Systematic Review of Discourse and Social Communication Interventions in Traumatic Brain Injury.
Systematic Review of Discourse and Social Communication Interventions in Traumatic Brain Injury.
复制标题
创伤性脑损伤中话语和社会沟通干预的系统回顾。
DOI：
10.1044/2021_ajslp-21-00088
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发表时间：
2022
影响因子：
2.6
通讯作者：
Fiszdon,Joanna
中科院分区：
文献类型：
--
作者：
Lê,Karen;Coelho,Carl;Fiszdon,Joanna
目的本研究回顾了创伤性脑损伤（TBI）中话语和社交沟通干预的现状，以提供有关治疗效果、TBI严重程度的治疗方法、治疗成分和治疗结果测量的临床重点指导。方法在五个电子数据库和2012年至2021年间发表的TBI话语或社交沟通干预主题文章的参考列表中进行搜索。搜索术语反映了三个概念：TBI、治疗和认知沟通。使用特定于研究设计的评级量表评估研究的方法学质量。结果识别出 767 条记录，最终形成 21 项定性综合研究。所有方法均导致治疗后有所改善，但证据的持久性和强度各不相同。五个治疗组成部分被确定为促进变革“必不可少”。话语方法通常对轻度至中度 TBI 更有效，而社交沟通方法对中度至重度 TBI 更有效。沟通结果测量通常比其他功能领域的测量对变化更敏感。结论证据表明话语和社交沟通治疗有望改善 TBI 中的沟通。治疗成分的选择和针对个体的治疗方案是重要的临床考虑因素。使用至少两个评估目标行为和功能泛化程度的最近结果测量可能是有利的。该领域将受益于更多、更严格的治疗研究，以更好地了解如何最好地治疗 TBI 患者的认知沟通障碍。补充材料https://doi.org/10.23641/asha.19233516
PurposeThis study reviewed the current state of discourse and social communication interventions in traumatic brain injury (TBI) to provide clinically focused guidance about treatment efficacy, treatment approaches by TBI severity, treatment components, and treatment outcome measures.MethodSearches were conducted in five electronic databases and reference lists of topical articles for discourse or social communication interventions in TBI published between 2012 and 2021. Search terms reflected three concepts: TBI, treatment, and cognitive-communication. Studies were evaluated for methodological quality using rating scales specific to study design.ResultsSeven hundred sixty-seven records were identified, culminating in 21 studies for qualitative synthesis. All approaches resulted in improvement posttreatment, but durability and strength of evidence varied. Five treatment components were identified as “essential” for fostering change. Discourse approaches were generally more effective in mild-to-moderate TBI, whereas social communication approaches were more effective in moderate-to-severe TBI. Communication outcome measures were generally more sensitive to change than measures of other domains of functioning.ConclusionsThe evidence suggests that discourse and social communication treatments are promising for improving communication in TBI. Selection of treatment components and tailoring treatment to the individual are important clinical considerations. Use of at least two proximal outcome measures that evaluate the target behavior and extent of functional generalization may be advantageous. The field would benefit from additional, more rigorous treatment studies to provide a greater understanding of how best to treat cognitive-communicative impairments in people with TBI.Supplemental Materialhttps://doi.org/10.23641/asha.19233516