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颅脑损伤后认知康复的现状:一项国际调查。

Current practice of cognitive rehabilitation following traumatic brain injury: An international survey.

机构信息

Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monsah University, Melbourne, Australia.

Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia.

出版信息

Neuropsychol Rehabil. 2020 Dec;30(10):1976-1995. doi: 10.1080/09602011.2019.1623823. Epub 2019 Jun 5.

Abstract

Traumatic brain injury (TBI) is a global public health issue, frequently resulting in impairments in the cognitive domains of attention, information processing speed, memory, executive function, and communication. Despite the importance of rehabilitating cognitive difficulties, and the release of clinical practice guidelines (CPGs) for cognitive rehabilitation, little is known about current clinician practice. This study aimed to explore current international clinician practice of cognitive rehabilitation. One hundred and fifteen English-speaking allied health professionals, including neuropsychologists and occupational therapists, from 29 countries outside Australia, were surveyed online about their current practice and reflections on cognitive rehabilitation. Both cognitive retraining and functional compensation approaches to cognitive rehabilitation were commonly utilized. Clinicians mostly targeted deficits in attention and executive functioning with retraining interventions, whilst memory deficits were mostly targeted with compensatory interventions. Clinicians were aware of and utilized various resources for cognitive rehabilitation, including CPGs. Clinicians considered the client's social support network, client engagement and motivation in rehabilitation, multidisciplinary team collaboration, and goal setting and implementation as highly impactful factors on the success of cognitive rehabilitation interventions. Whilst practice is broadly consistent with current CPG recommendations, addressing facilitating factors can further optimize client outcomes and quality of life following TBI.

摘要

创伤性脑损伤 (TBI) 是一个全球性的公共卫生问题,经常导致注意力、信息处理速度、记忆、执行功能和沟通等认知领域的损伤。尽管康复认知障碍非常重要,并且发布了认知康复的临床实践指南 (CPG),但目前对临床医生的实践知之甚少。本研究旨在探讨国际上认知康复的临床医生实践情况。对来自澳大利亚以外 29 个国家的 115 名讲英语的康复专业人员,包括神经心理学家和职业治疗师,进行了在线调查,了解他们目前的实践情况以及对认知康复的反思。认知再训练和功能补偿方法都常用于认知康复。临床医生主要针对注意力和执行功能缺陷进行再训练干预,而记忆缺陷主要通过补偿干预来解决。临床医生了解并利用各种认知康复资源,包括 CPG。临床医生认为,客户的社会支持网络、客户在康复中的参与度和积极性、多学科团队合作以及目标设定和实施,是认知康复干预成功的高度相关因素。尽管实践与当前的 CPG 建议基本一致,但解决促进因素可以进一步优化 TBI 后的客户结果和生活质量。

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