Competence in discourse as a measure of social integration and quality of life in persons with traumatic brain injury
Competence in discourse as a measure of social integration and quality of life in persons with traumatic brain injury
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DOI：
10.1080/026990598122160
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发表时间：
1998-09-01
期刊：
影响因子：
1.9
通讯作者：
Johnston, MV
中科院分区：
文献类型：
--
作者：
Galski, T;Tompkins, C;Johnston, MV
持续存在的沟通困难是许多创伤性脑损伤后面临的严重障碍，也是重返社区的主要障碍。传统的研究方法对TBI后的交际问题的研究主要集中在语言产生和表达的形式，通常是从语音，语义和句法特征方面。然而，大多数TBI患者在这些常规指标上的总体表现在正常范围内。最近，人们的注意力集中在自然发生的语言形式上，即话语，这在很大程度上受到语言，认知和社会技能的影响。由于大多数TBI患者在这些领域留下了残余缺陷，话语能力的研究似乎特别适合于了解他们的沟通问题，并促进最终重返社会。本研究旨在确定TBI患者的对话话语是否以及如何与匹配的非TBI组不同，以及是否有任何确定的变量与社区融合和生活质量衡量的结果有关。此外，本研究还探讨了跨会话、叙事、程序语类的TBI与语篇特征之间的关系。TBI患者（n = 30）从门诊脑损伤计划进行了比较，匹配的对照组（n = 10）在三种话语类型。双变量和多变量分析评估了23个措施的话语效率，复杂性，主题管理，信息和语用行为，在每一种体裁，以及措施的心理社会调整，特别是社会融合和生活质量。结果表明，TBI显着不同的控制在几个措施的话语和心理社会调整。研究发现，话语的许多其他特征与社会融合和生活质量显着相关。有趣的是，话语变量与社会融合的相关性似乎比年龄，性别，教育和其他传统的心理社会因素更强。与预测相反，会话话语的特征并没有比其他类型的话语更强烈地与社会融合和生活质量相关。讨论集中在与生活质量和社会融合有关的日常话语和社会心理障碍的明显共同特征上。
Persisting difficulties in communication are a serious handicap faced by many after traumatic brain injury (TBI) and a major barrier to community reintegration. Conventional approaches to the study of communication problems after TBI have focused on the form of language production and expression, usually in terms of phonological, semantic and syntactical features. Most TBI patients, however, perform overall within normal ranges on these conventional indicators. More recently, attention was focused on language in its naturally-occurring form, that is, discourse, which is heavily influenced by linguistic, cognitive and social skills. Because most TBI patients are left with residual deficits in these areas, study of discourse abilities seem to be particularly suited to understanding their problems in communication and facilitating eventual reintegration into the community. This study was designed to determine if and how the conversational discourse of TBI patients differs from a matched non-TBI group and whether any identified variables are related to measures of outcome as measured by community integration and quality of life. Additionally, the study was designed to explore the relationship between TBI and features of discourse across conversational, narrative, procedural genres. TBI patients (n = 30) from an out-patient brain injury programme were compared to matched controls (n = 10) in the three discourse genres. Bivariate and multivariate analyses evaluated 23 measures of discourse efficiency, complexity, topic management, information and pragmatic behaviours in each genre as well as measures of psyshosocial adjustment, particularly social integration and quality of life. Results indicated that TBIs were significantly different from controls on several measures of discourse and psychosocial adjustment. A number of other features of discourse were found to correlate significantly with social integration and quality of life. Interestingly, discourse variables appeared to correlate with social integration more strongly than age, gender, education, and other conventional psychosocial factors. Contrary to prediction, features of conversational discourse did not correlate more strongly than other types of discourse with social integration and quality of life. Discussion centred on the apparent comorbidity of features in everyday discourse and psychosocial deteriminants that were associated with quality of life and social integration.