Stiekema Annemarie P M, Winkens Bjorn, Bierlaagh Desiree, Donkervoort Mireille, Jansen Natska, Jurrius Kitty H M, Zadoks Judith, van Heugten Caroline M
Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
Limburg Brain Injury Center, Maastricht University, Maastricht, The Netherlands.
Int J Integr Care. 2025 Jul 7;25(3):5. doi: 10.5334/ijic.8649. eCollection 2025 Jul-Sep.
Many people with acquired brain injury (PwABI) and their family face long-term psychosocial problems and unmet needs. Currently, there are no structural and integrated health care services supporting life after brain injury. We evaluated Case Management (CM) for PWABI which aims to facilitate access to and integration of health care and social services for people with complex problems.
One-group repeated measures study including 62 PwABI and 36 caregivers in the Netherlands. Assessments were conducted every six months for 18-24 months. Primary outcome was psychosocial well-being (Hospital Anxiety and Depression Scale). Secondary outcomes were self-efficacy, participation, life satisfaction, and needs for PwABI and caregivers; and caregiver burden.
Anxiety reduced significantly in both PwABI and their caregivers. Over time, PwABI reported significantly fewer unmet needs, but more participation restrictions. Caregivers reported significantly less caregiver burden and more self-efficacy over time.
CM seems promising for reducing unmet needs in PwABI and improving some psychosocial outcomes in PwABI and caregivers. Lifelong CM may however be necessary. A randomized controlled study is needed to confirm whether the positive outcomes are due to CM.
This study warrants further research to establish the effectiveness of CM for PWABI.
许多后天性脑损伤患者（PwABI）及其家人面临长期的心理社会问题和未满足的需求。目前，尚无支持脑损伤后生活的结构化和综合性医疗保健服务。我们评估了针对PwABI的病例管理（CM），其目的是为有复杂问题的人提供获得医疗保健和社会服务的便利，并促进这些服务的整合。
在荷兰进行的一组重复测量研究，包括62名PwABI患者和36名护理人员。在18至24个月内每六个月进行一次评估。主要结局是心理社会幸福感（医院焦虑抑郁量表）。次要结局是自我效能感、参与度、生活满意度，以及PwABI患者和护理人员的需求；还有护理人员负担。
PwABI患者及其护理人员的焦虑均显著降低。随着时间的推移，PwABI患者报告的未满足需求显著减少，但参与限制增多。护理人员报告随着时间的推移护理负担显著减轻，自我效能感增强。
CM似乎有望减少PwABI患者未满足的需求，并改善PwABI患者及其护理人员的一些心理社会结局。然而，可能需要终身CM。需要进行一项随机对照研究来确认这些积极结果是否归因于CM。
本研究值得进一步开展，以确定CM对PwABI患者的有效性。
