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欧洲创伤性脑损伤后未满足的康复需求:CENTER-TBI研究结果

Unmet Rehabilitation Needs after Traumatic Brain Injury across Europe: Results from the CENTER-TBI Study.

作者信息

Andelic Nada, Røe Cecilie, Tenovuo Olli, Azouvi Philippe, Dawes Helen, Majdan Marek, Ranta Jukka, Howe Emilie I, Wiegers Eveline J A, Tverdal Cathrine, Borgen Ida, Forslund Marit V, Kleffelgaard Ingerid, Dahl Hilde M, Jacob Louis, Cogné Mélanie, Lu Juan, von Steinbuechel Nicole, Zeldovich Marina

机构信息

Department of Physical Medicine and Rehabilitation, Oslo University Hospital, 0424 Oslo, Norway.

Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Faculty of Medicine, Institute of Health and Society, University of Oslo, 0373 Oslo, Norway.

出版信息

J Clin Med. 2021 Mar 3;10(5):1035. doi: 10.3390/jcm10051035.

Abstract

This study aims to assess rehabilitation needs and provision of rehabilitation services for individuals with moderate-to-severe disability and investigate factors influencing the probability of receiving rehabilitation within six months after traumatic brain injury (TBI). Overall, the analyses included 1206 individuals enrolled in the CENTER-TBI study with severe-to-moderate disability. Impairments in five outcome domains (daily life activities, physical, cognition, speech/language, and psychological) and the use of respective rehabilitation services (occupational therapy, physiotherapy, cognitive and speech therapies, and psychological counselling) were recorded. Sociodemographic and injury-related factors were used to investigate the probability of receiving rehabilitation. Physiotherapy was the most frequently provided rehabilitation service, followed by speech and occupational therapy. Psychological counselling was the least frequently accessed service. The probability of receiving a rehabilitative intervention increased for individuals with greater brain injury severity (odds ratio (OR) 1.75, CI 95%: 1.27-2.42), physical (OR 1.92, CI 95%: 1.21-3.05) and cognitive problems (OR 4.00, CI 95%: 2.34-6.83) but decreased for individuals reporting psychological problems (OR 0.57, CI 95%: 1.21-3.05). The study results emphasize the need for more extensive prescription of rehabilitation services for individuals with disability. Moreover, targeted rehabilitation programs, which aim to improve outcomes, should specifically involve psychological services to meet the needs of individuals recovering from TBI.

摘要

本研究旨在评估中重度残疾个体的康复需求及康复服务提供情况,并调查创伤性脑损伤(TBI)后六个月内影响接受康复可能性的因素。总体而言,分析纳入了1206名参与CENTER-TBI研究的中重度残疾个体。记录了五个结果领域(日常生活活动、身体、认知、言语/语言和心理)的损伤情况以及相应康复服务(职业治疗、物理治疗、认知和言语治疗以及心理咨询)的使用情况。社会人口统计学和与损伤相关的因素用于调查接受康复的可能性。物理治疗是提供最频繁的康复服务,其次是言语和职业治疗。心理咨询是使用最少的服务。脑损伤严重程度较高(优势比(OR)1.75,95%置信区间:1.27 - 2.42)、存在身体(OR 1.92,95%置信区间:1.21 - 3.05)和认知问题(OR 4.00,95%置信区间:2.34 - 6.83)的个体接受康复干预的可能性增加,但报告有心理问题的个体接受康复干预的可能性降低(OR 0.57,95%置信区间:1.21 - 3.05)。研究结果强调需要为残疾个体更广泛地开具康复服务处方。此外,旨在改善结果的针对性康复计划应特别纳入心理服务,以满足从TBI中恢复的个体的需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5ee/7959119/54e679bde774/jcm-10-01035-g001.jpg

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