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脑耗竭:社会心理因素影响轻度创伤性脑损伤后的恢复-临床医生评估社会心理因素的 3 项建议。

Brain Drain: Psychosocial Factors Influence Recovery Following Mild Traumatic Brain Injury-3 Recommendations for Clinicians Assessing Psychosocial Factors.

出版信息

J Orthop Sports Phys Ther. 2019 Nov;49(11):842-844. doi: 10.2519/jospt.2019.8849. Epub 2019 Jun 1.

Abstract

Mild traumatic brain injury is a major global public health concern. While most people recover within days to months, 1 in 5 people with mild traumatic brain injury report persistent, disabling symptoms that interfere with participation in work, school, and sport. People with injuries to regions other than the head may report similar symptoms. The biopsychosocial model of health explains this phenomenon in terms of factors associated with recovery that are not biomedical. Important psychosocial factors include poor recovery expectations and pretraumatic and posttraumatic psychological symptoms. Recent clinical practice guidelines recommend that clinicians examine all relevant biopsychosocial factors that may contribute to persistent postconcussive symptoms and consider them when helping their patients make health-management decisions. However, because clinical training continues to prioritize biomedical symptoms, clinicians may not feel confident in the psychosocial domain. Our objective is to provide 3 recommendations for clinicians to assess psychosocial factors in patients after concussion, and to argue a case for clinicians to improve their skills in assessing psychosocial factors. .

摘要

轻度创伤性脑损伤是一个全球性的主要公共卫生关注点。虽然大多数人在数天到数月内康复,但每 5 个轻度创伤性脑损伤患者中就有 1 人报告持续存在、使人丧失能力的症状,这些症状会干扰他们参与工作、上学和运动。头部以外区域受伤的人也可能报告类似的症状。健康的生物心理社会模式从与恢复相关的非生物医学因素方面解释了这一现象。重要的心理社会因素包括不良的恢复预期以及创伤前和创伤后心理症状。最近的临床实践指南建议临床医生检查所有可能导致持续性脑震荡后症状的相关生物心理社会因素,并在帮助患者做出健康管理决策时考虑这些因素。然而,由于临床培训继续优先重视生物医学症状,临床医生可能在心理社会领域缺乏信心。我们的目的是为临床医生提供 3 项建议,以评估脑震荡后患者的心理社会因素,并为临床医生提高评估心理社会因素的技能提出理由。

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