Cognitive Rehabilitation of OIF/OEF Veterans with Cognitive Disorder
患有认知障碍的 OIF/OEF 退伍军人的认知康复
基本信息
- 批准号:7867280
- 负责人:
- 金额:--
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2010
- 资助国家:美国
- 起止时间:2010-04-01 至 2013-03-30
- 项目状态:已结题
- 来源:
- 关键词:AbstinenceAffectAfghanistanAftercareAlcohol or Other Drugs useAttentionAuditoryBrain ConcussionBrain InjuriesCalendarCaliforniaCaringCharacteristicsCognition DisordersCognitiveCognitive deficitsDataDiagnosisEducational InterventionEffect Modifiers (Epidemiology)EffectivenessEmploymentEnrollmentExclusion CriteriaFinancial compensationFreedomFunctional disorderGoalsHealthcareHealthcare SystemsIdahoImpaired cognitionInformed ConsentInjuryInterventionInvestigationIraqLifeLiteratureManualsMeasuresMediator of activation proteinMedicalMemoryMemory impairmentMilitary PersonnelModalityMultiple SclerosisNeurobehavioral ManifestationsNeuropsychological TestsOregonOutcomeOutcome MeasurePaperParticipantPatientsPerformancePilot ProjectsPsychotic DisordersPublishingQuality of lifeQuestionnairesRandomizedRandomized Controlled TrialsRecording of previous eventsRecruitment ActivityRehabilitation therapyReportingResearch DesignResourcesRiskScreening procedureSelf EfficacyServicesSeveritiesSoldierSubstance Use DisorderSymptomsSystemTestingTrainingTraumatic Brain InjuryTreatment FactorUnconscious StateVeteransVisual impairmentWashingtonabstractingcare seekingclinical careclinically significantcognitive functioncognitive rehabilitationcombatdesigneligible participantevidence baseexperiencefollow-upfunctional outcomesimprovedinclusion criteriainjuredmemberneuropsychologicaloperationpreventprospectivepsychologicrehabilitation servicesatisfactionsecondary outcomesoundtreatment as usualvisual imagery
项目摘要
DESCRIPTION (provided by applicant):
PROJECT SUMMARY - ABSTRACT As a result of the current military operations in Afghanistan (Operation Enduring Freedom; OEF) and Iraq (Operation Iraqi Freedom; OIF), the Department of Veterans Affairs (VA) is providing health care for increasing numbers of veterans who have experienced mild traumatic brain injury (MTBI) or concussion, many of whom complain of cognitive impairment. MTBI is the most common combat- related injury and can occur with or without direct impact, obvious external injuries, or loss of consciousness. Currently, cognitive rehabilitation for MTBI typically includes training in compensatory strategies that help patients develop internal strategies (e.g., visual imagery) and utilize external aides (e.g., memory notebooks, calendars/organizers, timers) to compensate for cognitive deficits. Initial data from our unfunded cognitive rehabilitation pilot study are encouraging and indicate post-treatment improvement on multiple outcome measures. However, to date, no published studies have evaluated the efficacy of specific cognitive rehabilitation interventions with OEF/OIF veterans who have experienced combat-related MTBI. The primary objective of this study, therefore, is to evaluate the efficacy of a manualized, 10-week, Compensatory Strategy Training (CST) intervention for OEF/OIF veterans with cognitive disorder resulting from the aftereffects of combat-related mild traumatic brain injury. The specific goals are: 1) to determine the efficacy of cognitive rehabilitation group treatment; and 2) to determine the treatment factors and patient characteristics that are associated with improved functional outcomes. The overall goal is to develop an evidence-based, manualized, group treatment that can be readily implemented in VHA treatment settings. The study design makes use of the convergent availability of resources available at the four participating VAs in Portland Oregon, Puget Sound Washington, San Diego California, and Boise Idaho. The study will recruit a total of 280 OEF/OIF veterans enrolled for medical services at these VAs. Inclusion criteria will be: 1) OEF/OIF veterans enrolled at a participating VA who are able to provide informed consent; and 2) As part of standard VA clinical care, have screened positive for MTBI and complain of cognitive impairment. Exclusion criteria will be: 1) Current substance use disorder with less than 30 days abstinence; 2) History of a primary psychotic disorder; and 3) Auditory or visual impairments that would prevent ability to participate in the cognitive rehabilitation group or benefit from compensatory strategies. In a randomized controlled trial, we will compare two groups: eligible participants will be randomly assigned to either the Cognitive Strategy Training (CST) group or Usual Care (UC) group. Participants in the CST group will receive the CST intervention during their participation in the study, which will consist of weekly 120-minute group sessions for 10 weeks as guided by the CST Treatment Manual. UC participants will continue to receive usual care (i.e., their regular medical, psychiatric, and psychotherapeutic care; no CST intervention) during their participation, but will be offered CST after the end of the study. Both groups will undergo assessments at baseline, 5 weeks (midway through CST), 10 weeks (immediately following the end of CST), and 15 weeks (5 weeks after CST is completed). These assessments will include a brief cognitive assessment battery and a battery of questionnaires and paper-pencil tests designed to assess current psychological and cognitive symptom severity, utility of compensatory strategies, self-efficacy, adaptive functioning, ability to reliably manage personal affairs, substance use, quality of life, and treatment satisfaction ratings. During their study participation, all participants will continue to receive their regular medical, psychiatric, and psychotherapeutic care.
PUBLIC HEALTH RELEVANCE:
PROJECT SUMMARY - NARRATIVE RELEVANCE The number of OEF/OIF veterans seeking care and rehabilitation services within the VA Health Care System is increasing rapidly. The cognitive effects of MTBI are clinically significant and can adversely affect a veteran's ability to reintegrate into civilian life, return to duty, succeed in competitive employment, or function independently. The primary product of the proposed study would be an empirically validated, manualized, cognitive rehabilitation intervention for OIF/OIF veterans with cognitive disorders. The group treatment modality has the virtue of efficiency and a manualized treatment approach would allow wide-ranging application throughout the VHA system. As such, the proposed study is likely to have a significant effect on the quality and effectiveness of rehabilitative services being offered to our returning soldiers with combat-related MTBI and cognitive impairment.
描述(由申请人提供):
项目概要-摘要由于目前在阿富汗(持久自由行动; OEF)和伊拉克(伊拉克自由行动; OIF)的军事行动,退伍军人事务部(VA)正在为越来越多的经历轻度创伤性脑损伤(MTBI)或脑震荡的退伍军人提供医疗保健,其中许多人抱怨认知障碍。MTBI是最常见的战斗相关损伤,可以发生或没有直接影响,明显的外部损伤或意识丧失。目前,MTBI的认知康复通常包括补偿策略的训练,帮助患者制定内部策略(例如,视觉成像)并利用外部辅助(例如,记忆笔记本、日历/记事本、计时器)以补偿认知缺陷。我们的无资金支持的认知康复试点研究的初步数据令人鼓舞,并表明治疗后多个结果指标的改善。然而,迄今为止,还没有发表的研究评估了特定认知康复干预措施对经历过战斗相关MTBI的OEF/OIF退伍军人的疗效。因此,本研究的主要目的是评估手动的10周补偿策略训练(CST)干预对OEF/OIF退伍军人的有效性,这些退伍军人因战斗相关轻度创伤性脑损伤的后遗症而患有认知障碍。具体目标是:1)确定认知康复团体治疗的疗效; 2)确定与改善功能结局相关的治疗因素和患者特征。总体目标是开发一种循证的、手动的、可在VHA治疗环境中容易实施的群体治疗。研究设计利用了波特兰俄勒冈州、普吉湾华盛顿、圣地亚哥加州和博伊西爱达荷州的四个参与VA的可用资源的聚合可用性。这项研究将招募总共280名在这些退伍军人协会登记接受医疗服务的持久自由行动/伊拉克自由行动退伍军人。入选标准为:1)OEF/OIF退伍军人在参与VA招募,能够提供知情同意; 2)作为标准VA临床护理的一部分,MTBI筛查呈阳性,并抱怨认知障碍。排除标准为:1)目前的物质使用障碍,戒断时间少于30天; 2)原发性精神病史; 3)听觉或视觉障碍,这将阻止参与认知康复组或从补偿策略中受益。在一项随机对照试验中,我们将比较两组:合格的参与者将被随机分配到认知策略训练(CST)组或康复护理(UC)组。科技委小组的参与者将在参与研究期间接受科技委的干预,研究将包括每周120分钟的小组会议,为期10周,以科技委治疗手册为指导。UC受试者将继续接受常规护理(即,他们在参与研究期间接受常规的医疗、精神病学和心理治疗护理;无CST干预),但将在研究结束后提供CST。两组将在基线、5周(CST中途)、10周(CST结束后立即)和15周(CST完成后5周)进行评估。这些评估将包括一组简短的认知评估和一组问卷和纸笔测试,旨在评估当前心理和认知症状的严重程度、补偿策略的效用、自我效能、适应功能、可靠管理个人事务的能力、物质使用、生活质量和治疗满意度评级。在参与研究期间,所有受试者将继续接受常规的医疗、精神病学和心理治疗护理。
公共卫生关系:
OEF/OIF退伍军人在VA医疗保健系统内寻求护理和康复服务的人数正在迅速增加。MTBI的认知影响在临床上是显著的,并且可能对退伍军人重新融入平民生活、重返岗位、在竞争性就业中取得成功或独立运作的能力产生不利影响。拟议研究的主要产品将是对OIF/OIF患有认知障碍的退伍军人进行经验验证的手动认知康复干预。小组治疗模式具有效率的优点,手动治疗方法将允许在整个VHA系统中广泛应用。因此,拟议的研究可能会对向我们返回的患有与战斗有关的MTBI和认知障碍的士兵提供的康复服务的质量和有效性产生重大影响。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Daniel M Storzbach其他文献
Daniel M Storzbach的其他文献
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{{ truncateString('Daniel M Storzbach', 18)}}的其他基金
Cognitively Augmented Behavioral Activation for Veterans with Comorbid TBI/PTSD
患有共病 TBI/PTSD 的退伍军人的认知增强行为激活
- 批准号:
9260708 - 财政年份:2015
- 资助金额:
-- - 项目类别:
Cognitive Rehabilitation of OIF/OEF Veterans with Cognitive Disorder
患有认知障碍的 OIF/OEF 退伍军人的认知康复
- 批准号:
8466775 - 财政年份:2010
- 资助金额:
-- - 项目类别:
Cognitive Rehabilitation of OIF/OEF Veterans with Cognitive Disorder
患有认知障碍的 OIF/OEF 退伍军人的认知康复
- 批准号:
8857408 - 财政年份:2010
- 资助金额:
-- - 项目类别:
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