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改善轻度创伤性脑损伤康复的简短干预措施的可行性和可接受性:解决问题训练-脑震荡。

Feasibility and acceptability of a brief intervention to improve mild traumatic brain injury recovery: Problem-solving training-concussion.

机构信息

VA Western New York Healthcare System, Center for Integrated Healthcare.

Department of Counseling, School, and Educational Psychology, University at Buffalo.

出版信息

Rehabil Psychol. 2023 May;68(2):135-145. doi: 10.1037/rep0000486. Epub 2023 Mar 9.

Abstract

OBJECTIVE

Mild traumatic brain injuries (mTBIs) are common among Veterans. Although the majority of neurobehavioral symptoms resolve following mTBI, studies with Veteran samples demonstrate a high frequency and chronicity of neurobehavioral complaints (e.g., difficulties with attention, frustration tolerance) often attributed to mTBI. Recent opinions suggest the primacy of mental health treatment, and existing mTBI practice guidelines promote patient-centered intervention beginning in primary care (PC). However, trial evidence regarding effective clinical management in PC is lacking. This study evaluated the feasibility and acceptability of a brief, PC-based problem-solving intervention to reduce psychological distress and neurobehavioral complaints.

RESEARCH METHOD/DESIGN: Mixed method open clinical trial of 12 combat Veterans with a history of mTBI, chronic neurobehavioral complaints, and psychological distress. Measures included qualitative and quantitative indicators of feasibility (recruitment and retention metrics, interview feedback), patient acceptability (treatment satisfaction, perceived effectiveness), and change in psychological distress as measured by the Brief Symptom Inventory-18.

RESULTS

The protocol was successfully delivered via in-person and telehealth treatment modalities (4.3 sessions attended on average; 58% completed the full protocol). Patient interview data suggested that treatment content was personally relevant, and patients were satisfied with their experience. Treatment completers described the intervention as helpful and reported corresponding reductions in psychological distress ( = 1.8). Dropout was influenced by the onset of the COVID-19 pandemic.

CONCLUSIONS/IMPLICATIONS: Further study with a more diverse, randomized sample is warranted. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

摘要

目的

轻度创伤性脑损伤(mTBI)在退伍军人中很常见。尽管大多数神经行为症状在 mTBI 后会得到缓解,但对退伍军人样本的研究表明,神经行为症状(例如注意力困难、挫折容忍力)的频率和慢性都很高,这些症状通常归因于 mTBI。最近的观点表明,心理健康治疗应优先考虑,现有的 mTBI 实践指南提倡从初级保健(PC)开始以患者为中心的干预。然而,PC 中关于有效临床管理的试验证据缺乏。本研究评估了一种基于 PC 的简短问题解决干预措施减少心理困扰和神经行为症状的可行性和可接受性。

研究方法/设计:对 12 名有 mTBI 病史、慢性神经行为症状和心理困扰的战斗退伍军人进行混合方法开放性临床试验。测量包括可行性的定性和定量指标(招募和保留指标、访谈反馈)、患者可接受性(治疗满意度、感知效果)以及Brief Symptom Inventory-18 测量的心理困扰变化。

结果

该方案通过面对面和远程医疗治疗模式成功实施(平均参加 4.3 次治疗;58%的患者完成了完整的方案)。患者访谈数据表明,治疗内容与个人相关,患者对治疗体验感到满意。完成治疗的患者将干预描述为有帮助,并报告心理困扰相应减少( = 1.8)。辍学受到 COVID-19 大流行的影响。

结论/意义:需要进一步研究更多样化的随机样本。(PsycInfo 数据库记录(c)2023 APA,保留所有权利)。

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