Rehabilitation Hospital of Indiana, Indianapolis, IN; Indiana University School of Medicine, Indianapolis, IN.
Rehabilitation Hospital of Indiana, Indianapolis, IN; Indiana University School of Medicine, Indianapolis, IN.
Arch Phys Med Rehabil. 2019 Feb;100(2):195-204.e1. doi: 10.1016/j.apmr.2018.08.174. Epub 2018 Sep 7.
This study aimed to (1) examine the efficacy of a treatment to enhance a couple's relationship after brain injury particularly in relationship satisfaction and communication; and (2) determine couples' satisfaction with this type of intervention.
Randomized waitlist-controlled trial.
Midwestern outpatient brain injury rehabilitation center.
Participants (N=44; 22 persons with brain injury and their intimate partners) were randomized by couples to the intervention or waitlist-controlled group, with 11 couples in each group.
The Couples Caring and Relating with Empathy intervention is a 16-week, 2-hour, manualized small group treatment utilizing psychoeducation, affect recognition, empathy training, cognitive-behavioral and dialectical-behavioral strategies, communication skills training, and Gottman's theoretical framework for couples adjusted for individuals with brain injury.
The Dyadic Adjustment Scale, Quality of Marriage Index (QMI), and the Four Horsemen of the Apocalypse communication questionnaire were implemented. Measures were completed by the person with brain injury and that person's partner at 3 time points: baseline, immediate postintervention, 3-month follow-up.
The experimental group showed significant improvement at posttest and follow-up on the Dyadic Adjustment Scale and the Horsemen questionnaire compared to baseline and to the waitlist-controlled group which showed no significant changes on these measures. No significant effects were observed on the QMI for either group. Satisfaction scores were largely favorable.
Results suggest this intervention can improve couples' dyadic adjustment and communication after brain injury. High satisfaction ratings suggest this small group intervention is feasible with couples following brain injury. Future directions for this intervention are discussed.
本研究旨在：（1）检验一种增强脑损伤后夫妻关系的治疗方法的疗效，特别是在关系满意度和沟通方面；（2）确定夫妻对这种干预的满意度。
随机等待对照试验。
中西部门诊脑损伤康复中心。
参与者（N=44；22 名脑损伤患者及其亲密伴侣）按夫妻分组随机分配至干预组或等待对照组，每组 11 对夫妻。
夫妻关爱与共情干预是一项为期 16 周、2 小时、手册化的小组治疗，利用心理教育、情感识别、共情训练、认知行为和辩证行为策略、沟通技巧训练，以及戈特曼夫妇理论框架，针对脑损伤个体进行调整。
采用对偶调整量表、婚姻质量指数（QMI）和四骑士沟通问卷进行测量。在 3 个时间点：基线、即时干预后和 3 个月随访，由脑损伤患者及其伴侣完成这些测量。
与基线和等待对照组相比，实验组在对偶调整量表和四骑士问卷上的后测和随访时都有显著改善，而对照组在这些测量上没有显著变化。两组在 QMI 上均无显著效果。满意度评分大多是有利的。
结果表明，这种干预可以改善脑损伤后夫妻的对偶调整和沟通。高满意度评分表明，这种针对脑损伤后夫妻的小组干预是可行的。讨论了该干预措施的未来方向。
