Elysium Neurological Services, Elysium Healthcare, The Avalon Centre, Swindon, UK.
Department of Psychology, Swansea University, Swansea, UK.
Neuropsychol Rehabil. 2022 Oct;32(9):2342-2369. doi: 10.1080/09602011.2021.1946092. Epub 2021 Jun 28.
Studies using the St Andrew's - Swansea Neurobehavioural Outcome Scale (SASNOS) confirm neurobehavioural disability (NBD) is highly prevalent in inpatient Neurobehavioural Rehabilitation and Stroke samples. However, a recent study amongst a Danish community sample of acquired brain injury survivors found a relative paucity of NBD symptoms; and when symptoms were present, they tended to be of mild severity. The current observational study employed the SASNOS to explore prevalence of NBD in survivors with traumatic brain injury (TBI) living in the community, the extent of survivors' self-awareness of NBD symptoms, and constructed prediction models of NBD. A de-identified data set was compiled, comprising data for 97 TBI survivors (74.2% men, mean time since injury 2.8 years). In addition to SASNOS self- and proxy-ratings, various demographic, clinical and injury-related characteristics were captured. NBD was found to be highly characteristic, although severity varied depending on subtype. Statistical comparison of self- and proxy-ratings did not support reduced self awareness regarding NBD, whereas treating the problem as one of inter-rater reliability suggested this was an issue. Executive impairment, depressed mood and sex were especially prognostic of NBD. Reasons accounting for differences in NBD between the community samples are discussed and recommendations for future research made.
使用圣安德鲁斯-斯旺西神经行为预后量表(SASNOS)的研究证实,神经行为障碍(NBD)在住院神经行为康复和中风患者中非常普遍。然而,最近一项针对丹麦社区获得性脑损伤幸存者的研究发现,NBD 症状相对较少;而且当出现症状时,它们往往是轻度的。本观察性研究采用 SASNOS 来探讨社区中创伤性脑损伤(TBI)幸存者的 NBD 患病率、幸存者对 NBD 症状的自我意识程度,并构建 NBD 的预测模型。编制了一个去识别数据集,其中包括 97 名 TBI 幸存者的数据(74.2%为男性,伤后时间平均为 2.8 年)。除了 SASNOS 的自我和代理评分外,还收集了各种人口统计学、临床和损伤相关特征。研究发现,NBD 高度特征化,尽管严重程度取决于亚型。自我和代理评分的统计学比较不支持对 NBD 的自我意识降低,而将该问题视为评分者间可靠性的问题,则表明这是一个问题。执行功能障碍、抑郁情绪和性别对 NBD 尤其具有预后意义。讨论了导致社区样本中 NBD 差异的原因,并提出了未来研究的建议。