School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.
School of Applied Psychology, and The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia.
Neurorehabil Neural Repair. 2022 Aug;36(8):487-499. doi: 10.1177/15459683221110886. Epub 2022 Jul 26.
Prospective memory (PM) failure can limit independence and productivity following traumatic brain injury (TBI). Compensatory strategy use may ameliorate the effect of PM impairment on daily life but requires sufficient self-awareness. Metacognitive skills training (MST) can facilitate self-awareness and strategy use and may improve the efficacy of PM rehabilitation.
To evaluate the effectiveness of compensatory strategy training (COMP) with an MST component (COMP-MST) for reducing everyday PM failure and improving psychosocial integration in adults with moderate-severe TBI, compared to COMP alone and a control condition. Secondary aims were to evaluate the effect of training on psychometric PM test scores, strategy use, self-awareness, and level of care.
Assessor and participant-blinded randomized controlled trial with 52 participants (77% male, mean age = 39.0. SD = 13.6) allocated to 3 groups: COMP-MST, COMP, and waitlist control. Interventions were delivered over 6 weekly sessions. Measures were collected pre- and post-intervention and 3-month follow-up. Data were analyzed using unstructured linear mixed-effects modeling for repeated measures and planned contrasts between time-points for each group.
The models showed no significant differences between the groups on primary or secondary outcome measures. Significant pre-post intervention improvements were found for significant other's ratings of everyday PM failure for both intervention groups but not the control group, with medium to large effect sizes. Clinically relevant improvements on primary outcomes were found for participants across all 3 groups.
This study found no significant benefits of combining MST with COMP for improving everyday PM and psychosocial integration.
Australian and New Zealand Clinical Trials Registry https://www.anzctr.org.au/ ACTRN12615000996561.
前瞻性记忆 (PM) 失败会限制创伤性脑损伤 (TBI) 后的独立性和生产力。补偿策略的使用可能会减轻 PM 损伤对日常生活的影响，但需要有足够的自我意识。元认知技能训练 (MST) 可以促进自我意识和策略的使用，并可能提高 PM 康复的效果。
评估包含 MST 成分的补偿策略训练 (COMP-MST) 对改善中度至重度 TBI 成人的日常 PM 失败和心理社会融合的效果，与 COMP 单独训练和对照组相比。次要目标是评估训练对心理测量 PM 测试分数、策略使用、自我意识和护理水平的影响。
采用评估员和参与者双盲随机对照试验，共纳入 52 名参与者（77%为男性，平均年龄为 39.0 岁，标准差为 13.6 岁），分为 3 组：COMP-MST、COMP 和等候组。干预措施在 6 周的时间内每周进行一次。在干预前、干预后和 3 个月随访时进行评估。采用非结构化线性混合效应模型进行重复测量分析，并对每组的各时间点进行计划对比。
模型显示，在主要和次要结局指标上，各组之间没有显著差异。干预组的主要照顾者对日常 PM 失败的评分都有显著改善，但对照组没有，干预效果为中到大。3 组参与者的主要结局指标都有临床相关的改善。
本研究发现，将 MST 与 COMP 相结合并不能显著提高日常 PM 和心理社会融合的效果。
澳大利亚和新西兰临床试验注册中心 https://www.anzctr.org.au/ ACTRN12615000996561。
