Juengst Shannon B, Terhorst Lauren, Kew Chung Lin, Wagner Amy K
a Department Physical Medicine and Rehabilitation , University of Texas Southwestern Medical Center , Dallas , TX , USA.
b Department Rehabilitation Counseling , University of Texas Southwestern Medical Center , Dallas , TX , USA.
Brain Inj. 2019;33(5):567-573. doi: 10.1080/02699052.2019.1584333. Epub 2019 Mar 5.
To investigate within-person variability in daily self-reported emotional and fatigue symptoms and factors associated with high within-person variability among individuals with chronic traumatic brain injury (TBI).
This was a prospective descriptive pilot study of n = 18 adults with chronic TBI (2-27 years post-injury) who owned and could independently use an Apple or Android device.
Participants completed daily assessments for 8 weeks via smartphone. Outcome measures included the Positive and Negative Affect Schedule, Patient Health Questionnaire-2, Generalized Anxiety Disorder-2, and a 7-point fatigue rating. We examined within-person variability over time using individual Multilevel Linear Models. We categorized within-person variability as High or Low based on individual standard deviations in relationship to sample standard deviation.
Significant temporal within-person variability occurred for all measures. High variability was associated with more symptom reporting versus Low variability, and variability was associated with sex (High variability: 88% women; Low variability 90% men).
Symptom measurement at a single time point among adults with chronic TBI may not capture day-to-day symptom fluctuation and may misidentify individuals in need of intervention. Assessing symptom profiles over time to capture temporal and individual variability may provide a more ecologically valid measure for managing long-term symptoms after TBI.
探讨慢性创伤性脑损伤（TBI）患者每日自我报告的情绪和疲劳症状的个体内变异性，以及与高个体内变异性相关的因素。
这是一项前瞻性描述性试点研究，纳入了n = 18名患有慢性TBI的成年人（受伤后2至27年），他们拥有并能够独立使用苹果或安卓设备。
参与者通过智能手机进行了为期8周的每日评估。结果测量包括正负情绪量表、患者健康问卷-2、广泛性焦虑症-2和7点疲劳评分。我们使用个体多级线性模型检查了个体内随时间的变异性。我们根据个体标准差与样本标准差的关系将个体内变异性分为高或低。
所有测量指标均出现显著的个体内随时间变异性。与低变异性相比，高变异性与更多的症状报告相关，并且变异性与性别有关（高变异性：88%为女性；低变异性：90%为男性）。
在患有慢性TBI的成年人中，单一时间点的症状测量可能无法捕捉到日常症状波动，可能会错误识别需要干预的个体。随着时间的推移评估症状特征以捕捉时间和个体变异性，可能为管理TBI后的长期症状提供更符合生态学的有效测量方法。
