Suppr
超能文献

《颅脑损伤后认知康复的 INCOG 2.0 指南》第四部分：认知-交流和社会认知障碍。

INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury, Part IV: Cognitive-Communication and Social Cognition Disorders.

机构信息

Discipline of Speech Pathology, Faculty of Health Sciences, The University of Sydney, Sydney, Australia (Dr Togher); Living With Disability Research Centre, La Trobe University, Melbourne, Australia, and Summer Foundation, Melbourne, Australia (Dr Douglas); Speech-Language Pathology Program, School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada (Drs Turkstra and Wiseman-Hakes); Parkwood Institute, St Joseph's Health Care, London, Ontario, Canada, and School of Communication Sciences and Disorders, University of Western Ontario, London, Ontario, Canada (Ms Welch-West); Lawson Health Research Institute, Parkwood Institute, London, Ontario, Canada (Mss Janzen and Harnett and Dr Teasell)); Department of Communication Sciences and Disorders, Chapman University, Irvine, California (Dr Kennedy); KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada (Mss Kua and Patsakos and Drs Bayley and Wiseman-Hakes); Monash Epworth Rehabilitation Research Centre, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia (Dr Ponsford); Department of Physical Medicine and Rehabilitation, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada (Dr Teasell); and Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (Dr Bayley).

出版信息

J Head Trauma Rehabil. 2023;38(1):65-82. doi: 10.1097/HTR.0000000000000835.

DOI:10.1097/HTR.0000000000000835

PMID:36594860

Abstract

INTRODUCTION

Moderate to severe traumatic brain injury causes significant cognitive impairments, including impairments in social cognition, the ability to recognize others' emotions, and infer others' thoughts. These cognitive impairments can have profound negative effects on communication functions, resulting in a cognitive-communication disorder. Cognitive-communication disorders can significantly limit a person's ability to socialize, work, and study, and thus are critical targets for intervention. This article presents the updated INCOG 2.0 recommendations for management of cognitive-communication disorders. As social cognition is central to cognitive-communication disorders, this update includes interventions for social cognition.

METHODS

An expert panel of clinicians/researchers reviewed evidence published since 2014 and developed updated recommendations for interventions for cognitive-communication and social cognition disorders, a decision-making algorithm tool, and an audit tool for review of clinical practice.

RESULTS

Since INCOG 2014, there has been significant growth in cognitive-communication interventions and emergence of social cognition rehabilitation research. INCOG 2.0 has 9 recommendations, including 5 updated INCOG 2014 recommendations, and 4 new recommendations addressing cultural competence training, group interventions, telerehabilitation, and management of social cognition disorders. Cognitive-communication disorders should be individualized, goal- and outcome-oriented, and appropriate to the context in which the person lives and incorporate social communication and communication partner training. Group therapy and telerehabilitation are recommended to improve social communication. Augmentative and alternative communication (AAC) should be offered to the person with severe communication disability and their communication partners should also be trained to interact using AAC. Social cognition should be assessed and treated, with a focus on personally relevant contexts and outcomes.

CONCLUSIONS

The INCOG 2.0 recommendations reflect new evidence for treatment of cognitive-communication disorders, particularly social interactions, communication partner training, group treatments to improve social communication, and telehealth delivery. Evidence is emerging for the rehabilitation of social cognition; however, the impact on participation outcomes needs further research.

摘要

简介

中度至重度创伤性脑损伤会导致严重的认知障碍，包括社交认知障碍、识别他人情绪的能力障碍和推断他人想法的能力障碍。这些认知障碍会对沟通功能产生深远的负面影响，导致认知-沟通障碍。认知-沟通障碍会极大地限制一个人社交、工作和学习的能力，因此是干预的关键目标。本文介绍了更新的 INCOG 2.0 认知-沟通障碍管理建议。由于社交认知是认知-沟通障碍的核心，因此本次更新包括了社交认知干预措施。

方法

一组临床医生/研究人员专家小组审查了自 2014 年以来发表的证据，并为认知-沟通和社会认知障碍的干预措施、决策算法工具以及用于审查临床实践的审核工具制定了更新的建议。

结果

自 2014 年 INCOG 以来，认知-沟通干预措施有了显著发展，社会认知康复研究也出现了。INCOG 2.0 有 9 项建议，其中包括 5 项更新的 2014 年 INCOG 建议和 4 项新建议，涉及文化能力培训、小组干预、远程康复和社会认知障碍管理。认知-沟通障碍的管理应个体化、以目标和结果为导向，并适合患者所处的生活环境，同时应纳入社交沟通和沟通伙伴培训。小组治疗和远程康复被推荐用于改善社交沟通。应向严重沟通障碍患者提供辅助沟通（AAC），并对患者及其沟通伙伴进行 AAC 使用培训。应评估和治疗社会认知，重点关注个人相关的背景和结果。