Optimizing Neurocritical Care Follow-Up Through the Integration of Neuropsychology
Optimizing Neurocritical Care Follow-Up Through the Integration of Neuropsychology
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DOI：
10.1016/j.pediatrneurol.2018.09.007
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发表时间：
2018-12-01
影响因子：
3.8
通讯作者：
Piantino, Juan
中科院分区：
文献类型：
--
作者：
Dodd, Jonathan N.;Hall, Trevor A.;Piantino, Juan
背景技术背景：儿科重症监护幸存者经常遭受持续的多系统健康问题，并且由于当前护理模式的限制而留下未满足的治疗需求。我们建议，神经心理学的整合到神经重症监护后续提供增量效益的识别和治疗持续的并发症和减少共病。基本程序：本研究的目的是三重。首先，我们描述了两个儿科医院的试点项目，作为实施系统随访护理的模式，由重症监护，神经病学和神经心理学组成的跨学科临床团队。其次，我们描述了这些项目中神经心理学服务提供的具体工作模式。第三，我们提出了初步的数据，从第一个六个月的试点项目之一，以检查增量效益的神经心理学在改善病人的护理和家长satisfactions.Main调查结果：共有16例（年龄范围3至17岁）被认为是神经心理学的前六个月内的程序。结果表明，将神经心理学纳入后续护理，导致81%的病例中提出了尚未解决的服务或问题的建议。家长的满意度很高，在96%的项目中获得了最高的评价。父母报告说，神经心理咨询提高了他们的理解和沟通，与他们的孩子，并帮助他们知道什么期望从他们的孩子在急性期后recovery.CONCLUSIONS：这项试点研究的结果表明，神经心理学的整合到神经重症监护的后续计划，有助于家长的满意度，并可能提供增量效益的病人护理。(C)2018爱思唯尔公司All rights reserved.
BACKGROUND: Pediatric critical care survivors often suffer persisting multisystem health problems and are left with treatment needs that go unmet due to limits in current care models. We proposed that integration of neuropsychology into neurocritical care followup provides incremental benefit to the identification and treatment of persisting complications and reduction in co-morbidities.BASIC PROCEDURES:The aims of this study were three-fold. First, we described pilot programs at two pediatric hospitals as models for implementing systematic follow-up care with interdisciplinary clinic teams consisting of critical care, neurology, and neuropsychology. Second, we described working models specific to neuropsychological service delivery in these programs. Third, we presented preliminary data from the first six months of one of the pilot programs in order to examine incremental benefit of neuropsychology in improving patient care and parent satisfaction.MAIN FINDINGS: A total of 16 patients (age range three to 17 years) were seen by neuropsychology within the first six months of the program. Results showed that integration of neuropsychology into follow-up care resulted in recommendations being made for services or concerns not already addressed in 81% of cases. Parents reported high satisfaction, endorsing the highest possible rating on 96% of all items. Parents reported that neuropsychological consultation improved their understanding and communication with their child, and helped them know what to expect from their child during postacute recovery.CONCLUSIONS: The results of this pilot study suggest that integration of neuropsychology into neurocritical care follow-up programs contributes to parent satisfaction and may provide incremental benefit to patient care. (C) 2018 Elsevier Inc. All rights reserved.