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创伤性脑损伤密切亲属的身心健康和功能:创伤后应激症状的作用。

Physical and Mental Health and Functioning Among Traumatic Brain Injury Close Relatives: The Role of Posttraumatic Stress Symptoms.

机构信息

Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.

Department of Psychology, Harvard University, Cambridge, MA.

出版信息

Fam Process. 2020 Jun;59(2):666-680. doi: 10.1111/famp.12454. Epub 2019 Apr 23.

Abstract

Severe Traumatic brain injury (sTBI) often instigates widespread long-lasting disability and is accompanied by extensive rehabilitation. Unsurprisingly, sTBI also holds malignant consequences for patients' close relatives. The burden caused by the injury and its severity explains some of the ramifications for the relatives. Additionally, some findings demonstrate that patients with sTBI and their relatives develop posttraumatic stress (PTS) symptoms. However, although the link between PTS symptoms and physical and mental health is well-documented in literature, the effect of PTS symptoms on relatives of patients with sTBI has barely been examined. This study examines the influence of PTS symptoms of patients with sTBI and their relatives on the physical and mental health and functioning of the relatives. Patients who sustained a severe sTBI (Abbreviated Injury Scale of the head region > 3) and close relatives were included in a multi-center, prospective cohort study (TRAST-MI). One-hundred patients and their relatives were assessed at 2, 6, and 12 months post injury. Outcome variables included health-related quality of life (SF-12) as well as emotional, cognitive, interpersonal, and total functioning (PCRS). Relatives' physical health was predicted by relatives' PTS symptoms (Slope=-1.76; p = .043), and mental health was predicted by both patients' (Slope=-2.77; p = .034) and relatives' (Slope=-6.59; p < .001) PTS symptoms. Functioning level was only predicted by patients' PTS symptoms (Slope=-.25; p .001). The findings emphasize that TBI should be considered a comprehensive traumatic experience reaching further than mere physical damage to the brain and its direct consequences, affecting the injured individual and close relatives.

摘要

严重创伤性脑损伤(sTBI)常导致广泛持久的残疾,并伴有广泛的康复。毫不奇怪,sTBI 也对患者的近亲造成恶性后果。损伤引起的负担及其严重程度解释了一些对亲属的影响。此外,一些研究结果表明,sTBI 患者及其亲属会出现创伤后应激(PTS)症状。然而,尽管 PTS 症状与患者身心健康之间的联系在文献中已有充分记载,但 PTS 症状对 sTBI 患者亲属的影响几乎没有被研究过。本研究探讨了 sTBI 患者及其亲属的 PTS 症状对亲属身心健康和功能的影响。患有严重 sTBI(头部区域损伤严重程度评分>3)的患者及其亲属被纳入一项多中心前瞻性队列研究(TRAST-MI)。100 名患者及其亲属在受伤后 2、6 和 12 个月进行评估。结果变量包括健康相关生活质量(SF-12)以及情绪、认知、人际关系和总功能(PCRS)。亲属的身体健康由亲属的 PTS 症状预测(斜率=-1.76;p=.043),心理健康由患者(斜率=-2.77;p=.034)和亲属(斜率=-6.59;p<.001)的 PTS 症状预测。功能水平仅由患者的 PTS 症状预测(斜率=-.25;p<.001)。研究结果强调,TBI 应被视为一种全面的创伤性体验,不仅涉及大脑的物理损伤及其直接后果,还会影响受伤个体及其亲属。

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