Department of Special Needs Education, University of Oslo, Oslo, Norway; Sunnaas Rehabilitation Hospital, Akershus, Norway.
Department of Special Needs Education, University of Oslo, Oslo, Norway.
Arch Phys Med Rehabil. 2023 Jul;104(7):1016-1025. doi: 10.1016/j.apmr.2023.02.023. Epub 2023 Mar 24.
To determine the efficacy of group interactive structured treatment (standard GIST) for improving social communication difficulties in a wider acquired brain injury (ABI) population compared to a waitlist control (WL). Secondary objectives were to (a) explore GIST across delivery formats by comparing the results to an intensive inpatient version of GIST (intensive GIST) and (b) compare the within-subject results for WL and intensive GIST.
Randomized controlled trial with WL and repeated measures (pre- and posttraining, 3- and 6-month follow-ups).
Community and rehabilitation hospital.
Forty-nine persons (27-74 years) with ABI and social communication difficulties (26.5% traumatic brain injury, 44.9% stroke, 28.6% other), minimum 12 months postinjury.
Standard GIST (n=24) consisted of 12 weekly outpatient interactive group sessions (2.5 hours/session) and follow-up. Intensive GIST (n=18) consisted of 4 weeks with daily 4-hour inpatient group sessions (2 × 3 d/wk, 2 × 4 d/wk) and follow-up.
La Trobe Questionnaire, a self-report questionnaire measuring social communication. Secondary measures: Social Communication Skills Questionnaire-Adapted, Goal Attainment Scale, Mind in the Eyes test, and questionnaires addressing mental and cognitive health, self-efficacy, and quality of life.
When comparing the standard GIST and WL results, a trend of improvement was found for the main outcome, La Trobe Questionnaire, and a statistically significant improvement was found for the secondary outcome Social Communication Skills Questionnaire-Adapted. Comparing standard GIST and intensive GIST, improvement in social communication skills after both treatments was detected and maintained at 6-month follow-up. No statistically significant difference was found between groups. Goal attainment was achieved and maintained during follow-up for both standard and intensive GIST.
Social communication skills were improved after both standard and intensive GIST, indicating that GIST can be delivered across treatment formats and to a wider ABI population.
与等待名单对照（WL）相比，确定团体互动结构化治疗（标准 GIST）在更广泛的后天性脑损伤（ABI）人群中改善社交沟通困难的疗效。次要目标是（a）通过比较密集型住院 GIST（密集型 GIST）的结果，探索 GIST 的不同实施方式，以及（b）比较 WL 和密集型 GIST 的个体内结果。
随机对照试验，包括 WL 和重复测量（训练前、后，3 个月和 6 个月随访）。
社区和康复医院。
49 名 ABI 伴有社交沟通困难的患者（27-74 岁；26.5%创伤性脑损伤，44.9%中风，28.6%其他），伤后至少 12 个月。
标准 GIST（n=24）由 12 周每周门诊互动团体课程（2.5 小时/次）和随访组成。密集型 GIST（n=18）由 4 周每日 4 小时住院团体课程（每周 2 次 3 天/周，每周 2 次 4 天/周）和随访组成。
拉筹伯问卷，一种自我报告问卷，用于测量社交沟通。次要测量：改良社会沟通技能问卷、目标实现量表、Mind in the Eyes 测试以及用于评估心理健康和认知、自我效能和生活质量的问卷。
当比较标准 GIST 和 WL 的结果时，主要结局（拉筹伯问卷）和次要结局（改良社会沟通技能问卷）均发现有改善的趋势。比较标准 GIST 和密集型 GIST，两种治疗后社交沟通技能都有所改善，并在 6 个月随访时保持改善。组间无统计学差异。对于标准和密集型 GIST，目标实现并在随访期间保持。
标准和密集型 GIST 后社交沟通技能均有所改善，表明 GIST 可以在不同的治疗形式下实施，也可以应用于更广泛的 ABI 人群。
