Self-Awareness and Neurobehavioral Outcomes, 5 Years or More After Moderate to Severe Brain Injury
Self-Awareness and Neurobehavioral Outcomes, 5 Years or More After Moderate to Severe Brain Injury
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DOI：
10.1097/htr.0b013e31826db6b9
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发表时间：
2014-03-01
影响因子：
2.4
通讯作者：
Poole, John H.
中科院分区：
文献类型：
--
作者：
Kelley, Elizabeth;Sullivan, Campbell;Poole, John H.
目的：研究创伤性脑损伤（TBI）后5年或更长时间的自我意识及其与预后的关系。参与者：62名中度至重度TBI的成年人和重要其他（SO）被试地点：区域退伍军人医疗中心。主要测量指标：TBI随访访谈、社区整合问卷、生活满意度量表和照顾者负担量表。设计：急性住院康复后5至16年，单独的工作人员接触和采访受试者和SO。受试者的意识被定义为逆subject-SO差异scores.Results：受试者显着漏报的神经系统症状和过度报告他们的工作和家庭功能，他们的情绪困扰和社会功能的自我评级没有不同的SO评级。即使在控制了受伤的严重程度之后，就业也与认知缺陷的自我意识增强有关。受试者的生活满意度与更好的自我报告的神经功能相关，这通常与SO评级不一致。照顾者的负担是更糟的SO认为科目有更糟糕的症状和较差的工作和社会integration.Conclusions：受损的自我意识仍然明显超过5年后TBI。当TBI患者意识到自己的认知缺陷和能力时，他们更有可能获得就业。然而，受试者和SO的主观生活质量与他们自己对TBI结局的看法有关。
Objective: To examine self-awareness 5 years or more after traumatic brain injury (TBI) and its relation to outcomes.Participants: Sixty-two adults with moderate to severe TBI and significant other (SO) informants (family or close friend).Setting: Regional veterans medical center.Main Measures: TBI Follow-up Interview, Community Integration Questionnaire, Satisfaction with Life Scale, and Caregiver Burden Inventory.Design: Five to 16 years after acute inpatient rehabilitation, separate staff contacted and interviewed subjects and SOs. Subject awareness was defined as inverse subject-SO discrepancy scores.Results: Subjects significantly underreported neurologic symptoms and overreported their work and home functioning; their self-ratings of emotional distress and social functioning did not differ from SO ratings. Employment was associated with greater self-awareness of cognitive deficits, even after controlling for injury severity. Subjects' life-satisfaction was associated with better self-reported neurologic functioning, which frequently did not agree with SO ratings. Caregiver burden was worse as SOs perceived subjects as having worse symptoms and poorer work and social integration.Conclusions: Impaired self-awareness remains evident more than 5 years after TBI. People with TBI are more likely to gain employment when they are aware of their cognitive deficits and abilities. However, subjective quality of life, for subjects and SOs, was related to their own perception of the TBI outcomes.