Neurological rehabilitation of severely disabled cardiac arrest survivors. Part II. Life situation of patients and families after treatment
Neurological rehabilitation of severely disabled cardiac arrest survivors. Part II. Life situation of patients and families after treatment
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DOI：
10.1016/s0300-9572(00)00240-9
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发表时间：
2000-11-01
期刊：
影响因子：
6.5
通讯作者：
Auff, E
中科院分区：
文献类型：
--
作者：
Pusswald, G;Fertl, E;Auff, E
背景：大约一半的院外心脏骤停幸存者经历继发性缺氧脑损伤。神经预后可受康复治疗方法的影响，但持续性残疾的性质和严重程度尚不清楚。本研究旨在探讨这些患者的持续性神经精神症状、整体功能和生活状况，并评估其家庭生活质量。方法：住院康复25个月后，12例患者（平均年龄51岁，10例男，2例女）与护理人员进行了横断面跨学科随访评估。通过临床评定量表、神经心理学标准测试和临床心理量表对功能进行调查。家庭成员被问及生活质量和对社会支持的满意度。结果：所有患者都有至少一个或多个认知领域的缺陷，如定向、记忆、警觉性和意识。观察到三种不同的临床综合征：非常严重的智力和身体障碍(2)，轻中度痴呆(5)和遗忘综合征(5)。多重残疾的患病率很高。自我评分与代理评分有显著差异（P < 0.01）。CA后，家庭成员的生活状况发生了巨大变化；60%的配偶有身心问题，50%的人抱怨缺乏社会支持。结论：重度缺氧性脑损伤虽经最佳住院治疗，但仍导致永久性认知能力下降、意识和生活自理能力受损。家庭感到孤立，超过一半的人需要更多的支持来防止倦怠。(C) 2000爱思唯尔科学爱尔兰有限公司版权所有。
Background: About half of out-of-hospital cardiac arrest survivors experience secondary anoxic brain damage. Neurological outcome can be influenced by rehabilitative treatment approaches, but the nature and severity of persistent disabilities remain unclear. The aim of the study was to explore persistent neuropsychiatric symptoms, global function and life situation of these patients, and to evaluate quality of life in families. Methods: 25 months after inpatient rehabilitation, 12 individuals (mean age = 51 years; ten M: two F) attended a cross-sectional interdisciplinary follow-up assessment with their carers. Function was investigated by clinical rating scales, neuropsychological standard tests, and clinical psychological inventories. Family members were asked about quality of life and satisfaction with social support. Results: All patients had deficits in at least one or more cognitive areas such as orientation, memory, alertness, and awareness. Three different clinical syndromes were observed: very severe intellectual and physical impairment, (two), mild to moderate dementia, (five), and amnesic syndrome, (five). Prevalence of multiple disabilities, was high. A striking discrepancy was found between self and proxy rating of disabilities (P < 0.01). Family members faced dramatically altered life situations after CA; 60% of spouses suffered from psychosomatic problems, 50% complained of lack of social support. Conclusion: Despite optimal in-hospital treatment, severe anoxic brain damage resulted in permanent cognitive decline, impaired awareness and self care ability. Families felt isolated, and more than half need more support to prevent burn out. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.