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创伤性脑损伤康复干预措施在自然灾害环境中的适用性。

Applicability of traumatic brain injury rehabilitation interventions in natural disaster settings.

作者信息

Lee Su Yi, Amatya Bhasker, Judson Rodney, Truesdale Melinda, Reinhardt Jan D, Uddin Taslim, Xiong Xiang-Hu, Khan Fary

机构信息

a Department of Rehabilitation, Royal Melbourne Hospital , Parkville , Victoria , Australia.

b Department of Medicine, The University of Melbourne , Parkville , Victoria , Australia.

出版信息

Brain Inj. 2019;33(10):1293-1298. doi: 10.1080/02699052.2019.1641748. Epub 2019 Jul 17.

Abstract

: To evaluate published traumatic brain injury (TBI) clinical practice guidelines (CPGs) and assess rehabilitation intervention recommendations for applicability in disaster settings. : Recommendations for rehabilitation interventions were synthesized from currently published TBI CPGs, developed by the Department of Labor and Employment (DLE); Scottish Intercollegiate Guidelines Network (SIGN); Department of Veterans Affairs/Department of Defence (DVA/DOD); and American Occupational Therapy Association (AOTA). Three authors independently extracted, compared, and categorized evidence-based rehabilitation intervention recommendations from these CPGs for applicability in disaster settings. : The key recommendations from a rehabilitation perspective for TBI survivors in disaster settings included patient/carer education, general physical therapy, practice in daily living activities and safe equipment use, direct cognitive/behavioral feedback, basic compensatory memory/visual strategies, basic swallowing/communication, and psychological input. More advanced interventions are generally not applicable following disasters due to limited access to services, trained staff/resources, equipment, funding, and operational issues. : Many recommendations for TBI care are challenging to implement in disaster settings due to complexities related to the environment, resources, service provision, workforce, and other reasons. Further research is needed to identify and address barriers for implementation.

摘要

评估已发表的创伤性脑损伤(TBI)临床实践指南(CPG),并评估康复干预建议在灾难环境中的适用性。:康复干预建议源自目前已发表的由劳动就业部(DLE)、苏格兰校际指南网络(SIGN)、退伍军人事务部/国防部(DVA/DOD)以及美国职业治疗协会(AOTA)制定的TBI CPG。三位作者独立从这些CPG中提取、比较并分类基于证据的康复干预建议,以评估其在灾难环境中的适用性。:从康复角度来看,针对灾难环境中TBI幸存者的关键建议包括患者/护理人员教育、一般物理治疗、日常生活活动练习和安全设备使用、直接认知/行为反馈、基本补偿性记忆/视觉策略、基本吞咽/沟通以及心理干预。由于服务获取有限、训练有素的工作人员/资源、设备、资金以及运营问题,更高级的干预措施在灾难后通常不适用。:由于与环境、资源、服务提供、劳动力等相关的复杂性,许多TBI护理建议在灾难环境中实施具有挑战性。需要进一步研究以识别并解决实施障碍。

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