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言语病理学在轻度创伤性脑损伤持续症状的跨学科护理模式中的作用。

The Role of Speech-Language Pathology in an Interdisciplinary Care Model for Persistent Symptomatology of Mild Traumatic Brain Injury.

作者信息

Hardin Kathryn Y, Kelly James P

机构信息

Marcus Institute for Brain Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado.

Department of Physical Medicine & Rehabilitation, University of Colorado School of Medicine Aurora, Colorado.

出版信息

Semin Speech Lang. 2019 Feb;40(1):65-78. doi: 10.1055/s-0038-1676452. Epub 2019 Jan 7.

Abstract

The Marcus Institute for Brain Health (MIBH) provides interdisciplinary care for adults struggling with persistent effects of mild traumatic brain injury and accompanying changes in behavioral health, with specific emphases on Veterans and retired elite athletes. The cognitive, physical, and behavioral symptoms associated with mild traumatic brain injury are interrelated, with neurobiopsychosocial modeling encompassing the factors related to recovery from a traumatic brain injury. The diffuse impacts of chronic concussive injuries require multiple clinical providers to address the breadth of symptoms, facilitating both interdisciplinary and transdisciplinary care models. By implementing integrated practice units, patients receive advanced medical care, imaging, speech-language pathology, physical therapy, behavioral health, neuropsychology, and clinical pharmacy for a cohesive diagnostic and intervention plan. Nationally, speech-language pathologists report challenges with best-practice options for concussion, particularly in the domain of assessment practices. At the MIBH, speech-language pathologists begin their assessment with a structured clinical interview that focuses on patients' needs and concerns. Evaluation modalities focus on hearing, communication, and functional cognition to guide therapeutic treatment planning. The intensive outpatient care program at MIBH incorporates both individual sessions targeting patient-centered goals and group care, where speech-language pathologists work transdisciplinarily to generalize care from all disciplines out into the community. Care practices for concussive injuries continue to evolve rapidly; speech-language pathology at the MIBH offers one such vision for excellence in clinical care.

摘要

马库斯脑健康研究所(MIBH)为那些因轻度创伤性脑损伤的持续影响以及伴随的行为健康变化而苦苦挣扎的成年人提供跨学科护理,特别关注退伍军人和退役精英运动员。与轻度创伤性脑损伤相关的认知、身体和行为症状相互关联,神经生物心理社会模型涵盖了与创伤性脑损伤恢复相关的因素。慢性脑震荡损伤的广泛影响需要多个临床提供者来应对症状的广度,这促进了跨学科和跨专业护理模式。通过实施综合实践单元,患者可以获得先进的医疗护理、影像学检查、言语病理学、物理治疗、行为健康、神经心理学和临床药学服务,以制定连贯的诊断和干预计划。在全国范围内,言语病理学家报告了在脑震荡最佳实践方案方面面临的挑战,尤其是在评估实践领域。在MIBH,言语病理学家通过结构化临床访谈开始评估,该访谈侧重于患者的需求和担忧。评估方式侧重于听力、沟通和功能认知,以指导治疗计划的制定。MIBH的强化门诊护理计划包括针对以患者为中心目标的个体治疗以及小组护理,言语病理学家在其中跨专业协作,将所有学科的护理推广到社区。脑震荡损伤的护理实践仍在迅速发展;MIBH的言语病理学为卓越的临床护理提供了这样一种愿景。

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