The University of Sydney, Sydney School of Health Sciences, New South Wales, Australia.
The University of Technology Sydney, Graduate School of Health, New South Wales, Australia.
J Speech Lang Hear Res. 2020 Feb 26;63(2):615-632. doi: 10.1044/2019_JSLHR-19-00076. Epub 2020 Feb 20.
Purpose The aim of the study was to investigate the effectiveness of social communication skills training (TBIconneCT) for people with traumatic brain injury (TBI) and their communication partners, delivered in-person or via telehealth, on quality of conversations. Method This study is a clinical trial, including an in-person intervention group ( 17), a telehealth intervention group ( 19), and a historical control group ( 15). Participants were adults at least 6 months post moderate-to-severe TBI with social communication skills deficits and their usual communication partners. Participants completed a casual and purposeful conversation task at pre-intervention, postintervention, and a follow-up assessment. A blinded assessor evaluated conversations using the Adapted Measure of Participation in Conversation and the Adapted Measure of Support in Conversation. Treatment effects were examined by comparing groups on change in ratings between pre- and posttraining. Maintenance of effects was examined using change between posttraining and follow-up assessment. The trial protocol was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12615001024538). Results Trained participants with TBI had significant improvements in participation in casual conversation compared to controls. Trained communication partners also had significant improvements compared to controls on ratings of support in casual conversations. However, treatment effects were not maintained at follow-up for two of eight measures. Comparisons between outcomes of in-person and telehealth groups found negligible to small effect sizes for six of eight measures. Conclusions The findings reinforce previous studies demonstrating the efficacy of communication partner training after TBI. Telehealth delivery produced similar outcomes to in-person delivery.
本研究旨在探讨创伤性脑损伤(TBI)患者及其交流伙伴接受面对面或远程医疗的社交沟通技巧训练(TBIconneCT)对对话质量的有效性。
这是一项临床试验,包括面对面干预组(17 人)、远程医疗干预组(19 人)和历史对照组(15 人)。参与者为至少在中度至重度 TBI 后 6 个月以上且存在社交沟通技能缺陷的成年人及其惯用交流伙伴。参与者在干预前、干预后和随访评估时完成了随意和有目的的对话任务。一位盲评员使用经过改编的对话参与评估量表和经过改编的对话支持评估量表评估对话。通过比较各组在预训练和后训练之间的评分变化来评估治疗效果。通过比较后训练和随访评估之间的变化来评估效果的维持。该试验方案已在澳大利亚和新西兰临床试验注册中心(ACTRN12615001024538)注册。
接受过训练的 TBI 参与者在随意对话中的参与度与对照组相比有显著提高。经过训练的交流伙伴在随意对话中的支持评分也与对照组相比有显著提高。然而,在随访时,有八项测量中的两项治疗效果未能维持。面对面组和远程医疗组之间的结果比较发现,八项测量中的六项具有可忽略或小的效应大小。
这些发现强化了先前研究的结果,证明了 TBI 后进行沟通伙伴训练的有效性。远程医疗的效果与面对面医疗相似。