访谈(SRSI)、医院焦虑和抑郁量表。

结果

所有患者需要的培训师反馈都减少了,其中 4 名患者中有 3 名的变化具有统计学意义。1 名患者表现出明显的公开自我纠正行为。所有患者的 SRSI 表现均有所提高(中等至强效果大小),2 名患者的 PCRS 表现也有所提高(中等和强效果大小)。1 名患者在训练开始时情绪和焦虑水平升高,在训练结束时降至正常水平。该方案的可行性评分为 10 分中的 9 分。

结论

苏格拉底反馈方法是一种有前途的干预措施,可提高 ABI 患者对缺陷的意识。需要进行更多的、有更大人群的对照研究,以得出关于该方法效果的更确凿结论。

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