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创伤性脑损伤患者住院康复期照料者的一种基于手册的干预措施的随机对照初步研究。

A Randomized Controlled Pilot Study of a Manualized Intervention for Caregivers of Patients With Traumatic Brain Injury in Inpatient Rehabilitation.

机构信息

Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA.

Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA.

出版信息

Arch Phys Med Rehabil. 2019 Apr;100(4S):S65-S75. doi: 10.1016/j.apmr.2018.07.422. Epub 2018 Jul 31.

Abstract

OBJECTIVE

Investigate effectiveness of a 5-session manualized intervention for addressing needs of caregivers of persons in acute traumatic brain injury (TBI) rehabilitation.

DESIGN

Prospective, pilot randomized controlled trial.

SETTING

Inpatient brain injury rehabilitation unit, level 1 trauma center.

PARTICIPANTS

Patients (N=93) with moderate-to-severe TBI and their family members were enrolled in the study with 42 randomized to the treatment group, 51 to the control group.

INTERVENTION

Five-session manualized caregiver intervention with educational, stress and anxiety self-management, coping, and emotional support components.

MAIN OUTCOME MEASURES

Family Needs Questionnaire-Revised, knowledge assessment, Zarit Family Burden Scale, and Brief Symptom Inventory-18 were collected at pretreatment, posttreatment, and 3-month follow-up.

RESULTS

Treatment group caregivers showed an increase in met needs for emotional, instrumental, and professional support, and brain injury knowledge from baseline to posttreatment, whereas controls did not. Between-group differences were significant for only emotional support needs. Treatment effects were not sustained at 3-month follow-up.

CONCLUSIONS

Caregivers of persons undergoing acute TBI rehabilitation may benefit from interventions that target their unique needs. Caregivers may require additional and longer-term supports to sustain treatment benefits.

摘要

目的

调查 5 节基于手册的干预措施对满足急性创伤性脑损伤(TBI)康复患者照顾者需求的效果。

设计

前瞻性、试点随机对照试验。

地点

住院脑损伤康复病房,1 级创伤中心。

参与者

患有中重度 TBI 的患者(N=93)及其家属参加了这项研究,其中 42 名随机分配到治疗组,51 名分配到对照组。

干预措施

有教育、压力和焦虑自我管理、应对和情感支持组成部分的 5 节基于手册的照顾者干预。

主要观察指标

家庭需求问卷修订版、知识评估、Zarit 家庭负担量表和Brief Symptom Inventory-18 在治疗前、治疗后和 3 个月随访时收集。

结果

治疗组的照顾者在情感、工具和专业支持以及脑损伤知识方面的需求从基线到治疗后都有所增加,而对照组则没有。只有在情感支持需求方面,两组间的差异才有统计学意义。治疗效果在 3 个月随访时没有维持。

结论

正在接受急性 TBI 康复治疗的患者的照顾者可能会受益于针对他们独特需求的干预措施。照顾者可能需要额外的和长期的支持来维持治疗效果。

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