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小儿获得性脑损伤后疲劳的评估与管理:康复临床医生的观点

The assessment and management of fatigue following paediatric acquired brain injury: rehabilitation clinicians' perspectives.

作者信息

Mazzone Olivia, Conroy Rowena, Jenkin Taylor, Scheinberg Adam, Knight Sarah

机构信息

Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia.

Murdoch Children's Research Institute, Melbourne, Australia.

出版信息

Neuropsychol Rehabil. 2025 Jun;35(5):930-959. doi: 10.1080/09602011.2024.2383337. Epub 2024 Jul 30.

Abstract

Fatigue is common following paediatric acquired brain injury (ABI) and can negatively impact quality of life. Despite this, there is limited understanding of how clinicians currently assess and manage fatigue in rehabilitation. This study explored how Australian rehabilitation clinicians recognize, assess, and manage fatigue following paediatric ABI. Using a qualitative research design, semi-structured interviews were conducted with 11 clinicians who work with children (0-18 years) with ABI in rehabilitation. Interview transcripts were analysed using constructivist grounded theory methods. Two main themes and sub-themes were developed: (1) Reaching a shared understanding: Identifying and understanding fatigue; Unpacking fatigue with children and their families; and (2) Using the shared understanding: Clinicians working collaboratively to manage fatigue; Planning for and supporting children and their family through transitions; Anticipating and problem-solving speedbumps. Participants reflected on the importance of reaching a shared understanding of fatigue within each child's unique context, requiring the collaborative effort of the child, family, school, and interdisciplinary rehabilitation team, to problem-solve and manage fatigue together over time. These findings provide insights into the processes of assessing and managing fatigue from rehabilitation clinicians' perspectives and highlight the importance of a collaborative approach to support the individual needs of the child during their rehabilitation.

摘要

疲劳在儿童获得性脑损伤(ABI)后很常见,并且会对生活质量产生负面影响。尽管如此,目前临床医生对如何在康复过程中评估和管理疲劳的了解有限。本研究探讨了澳大利亚康复临床医生如何识别、评估和管理儿童ABI后的疲劳。采用定性研究设计,对11名在康复中为患有ABI的儿童(0至18岁)提供治疗的临床医生进行了半结构化访谈。使用建构主义扎根理论方法对访谈记录进行了分析。形成了两个主要主题和子主题:(1)达成共识:识别和理解疲劳;与儿童及其家庭剖析疲劳;以及(2)运用共识:临床医生协同管理疲劳;通过过渡阶段为儿童及其家庭制定计划并提供支持;预见并解决阻碍。参与者反思了在每个孩子的独特背景下达成对疲劳的共识的重要性,这需要孩子、家庭、学校和跨学科康复团队共同努力,随着时间的推移共同解决问题并管理疲劳。这些发现从康复临床医生的角度深入了解了评估和管理疲劳的过程,并强调了采用协作方法在儿童康复期间支持其个体需求的重要性。

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