School of Rehabilitation Sciences, Moravian University, Bethlehem, Pennsylvania, USA.
Speech Pathology, Faculty of Medicine and Health, School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia.
Int J Lang Commun Disord. 2024 Mar-Apr;59(2):532-542. doi: 10.1111/1460-6984.12790. Epub 2022 Oct 14.
There is a growing body of literature that indicates positive outcomes of group treatment approaches to intervention for communication difficulties in chronic traumatic brain injury (TBI). The published research to date examines face-to-face group intervention.
This study draws on one of these approaches, 'Improving Natural Social Interaction: Group reHabilitation after Traumatic brain injury' (INSIGHT), and examines the adaptation of this program to a virtual setting. The principles underlying the program, which involved providing an authentic contextualised and natural environment for group interactions and enhancing opportunities for identity expression, were maintained.
METHODS & PROCEDURES: Six participants with mild to severe TBI and cognitive communication difficulties participated in an 8-week pilot program of the virtual INSIGHT program. Goal Attainment Scaling (GAS) scores completed over the course of the intervention served as the primary outcome measure. Secondary outcomes measures included The Repeatable Battery for the Assessment of Neuropsychological Status Update, The Awareness of Social Inference Test-Revised, the La Trobe Communication Questionnaire and the Satisfaction with Life Scale.
OUTCOMES & RESULTS: A mixed multilevel analysis revealed significant improvement in GAS scores. A Wilcoxon signed rank test revealed no significant changes in secondary measures.
CONCLUSIONS & IMPLICATIONS: There is a growing potential for this group treatment approach, in an online medium, and progress towards individualised goals was clear. The data have implications for examining the assessment measures typically used to document functional outcomes in clinical intervention. Future directions indicate a need to pursue more ecologically valid assessment methods.
What is already known on the subject Recent literature has focused on the benefits of group intervention for cognitive communication diffuclties after traumatic brain injury (TBI). However, research to date examines only face-to-face group rehabilitation. As there has been a demand for a shift in the way we communicate worldwide, we must make adaptations to current intervention procedures to continue to serve individuals with diverse communication needs. What this paper adds to existing knowledge This study contributes new information about the feasibility of a virtual communication skills group for individuals with TBI. This virtual INSIGHT (Improving Natural Social Interaction: Group ehabilitation after Traumatic brain injury) group intervention facilitates progress towards collaboratively set communication goals and the online setting has the potential to increase the accessibility of these services. What are the potential or actual clinical implications of this work? Progress towards cognitive and social communication goals can be facilitated by an online group intervention. However, this progress was not correlated with scores on standard assessments of cognitive communication, social communication and quality of life. This has implications for the evaluation of the assessments typically used and their ecological validity and applicability to the communication context.
越来越多的文献表明,团体治疗方法对慢性创伤性脑损伤(TBI)患者的沟通障碍干预具有积极效果。迄今为止,已发表的研究都集中在面对面的团体干预上。
本研究借鉴了其中一种方法,即“改善创伤性脑损伤后的自然社交互动:团体康复(INSIGHT)”,并考察了该方案在虚拟环境中的应用。该方案的原则是为团体互动提供一个真实的、有上下文的和自然的环境,并增强身份表达的机会,这些原则得到了保留。
六名患有轻度至重度 TBI 和认知沟通障碍的参与者参加了 INSIGHT 虚拟方案的 8 周试点计划。在干预过程中完成的目标实现量表(GAS)评分是主要的结果测量指标。次要结果测量指标包括重复性神经心理状态评估测试更新版、社会推理意识测试修订版、拉筹伯沟通问卷和生活满意度量表。
混合多层分析显示 GAS 评分有显著改善。威尔科克森符号秩检验显示,次要指标没有显著变化。
这种团体治疗方法在网络环境中具有很大的潜力,并且在实现个体化目标方面取得了明显的进展。数据对检查临床干预中通常用于记录功能结果的评估方法具有启示意义。未来的研究方向表明,需要采用更具生态有效性的评估方法。
关于主题的已知内容:最近的文献集中在团体干预对创伤性脑损伤(TBI)后认知沟通障碍的益处。然而,迄今为止的研究仅检查了面对面的团体康复。由于全球范围内对沟通方式的需求发生了转变,我们必须对当前的干预程序进行调整,以继续为具有不同沟通需求的个体提供服务。
本文对现有知识的新增内容:本研究提供了关于 TBI 患者虚拟沟通技能团体可行性的新信息。这种虚拟 INSIGHT(改善创伤性脑损伤后的自然社交互动:团体康复)团体干预有助于朝着共同设定的沟通目标取得进展,并且在线环境有可能增加这些服务的可及性。
这项工作的潜在或实际临床意义是什么?在线团体干预可以促进认知和社会沟通目标的实现。然而,这一进展与认知沟通、社会沟通和生活质量的标准评估得分并没有相关性。这对评估通常使用的评估及其生态有效性和对沟通环境的适用性具有启示意义。