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少数族裔女性的恢复力与脑震荡康复:促进健康公平

Resilience and Concussion Recovery in Minority Women: Promoting Health Equity.

作者信息

Ruiter-Lopez Leon, Donohue Jack K, Vempalli Hemika, Thurston Rebecca C, Levine Michele D, Snedaker Katherine, Donnelly Kyla Z, Okonkwo David O, Anto-Ocrah Martina

机构信息

Neuroscience, Kenneth P. Dietrich School of Arts & Science , University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

出版信息

Neurotrauma Rep. 2024 Oct 9;5(1):989-997. doi: 10.1089/neur.2024.0075. eCollection 2024.

Abstract

Resilience is associated with the degree to which post-concussion symptoms (PCS) are experienced. However, the role of resilience in the recovery trajectory of minority women, who tend to have prolonged concussion recovery, is poorly characterized. We evaluated the association between resilience and PCS, to determine if the association differed by race. A secondary data analysis was performed. Resilience was assessed using the Resilience Scale and PCS with the Rivermead questionnaire. Both variables were evaluated 6-10 weeks post-injury. Baseline demographics, spearman correlation, and multivariable linear regression models were used to determine the association between resilience and PCS. Seventy-seven women (mean age 28 ± 7.6) were included, 57% were White, and 43% were Black or Hispanic. The overall cohort had a moderate association between resilience and PCS ( = -0.304, = 0.007). The association was present in minorities ( = -0.486, = 0.004), and was stronger for Blacks ( = -0.745, < 0.001). After adjusting for religion as a covariate separately, resilience ( = -0.156, 95% confidence interval [CI]: -0.285, -0.026; = 0.019) and mood ( = 1.082, 95% CI: 0.847, 1.317; < 0.001), were both independent predictors of PCS. The adjusted associations were stronger for the minority subgroup for both resilience ( = -0.231, 95% CI: -0.413, -0.050; = 0.014) and mood ( = 1.122, 95% CI: 0.753, 1.491; < 0.001). Our findings show that compared with Whites, minority individuals with higher resilience have greater resolution of PCS. However, mood is also of importance in this association. Thus resilience-based interventions must also target mood. Interventions that strengthen resilience may have promise in promoting equitable recovery in the setting of female concussions.

摘要

心理韧性与脑震荡后症状(PCS)的体验程度相关。然而,心理韧性在少数族裔女性(她们的脑震荡恢复往往会延长)恢复轨迹中的作用却鲜有描述。我们评估了心理韧性与PCS之间的关联,以确定这种关联是否因种族而异。进行了二次数据分析。使用心理韧性量表评估心理韧性,使用Rivermead问卷评估PCS。在受伤后6 - 10周对这两个变量进行评估。使用基线人口统计学、斯皮尔曼相关性和多变量线性回归模型来确定心理韧性与PCS之间的关联。纳入了77名女性(平均年龄28±7.6岁),其中57%为白人,43%为黑人或西班牙裔。整个队列中,心理韧性与PCS之间存在中等程度的关联( = -0.304, = 0.007)。这种关联在少数族裔中存在( = -0.486, = 0.004),且在黑人中更强( = -0.745, < 0.001)。在分别将宗教作为协变量进行调整后,心理韧性( = -0.156,95%置信区间[CI]:-0.285,-0.026; = 0.019)和情绪( = 1.082,95% CI:0.847,1.317; < 0.001)都是PCS的独立预测因素。对于少数族裔亚组,调整后的心理韧性( = -0.231,95% CI:-0.413,-0.050; = 0.014)和情绪( = 1.122,95% CI:0.753,1.491; < 0.001)的关联更强。我们的研究结果表明,与白人相比,心理韧性较高的少数族裔个体的PCS缓解程度更大。然而,情绪在这种关联中也很重要。因此,基于心理韧性的干预措施也必须针对情绪。增强心理韧性的干预措施可能有望促进女性脑震荡患者的公平恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17bb/11491579/e0e56dee3170/neur.2024.0075_figure1.jpg

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