Craig Hospital, Englewood, CO; Traumatic Brain Injury Model Systems National Data and Statistical Center, Englewood, CO.
Craig Hospital, Englewood, CO.
Arch Phys Med Rehabil. 2018 Nov;99(11):2131-2142. doi: 10.1016/j.apmr.2018.05.030. Epub 2018 Jun 30.
To evaluate the effectiveness of a replicable group treatment program for improving social competence after traumatic brain injury (TBI).
Multicenter randomized controlled trial comparing 2 methods of conducting a social competency skills program, an interactive group format versus a classroom lecture.
Community and veteran rehabilitation centers.
Civilian, military, and veteran adults with TBI and social competence difficulties (N=179), at least 6 months postinjury.
The experimental intervention consisted of 13 weekly group interactive sessions (1.5h) with structured and facilitated group interactions to improve social competence, and the control consisted of 13 traditional classroom sessions using the same curriculum with brief supplemental individual sessions but without structured group interaction.
Profile of Pragmatic Impairment in Communication (PPIC), an objective behavioral rating of social communication impairments after TBI. LaTrobe Communication Questionnaire (LCQ), Goal Attainment Scale (GAS), Satisfaction with Life Scale, Posttraumatic Stress Disorder Checklist-C (PCL) civilian version, Brief Symptom Inventory 18 (BSI-18), Scale of Perceived Social Self-Efficacy (PSSE).
Social competence goals (GAS) were achieved and maintained for most participants regardless of treatment method. Significant improvements in the primary outcome (PPIC) and 2 of the secondary outcomes (LCQ and BSI) were seen immediately posttreatment and at 3 months posttreatment in the alternative treatment arm only; however, these improvements were not significantly different between the group interactive structured treatment and alternative treatment arms. Similar trends were observed for PSSE and PCL-C.
Social competence skills improved for persons with TBI in both treatment conditions. The group interactive format was not found to be a superior method of treatment delivery in this study.
评估可复制的团体治疗方案在改善创伤性脑损伤（TBI）后社交能力的有效性。
多中心随机对照试验，比较两种方法开展社交能力技能方案，即互动小组形式与课堂讲座。
社区和退伍军人康复中心。
有 TBI 和社交能力困难的平民、军人和退伍军人成年人（N=179），至少伤后 6 个月。
实验组干预包括 13 周的每周团体互动课程（1.5 小时），有结构化和促进团体互动，以提高社交能力，对照组则包括 13 节传统课堂课程，使用相同的课程，辅以简短的补充个别课程，但没有结构化的团体互动。
交际障碍剖面图（PPIC），这是一种对 TBI 后社交沟通障碍的客观行为评定。拉筹伯交际问卷（LCQ），目标达成量表（GAS），生活满意度量表，创伤后应激障碍检查表-C（PCL-C）平民版，简明症状问卷 18（BSI-18），感知社交自我效能感量表（PSSE）。
无论治疗方法如何，大多数参与者的社交能力目标（GAS）都得到了实现和维持。主要结局（PPIC）和 2 个次要结局（LCQ 和 BSI）在替代治疗组中，治疗后即刻和治疗后 3 个月均显著改善；然而，这些改善在结构化治疗组和替代治疗组之间没有显著差异。PSSE 和 PCL-C 也出现了类似的趋势。
在这两种治疗条件下，TBI 患者的社交能力都有所提高。在本研究中，小组互动形式并不是一种优越的治疗方法。
