Behn Nicholas, Francis Jill, Togher Leanne, Hatch Ellie, Moss Becky, Hilari Katerina
Divisions of Language and Communication Science (Drs Behn, Moss, and Hilari and Ms Hatch) and Health Services Research and Management (Dr Francis), School of Health Sciences, City, University of London, England; and Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Australia (Dr Togher).
J Head Trauma Rehabil. 2021;36(1):56-71. doi: 10.1097/HTR.0000000000000580.
To evaluate the current evidence on communication partner training and its effectiveness on outcomes for people with traumatic brain injury (TBI) and/or their communication partners.
Information sources: Systematic searches of 9 databases (AMED, CINAHL, EMBASE, Medline/EBSCOHOST, PsycINFO, PsycBITE, PsycARTICLES, PubMed, and Scopus) from database inception to February 2019. Eligibility criteria: Empirical studies on interventions for adult communication partners where the primary focus of the program (>50%) was on improving communication skills of people with TBI and/or communication partners. Data: Participants, characteristics of the training, outcome measures, and findings. Risk of bias: Standard checklists were used for methodological quality (PEDro, ROBiN-T) and intervention description (TIDieR). Synthesis: Narrative synthesis and effect sizes (Cohen's d) for group-level studies.
Ten articles (describing 8 studies) met eligibility criteria: 3 randomized controlled trials, 2 nonrandomized controlled trials, and 3 single-case experimental designs. Studies included a total of 258 people with TBI and 328 communication partners; however, all but one study had fewer than 65 participants. Methodological quality varied and intervention description was poor. Three studies in the final synthesis (n = 41 communication partners, n = 36 people with TBI) reported positive intervention effects. Effect sizes in group studies were d = 0.80 to 1.13 for TBI and d = 1.16 to 2.09 for communication partners.
The articles provided encouraging, though limited, evidence for training communication partners. Greater methodological rigor, more clearly described interventions, and consistent use of outcome measures and follow-up after treatment are needed. Further research on this topic is warranted.
评估目前关于沟通伙伴培训及其对创伤性脑损伤（TBI）患者和/或其沟通伙伴的结局有效性的证据。
信息来源：对9个数据库（AMED、CINAHL、EMBASE、Medline/EBSCOHOST、PsycINFO、PsycBITE、PsycARTICLES、PubMed和Scopus）从建库至2019年2月进行系统检索。纳入标准：针对成年沟通伙伴干预措施的实证研究，其中项目的主要重点（>50%）是提高TBI患者和/或沟通伙伴的沟通技能。数据：参与者、培训特征、结局指标和研究结果。偏倚风险：使用标准清单评估方法学质量（PEDro、ROBiN-T）和干预描述（TIDieR）。综合分析：对组水平研究进行叙述性综合分析和效应量（Cohen's d）分析。
10篇文章（描述8项研究）符合纳入标准：3项随机对照试验、2项非随机对照试验和3项单病例实验设计。研究共纳入258例TBI患者和328名沟通伙伴；然而，除一项研究外，所有研究的参与者均少于65人。方法学质量参差不齐，干预描述不佳。最终综合分析中的3项研究（n = 41名沟通伙伴，n = 36例TBI患者）报告了积极的干预效果。组水平研究中，TBI患者的效应量为d = 0.80至1.13，沟通伙伴的效应量为d = 1.16至2.09。
这些文章为培训沟通伙伴提供了令人鼓舞但有限的证据。需要更高的方法学严谨性、更清晰描述的干预措施，以及在治疗后一致使用结局指标和进行随访。对此主题进行进一步研究是有必要的。
