Fraser Elinor E, Downing Marina G, Haines Kerrie, Bennett Linda, Olver John, Ponsford Jennie L
Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia.
Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Richmond, VIC 3121, Australia.
J Clin Med. 2022 Jun 19;11(12):3525. doi: 10.3390/jcm11123525.
There has been little progress in development of evidence-based interventions to improve sexuality outcomes for individuals with traumatic brain injury (TBI). This study aimed to evaluate the preliminary efficacy of an individualised intervention using a cognitive behaviour therapy (CBT) framework to treat sexuality problems after TBI. A nonconcurrent multiple baseline single-case design with 8-week follow-up and randomisation to multiple baseline lengths (3, 4, or 6 weeks) was repeated across nine participants (five female) with complicated mild-severe TBI (mean age = 46.44 years (SD = 12.67), mean post-traumatic amnesia = 29.14 days (SD = 29.76), mean time post-injury = 6.56 years (median = 2.50 years, SD = 10.11)). Treatment comprised eight weekly, individual sessions, combining behavioural, cognitive, and educational strategies to address diverse sexuality problems. Clinical psychologists adopted a flexible, patient-centred, and goal-orientated approach whilst following a treatment guide and accommodating TBI-related impairments. Target behaviour was subjective ratings of satisfaction with sexuality, measured three times weekly. Secondary outcomes included measures of sexuality, mood, self-esteem, and participation. Goal attainment scaling (GAS) was used to measure personally meaningful goals. Preliminary support was shown for intervention effectiveness, with most cases demonstrating sustained improvements in subjective sexuality satisfaction and GAS goal attainment. Based on the current findings, larger clinical trials are warranted.
在开发基于证据的干预措施以改善创伤性脑损伤（TBI）患者的性健康结局方面进展甚微。本研究旨在评估使用认知行为疗法（CBT）框架的个体化干预措施治疗TBI后性问题的初步疗效。对9名（5名女性）患有复杂轻-重度TBI（平均年龄 = 46.44岁（标准差 = 12.67），平均创伤后遗忘症 = 29.14天（标准差 = 29.76），平均受伤后时间 = 6.56年（中位数 = 2.50年，标准差 = 10.11））的参与者重复采用非同期多基线单病例设计，并进行8周随访以及随机分配至不同的多基线长度（3、4或6周）。治疗包括每周一次、共八次的个体治疗，结合行为、认知和教育策略来解决各种性问题。临床心理学家采用灵活、以患者为中心和目标导向的方法，同时遵循治疗指南并适应与TBI相关的损伤。目标行为是对性满意度的主观评分，每周测量三次。次要结局包括性、情绪、自尊和参与度的测量。目标达成量表（GAS）用于衡量个人有意义的目标。研究显示了对干预效果的初步支持，大多数病例在主观性满意度和GAS目标达成方面都有持续改善。基于目前的研究结果，有必要开展更大规模的临床试验。
