Forster Saskia D, Gauggel Siegfried, Petershofer Axel, Völzke Volker, Mainz Verena
Institute of Medical Psychology and Medical Sociology, University Hospital of the RWTH Aachen, Aachen, Germany.
VAMED Klinik Hattingen GmbH, Rehabilitation Centre for Neurology, Neurosurgery, Neuropaediatrics, Hattingen, Germany.
Front Neurol. 2020 Mar 5;11:115. doi: 10.3389/fneur.2020.00115. eCollection 2020.
Ecological Momentary Assessment (EMA) promises to be a suitable method for capturing the dynamics in self-assessments through repeated measurements in naturalistic environments using common mobile devices. Therefore, EMA could increase the power of neuropsychological assessment by obtaining a more fine-grained picture of symptoms, limitations, and strengths in patients with an acquired brain injury (ABI) in real-life situations. The present study examined 15 patients with an ABI with cognitive and motor impairments. Following a semirandomized high-frequency sampling plan to assess EMA's feasibility and applicability, data were collected across 7 days. At eight prompts per day, patients were asked about their current activities, the social context they were in, their current mood, performance judgments of their own functional status, and the frequency of self-reflections. The average compliance rate was 71.6%. The fluctuations in patients' responses were measured in terms of variance distributions within simple (intercept only) three-level models and root mean square of successive difference values. They were sufficient, as shown, for example, by the mean within-person variability of 44.9% across all of the items studied. There were no significant correlations between patients' age, severity of depressive symptoms, or their level of functioning and their compliance with study participation or the variability of their responses. The results support the feasibility and applicability of EMA as an assessment technique in patients with an ABI. There are, however, limitations that should be considered when planning an assessment of brain-injured patients using EMA.
生态瞬时评估（EMA）有望成为一种合适的方法，通过使用普通移动设备在自然环境中进行重复测量来捕捉自我评估中的动态变化。因此，EMA可以通过在现实生活中获取后天性脑损伤（ABI）患者症状、局限性和优势的更精细图像，来提高神经心理学评估的效力。本研究对15名患有认知和运动障碍的ABI患者进行了检查。按照半随机高频抽样计划评估EMA的可行性和适用性，在7天内收集数据。每天有8次提示，询问患者当前的活动、所处的社会环境、当前的情绪、对自身功能状态的表现判断以及自我反思的频率。平均依从率为71.6%。患者反应的波动是根据简单（仅截距）三级模型内的方差分布和连续差值的均方根来测量的。例如，在所研究的所有项目中，人均变异性平均为44.9%，这表明波动是足够的。患者的年龄、抑郁症状严重程度、功能水平与他们参与研究的依从性或反应的变异性之间没有显著相关性。结果支持EMA作为ABI患者评估技术的可行性和适用性。然而，在计划使用EMA对脑损伤患者进行评估时，有一些局限性需要考虑。
