Løke Daniel, Andelic Nada, Helseth Eirik, Vassend Olav, Andersson Stein, Ponsford Jennie L, Tverdal Cathrine, Brunborg Cathrine, Løvstad Marianne
Department of Research, Sunnaas Rehabilitation Hospital, Bjørnemyrveien 11, 1453 Nesoddtangen, Norway.
Department of Psychology, Faculty of Social Sciences, University of Oslo, 0316 Oslo, Norway.
J Clin Med. 2022 Mar 21;11(6):1733. doi: 10.3390/jcm11061733.
Fatigue is a common symptom after traumatic brain injuries (TBI) and a crucial target of rehabilitation. The subjective and multifactorial nature of fatigue necessitates a biopsychosocial approach in understanding the mechanisms involved in its development. The aim of this study is to provide a comprehensive exploration of factors relevant to identification and rehabilitation of fatigue following TBI. Ninety-six patients with TBI and confirmed intracranial injuries were assessed on average 200 days post-injury with regard to injury-related factors, several patient-reported outcome measures (PROMS) of fatigue, neuropsychological measures, and PROMS of implicated biopsychosocial mechanisms. Factor analytic approaches yielded three underlying factors, termed Psychosocial Robustness, Somatic Vulnerability and Injury Severity. All three dimensions were significantly associated with fatigue in multiple regression analyses and explained 44.2% of variance in fatigue. Post hoc analyses examined univariate contributions of the associations between the factors and fatigue to illuminate the relative contributions of each biopsychosocial variable. Implications for clinical practice and future research are discussed.
疲劳是创伤性脑损伤（TBI）后的常见症状，也是康复的关键目标。疲劳的主观性和多因素性质使得在理解其发生机制时需要采用生物心理社会方法。本研究的目的是全面探讨与TBI后疲劳的识别和康复相关的因素。对96例确诊为颅内损伤的TBI患者在受伤后平均200天进行了评估，评估内容包括与损伤相关的因素、几种患者报告的疲劳结局指标（PROMS）、神经心理学指标以及涉及的生物心理社会机制的PROMS。因子分析方法产生了三个潜在因素，分别称为社会心理韧性、躯体易损性和损伤严重程度。在多元回归分析中，所有这三个维度均与疲劳显著相关，并解释了疲劳方差的44.2%。事后分析检验了各因素与疲劳之间关联的单变量贡献，以阐明每个生物心理社会变量的相对贡献。讨论了对临床实践和未来研究的启示。
