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1.
Sarah L. Martindale Erica L. Epstein Katherine H. Taber 《Archives of physical medicine and rehabilitation》2018,99(12):2485-2495
Objective
To characterize behavioral and health outcomes in veterans with traumatic brain injury (TBI) acquired in nondeployment and deployment settings.Design
Cross-sectional assessment evaluating TBI acquired during and outside of deployment, mental and behavioral health symptoms, and diagnoses.Setting
Veterans Affairs Medical Centers.Participants
Iraq and Afghanistan veterans who were deployed to a warzone (N=1399).Interventions
Not applicable.Main Outcome Measures
Comprehensive lifetime TBI interview, Structured Clinical Interview for DSM-IV Disorders, Combat Exposure Scale, and behavioral and health measures.Results
There was a main effect of deployment TBI on depressive symptoms, posttraumatic stress symptoms, poor sleep quality, substance use, and pain. Veterans with deployment TBI were also more likely to have a diagnosis of bipolar, major depressive, alcohol use, and posttraumatic stress disorders than those who did not have a deployment TBI.Conclusions
TBIs acquired during deployment are associated with different behavioral and health outcomes than TBI acquired in nondeployment environments. The presence of TBI during deployment is associated with poorer behavioral outcomes, as well as a greater lifetime prevalence of behavioral and health problems in contrast to veterans without deployment TBI. These results indicate that problems may persist chronically after a deployment TBI and should be considered when providing care for veterans. Veterans with deployment TBI may require treatment alterations to improve engagement and outcomes. 相似文献2.
Natalie Kreitzer Brad G. Kurowski Tamilyn Bakas 《Archives of physical medicine and rehabilitation》2018,99(11):2342-2354
Objective
To describe and synthesize the literature on adult traumatic brain injury (TBI) family caregiver and dyad intervention. TBI is a common injury that has a significant long-term impact, and is sometimes even characterized as a chronic condition. Informal (ie, unpaid) family caregivers of adults with TBI experience high rates of burnout, depression, fatigue, anxiety, lower subjective well-being, and poorer levels of physical health compared to noncaregivers. This study addresses the critical gap in the understanding of interventions designed to address the impact of TBI on adult patients and their family caregivers.Data Sources
PubMed and MEDLINE.Study Selection
Studies selected for review had to be written in English and be quasi-experimental or experimental in design, report on TBI caregivers, survivors with heavy involvement of caregivers, or caregiver dyads, involve moderate and severe TBI, and describe an intervention implemented during some portion of the TBI care continuum.Data Extraction
The search identified 2171 articles, of which 14 met our criteria for inclusion. Of the identified studies, 10 were randomized clinical trials and 4 were nonrandomized quasi-experimental studies. A secondary search to describe studies that included individuals with other forms of acquired brain injury in addition to TBI resulted in 852 additional titles, of which 5 met our inclusion criteria.Data Synthesis
Interventions that targeted the caregiver primarily were more likely to provide benefit than those that targeted caregiver/survivor dyad or the survivor only. Many of the studies were limited by poor fidelity, low sample sizes, and high risk for bias based on randomization techniques.Conclusions
Future studies of TBI caregivers should enroll a more generalizable number of participants and ensure adequate fidelity to properly compare interventions. 相似文献3.
Anthony H. Lequerica Christian Lucca Nancy D. Chiaravalloti Irene Ward John D. Corrigan 《Archives of physical medicine and rehabilitation》2018,99(9):1811-1817
Objective
To test the feasibility and validity of an online version of an established interview designed to determine a lifetime history of traumatic brain injury (TBI).Design
Cross-sectional.Setting
General community.Participants
A volunteer sample of individuals (N= 265) from the general population across the United States.Interventions
Not applicable.Main Outcome Measure(s)
Online version of the Ohio State University Traumatic Brain Injury Identification Method, Rivermead Postconcussion Symptoms Questionnaire (RPQ), Patient-Reported Outcomes Measurement Information System Cognitive Concerns Scale.Results
The measure was completed by 89.4% of the sample with most participants completing the measure in <8 minutes. After controlling for age, sex, psychiatric history, drug or alcohol history, and history of developmental disability, worst TBI severity was significantly associated with scores on the RPQ, F(2,230)=4.56, P=.011, and having a TBI within the past 2 years was associated with higher scores on the cognitive factor subscale of the RPQ, F(1,75)=7.7, P=.007.Conclusions
The online administration of the Ohio State University Traumatic Brain Injury Identification Method appears to be feasible in the general population. Preliminary validity was demonstrated for the indices of worst TBI severity and time since most recent TBI. 相似文献4.
Theresa Louise Bender Pape Bridget Smith Judith Babcock-Parziale Charlesnika T. Evans Amy A. Herrold Kelly Phipps Maieritsch Walter M. High 《Archives of physical medicine and rehabilitation》2018,99(7):1370-1382
Objective
To comprehensively estimate the diagnostic accuracy and reliability of the Department of Veterans Affairs (VA) Traumatic Brain Injury (TBI) Clinical Reminder Screen (TCRS).Design
Cross-sectional, prospective, observational study using the Standards for Reporting of Diagnostic Accuracy criteria.Setting
Three VA Polytrauma Network Sites.Participants
Operation Iraqi Freedom, Operation Enduring Freedom veterans (N=433).Main Outcome Measures
TCRS, Comprehensive TBI Evaluation, Structured TBI Diagnostic Interview, Symptom Attribution and Classification Algorithm, and Clinician-Administered Posttraumatic Stress Disorder (PTSD) Scale.Results
Forty-five percent of veterans screened positive on the TCRS for TBI. For detecting occurrence of historical TBI, the TCRS had a sensitivity of .56 to .74, a specificity of .63 to .93, a positive predictive value (PPV) of 25% to 45%, a negative predictive value (NPV) of 91% to 94%, and a diagnostic odds ratio (DOR) of 4 to 13. For accuracy of attributing active symptoms to the TBI, the TCRS had a sensitivity of .64 to .87, a specificity of .59 to .89, a PPV of 26% to 32%, an NPV of 92% to 95%, and a DOR of 6 to 9. The sensitivity was higher for veterans with PTSD (.80–.86) relative to veterans without PTSD (.57–.82). The specificity, however, was higher among veterans without PTSD (.75–.81) relative to veterans with PTSD (.36–.49). All indices of diagnostic accuracy changed when participants with questionably valid (QV) test profiles were eliminated from analyses.Conclusions
The utility of the TCRS to screen for mild TBI (mTBI) depends on the stringency of the diagnostic reference standard to which it is being compared, the presence/absence of PTSD, and QV test profiles. Further development, validation, and use of reproducible diagnostic algorithms for symptom attribution after possible mTBI would improve diagnostic accuracy. 相似文献5.
Mattia Morri Paolo Chiari Cristiana Forni Antonella Orlandi Magli Domenica Gazineo Natalia Franchini Lorenzo Marconato Tiziana Giamboi Andrea Cotti 《Archives of physical medicine and rehabilitation》2018,99(5):893-899
Objective
To identify the factors associated with recovering autonomy in activities of daily living (ADL) in patients who have had a hip fracture.Design
A prospective cohort study.Setting
The orthopedic and orthogeriatric departments of 2 regional hospitals.Participants
Patients (N=742) aged ≥65 years with a diagnosis of fragility hip fracture.Main Outcome Measures
The level of autonomy at 4 months was assessed using the ADL scale.Results
The median score on the ADL scale at 4 months was 3 (interquartile range, 5). Half of the population was unable to recover their prefracture autonomy levels. The following were found to be risk factors: increasing age (B=.02, P<.001); an elevated number of comorbidities (B=.044, P=.005); a lower level of prefracture autonomy (B=.087, P<.001); more frequent use of an antidecubitus mattress (B=.211, P<.001); an increased number of days with disorientation (B=.002, P=.012); failure to recover deambulation (B=.199, P<.001); an increased number of days with diapers (B=.003, P<.001), with a urinary catheter (B=.03, P<.001), and with bed rails (B=.001, P=.014); and a nonintensive care pathway (B=.199, P=.014).Conclusions
Recovery of deambulation, treatment of disorientation and management of incontinence are modifiable factors significantly associated with the functional recovery of autonomy. 相似文献6.
7.
Jessica Trevena-Peters Adam McKay Gershon Spitz Rachel Suda Belinda Renison Jennie Ponsford 《Archives of physical medicine and rehabilitation》2018,99(2):329-337.e2
Objective
To assess the efficacy of activities of daily living (ADL) retraining during posttraumatic amnesia (PTA) compared with ADL retraining commencing after emergence from PTA.Design
Randomized controlled trial.Setting
Inpatient rehabilitation center.Participants
Participants with severe TBI (N=104), admitted to rehabilitation and remaining in PTA for >7 days, were randomized to receive either treatment as usual (TAU) with daily ADL retraining (treatment), or TAU alone (physiotherapy and/or necessary speech therapy) during PTA.Interventions
ADL retraining was manualized, followed errorless and procedural learning principles, and included individualized goals. Both groups received occupational therapy as usual after PTA.Main Outcome Measures
Primary outcome was the FIM completed at admission, PTA emergence, discharge, and 2-month follow-up. Secondary outcomes included length of rehabilitation inpatient stay, PTA duration, Agitated Behavior Scale scores, and Community Integration Questionnaire (CIQ) scores at follow-up. Groups did not significantly differ in baseline characteristics.Results
On the primary outcome, FIM total change, random effects regression revealed a significant interaction of group and time (P<.01). The treatment group had greater improvement in FIM scores from baseline to PTA emergence, which was maintained at discharge, but not at follow-up. Twenty-seven percent more of the treatment group reliably changed on FIM scores at PTA emergence. Group differences in length of stay, PTA duration, agitation, and CIQ scores were not significant; however, TAU trended toward longer length of stay and PTA duration.Conclusions
Individuals in PTA can benefit from skill retraining. 相似文献8.
Jennifer H. Marwitz Adam P. Sima Jeffrey S. Kreutzer Laura E. Dreer Thomas F. Bergquist Ross Zafonte Douglas Johnson-Greene Elizabeth R. Felix 《Archives of physical medicine and rehabilitation》2018,99(2):264-271
Objectives
To evaluate (1) the trajectory of resilience during the first year after a moderate-severe traumatic brain injury (TBI); (2) factors associated with resilience at 3, 6, and 12 months postinjury; and (3) changing relationships over time between resilience and other factors.Design
Longitudinal analysis of an observational cohort.Setting
Five inpatient rehabilitation centers.Participants
Patients with TBI (N=195) enrolled in the resilience module of the TBI Model Systems study with data collected at 3-, 6-, and 12-month follow-up.Interventions
Not applicable.Main Outcome Measure
Connor-Davidson Resilience Scale.Results
Initially, resilience levels appeared to be stable during the first year postinjury. Individual growth curve models were used to examine resilience over time in relation to demographic, psychosocial, and injury characteristics. After adjusting for these characteristics, resilience actually declined over time. Higher levels of resilience were related to nonminority status, absence of preinjury substance abuse, lower anxiety and disability level, and greater life satisfaction.Conclusions
Resilience is a construct that is relevant to understanding brain injury outcomes and has potential value in planning clinical interventions. 相似文献9.
Investigating the Variability in Mild Traumatic Brain Injury Definitions: A Prospective Cohort Study
Louise M. Crowe Stephen Hearps Vicki Anderson Meredith L. Borland Natalie Phillips Amit Kochar Sarah Dalton John A. Cheek Yuri Gilhotra Jeremy Furyk Jocelyn Neutze Mark D. Lyttle Silvia Bressan Susan Donath Charlotte Molesworth Ed Oakley Stuart R. Dalziel Franz E. Babl 《Archives of physical medicine and rehabilitation》2018,99(7):1360-1369
Objective
To prospectively compare the proportion of traumatic brain injuries (TBIs) that would be classified as mild by applying different published definitions of mild TBI to a large prospectively collected dataset, and to examine the variability in the proportions included by various definitions.Design
Prospective observational study.Setting
Hospital emergency departments.Participants
Children (N=11,907) aged 3 to 16 years (mean age, 8.2±3.9y). Of the participants, 3868 (32.5%) were girls, and 7374 (61.9%) of the TBIs were the result of a fall. Median Glasgow Coma Scale score was 15.Main Outcome Measures
We applied 17 different definitions of mild TBI, identified through a published systematic review, to children aged 3 to 16 years. Adjustments and clarifications were made to some definitions. The number and percentage identified for each definition is presented.Results
Adjustments had to be made to the 17 definitions to apply to the dataset: none in 7, minor to substantial in 10. The percentage classified as mild TBI across definitions varied from 7.1% (n=841) to 98.7% (n=11,756) and varied by age group.Conclusions
When applying the 17 definitions of mild TBI to a large prospective multicenter dataset of TBI, there was wide variability in the number of cases classified. Clinicians and researchers need to be aware of this variability when examining literature concerning children with mild TBI. 相似文献10.
Brenda Brouwer Dianne Bryant S. Jayne Garland 《Archives of physical medicine and rehabilitation》2018,99(7):1325-1332
Objective
To explore the effectiveness of a 2-week client-centered rehabilitation intervention (tune-up) delivered 6 months after inpatient discharge on community reintegration at 1 year in people with stroke.Design
A multicenter randomized controlled trial with 2 groups: an intervention (“tune-up”) group and a control group having the same exposure to assessment.Setting
Three research laboratories.Participants
Participants (N=103) with hemiparetic stroke recruited from inpatient rehabilitation units at the time of discharge.Interventions
Participants randomized to the tune-up group received 1-hour therapy sessions in their home 3times/wk for 2 weeks at 6 months postdischarge focusing on identified mobility-related goals. A second tune-up was provided at 12 months.Main Outcome Measures
Community reintegration measured by the Subjective Index of Physical and Social Outcome at 12 months and secondary outcomes included the Berg Balance Scale and measures of mobility and health-related quality of life up to 15 months.Results
At 12 months, both groups showed significant improvement in community reintegration (P<.05), a trend evident at all time points, with no difference between groups (mean difference, ?0.5; 95% confidence interval, ?1.8 to 2.7; P=.68). Similarly, a main effect of time reflected improvement in mobility-related and quality of life outcomes for both groups (P≤.0.5), but no group differences (P≥.30).Conclusions
All participants in the tune-up group met or exceeded at least 1 mobility-related goal; however, the intervention did not differentially improve community reintegration. The improvements in mobility and quality of life over the 15-month postdischarge period may be secondary to high activity levels in both study groups and exposure to regular assessment. 相似文献11.
Joshua W. Cohen Tanya D. Ivanova Brenda Brouwer Kimberly J. Miller Dianne Bryant S. Jayne Garland 《Archives of physical medicine and rehabilitation》2018,99(4):713-719
Objective
To investigate the extent to which physical performance measures of strength, balance, and mobility taken at discharge from inpatient stroke rehabilitation can predict health-related quality of life (HRQoL) and community reintegration after 6 months.Design
Longitudinal study.Setting
University laboratory.Participants
Adults (N=75) recruited within 1 month of discharge home from inpatient stroke rehabilitation.Interventions
Not applicable.Main Outcome Measures
36-Item Short Form Health Survey (SF-36) for HRQoL and Subjective Index of Physical and Social Outcome (SIPSO) for community reintegration. Physical performance measures were the 6-minute walk test, timed Up and Go (TUG) test, Berg Balance Scale, Community Balance and Mobility Scale, and isokinetic torque and power of hip, knee, and ankle on the paretic and nonparetic sides. Other prognostic variables included age, sex, stroke type and location, comorbidities, and motor FIM score.Results
Separate stepwise linear regressions were performed using the SF-36 and SIPSO as dependent variables. The total paretic lower limb torque and 6-minute walk test predicted the SF-36 Physical Component Summary (adjusted R2=.30). The total paretic lower limb torque and TUG test predicted the SIPSO physical component (adjusted R2=.47). The total paretic lower limb torque significantly predicted the SF-36 Mental Component Summary, but the adjusted R2 was low (.06). Similarly, the TUG test significantly predicted the SIPSO social component, but again the adjusted R2 was low (.09).Conclusions
Measures of physical performance including muscle strength and mobility at discharge can partially predict HRQoL and community reintegration 6 months later. Further research is necessary for more accurate predictions. 相似文献12.
Lenore A. Hawley Jessica M. Ketchum Clare Morey Kathleen Collins Susan Charlifue 《Archives of physical medicine and rehabilitation》2018,99(8):1584-1590
Objectives
To describe the prevalence of cannabis use in an adult sample with spinal cord injury (SCI) or traumatic brain injury (TBI) in Colorado, and to describe the self-reported reasons and side effects of cannabis use in this sample.Design
Mixed-methods observational study, using focus group data and telephone survey.Setting
Community.Participants
Colorado adults who sustained SCI or moderate to severe TBI and received services through Craig Hospital.Interventions
None.Main Outcome Measures
Survey.Results
Focus group participants identified issues that were then included in the survey development. Seventy percent of the 116 participants surveyed reported cannabis use before their injury (67% SCI, 74% TBI) and 48% reported use after their injury (53% SCI, 45% TBI). Overall, the most common reason for use was recreational (67%), followed by reducing stress/anxiety (62.5%) and improving sleep (59%). Among the respondents with SCI, the most common reasons for use were to reduce spasticity (70%), recreation (63%), and to improve sleep (63%). Among those with TBI, reasons endorsed were recreational (72%), reducing stress/anxiety (62%), and improving sleep (55%). Smoking was the most common method of use.Conclusions
A majority of this sample reported using cannabis before injury, and approximately half reported using cannabis after injury. Both groups reported recreational use, whereas the group with SCI also highly endorsed using cannabis to address chronic medical conditions. Clinicians should be aware of the high prevalence of cannabis use in these populations and the impact such use may have on the individual’s medical management. Further research in this area is needed. 相似文献13.
James F. Malec Timothy E. Stump Patrick O. Monahan Jacob Kean Dawn Neumann Flora M. Hammond 《Archives of physical medicine and rehabilitation》2018,99(2):281-288.e2
Objectives
To develop, for versions completed by individuals with traumatic brain injury (TBI) and an observer, a more precise metric for the Neuropsychiatric Inventory (NPI) Irritability and Aggression subscales using all behavioral item ratings for use with individuals with TBI and to address the dimensionality of the represented behavioral domains.Design
Rasch and confirmatory factor analyses of retrospective baseline NPI data from 3 treatment studies.Setting
Postacute rehabilitation clinic.Participants
NPI records (N = 525) consisting of observer ratings (n = 287) and self-ratings (n = 238) by participants with complicated mild, moderate, or severe TBI at least 6 months postinjury.Interventions
Not applicable.Main Outcome Measures
Frequency and severity ratings from NPI Irritability/Lability and Agitation/Aggression subscales.Results
Confirmatory factor analyses of both observer and participant ratings showed good fit for either a 1-factor or a 2-factor solution. Consistent with this, the Rasch model also fit the data well with aggression items indicating the more severe end of the construct and irritability items populating the milder end.Conclusions
Irritability and aggression appear to represent different levels of severity of a single construct. The derived Rasch metric offers a measure of this construct based on responses to all specific items that is appropriate for parametric statistical analysis and may be useful in research and clinical assessments of individuals with TBI. 相似文献14.
Y. Goverover B.M. Sandroff J. DeLuca 《Archives of physical medicine and rehabilitation》2018,99(4):635-640
Objectives
To (1) examine and compare dual-task performance in patients with multiple sclerosis (MS) and healthy controls (HCs) using mathematical problem-solving questions that included an everyday competence component while performing an upper extremity fine motor task; and (2) examine whether difficulties in dual-task performance are associated with problems in performing an everyday internet task.Design
Pilot study, mixed-design with both a within and between subjects' factor.Setting
A nonprofit rehabilitation research institution and the community.Participants
Participants (N=38) included persons with MS (n=19) and HCs (n=19) who were recruited from a nonprofit rehabilitation research institution and from the community.Interventions
Not applicable.Main Outcome Measures
Participant were presented with 2 testing conditions: (1) solving mathematical everyday problems or placing bolts into divots (single-task condition); and (2) solving problems while putting bolts into divots (dual-task condition). Additionally, participants were required to perform a test of everyday internet competence.Results
As expected, dual-task performance was significantly worse than either of the single-task tasks (ie, number of bolts into divots or correct answers, and time to answer the questions). Cognitive but not motor dual-task cost was associated with worse performance in activities of everyday internet tasks.Conclusions
Cognitive dual-task cost is significantly associated with worse performance of everyday technology. This was not observed in the motor dual-task cost. The implications of dual-task costs on everyday activity are discussed. 相似文献15.
Hillary R. Bogner Heather F. de Vries McClintock Jibby E. Kurichi Pui L. Kwong Dawei Xie Sean Hennessy Joel E. Streim Margaret G. Stineman 《Archives of physical medicine and rehabilitation》2017,98(1):1-10
Objective
To examine how patient satisfaction with care coordination and quality and access to medical care influence functional improvement or deterioration (activity limitation stage transitions), institutionalization, or death among older adults.Design
National representative sample with 2-year follow-up.Setting
Medicare Current Beneficiary Survey from calendar years 2001 to 2008.Participants
Community-dwelling adults (N=23,470) aged ≥65 years followed for 2 years.Interventions
Not applicable.Main Outcome Measures
A multinomial logistic regression model taking into account the complex survey design was used to examine the association between patient satisfaction with care coordination and quality and patient satisfaction with access to medical care and activities of daily living (ADL) stage transitions, institutionalization, or death after 2 years, adjusting for baseline socioeconomics and health-related characteristics.Results
Out of 23,470 Medicare beneficiaries, 14,979 (63.8% weighted) remained stable in ADL stage, 2508 (10.7% weighted) improved, 3210 (13.3% weighted) deteriorated, 582 (2.5% weighted) were institutionalized, and 2281 (9.7% weighted) died. Beneficiaries who were in the top quartile of satisfaction with care coordination and quality were less likely to be institutionalized (adjusted relative risk ratio [RRR], .68; 95% confidence interval [CI], .54–.86). Beneficiaries who were in the top quartile of satisfaction with access to medical care were less likely to functionally deteriorate (adjusted RRR, .87; 95% CI, .79–.97), be institutionalized (adjusted RRR, .72; 95% CI, .56–.92), or die (adjusted RRR, .86; 95% CI, .75–.98).Conclusions
Knowledge of patient satisfaction with medical care and risk of functional deterioration may be helpful for monitoring and addressing disability-related health care disparities and the effect of ongoing policy changes among Medicare beneficiaries. 相似文献16.
Chih-Ying Li Sergio Romero Annie N. Simpson Heather S. Bonilha Kit N. Simpson Ickpyo Hong Craig A. Velozo 《Archives of physical medicine and rehabilitation》2018,99(3):534-541.e2
Objective
To improve the practical use of the short forms (SFs) developed from the item bank, we compared the measurement precision of the 4- and 8-item SFs generated from a motor item bank composed of the FIM and the Minimum Data Set (MDS).Design
The FIM-MDS motor item bank allowed scores generated from different instruments to be co-calibrated. The 4- and 8-item SFs were developed based on Rasch analysis procedures. This article compared person strata, ceiling/floor effects, and test SE plots for each administration form and examined 95% confidence interval error bands of anchored person measures with the corresponding SFs. We used 0.3 SE as a criterion to reflect a reliability level of .90.Setting
Veterans' inpatient rehabilitation facilities and community living centers.Participants
Veterans (N=2500) who had both FIM and the MDS data within 6 days during 2008 through 2010.Interventions
Not applicable.Main Outcome Measures
Four- and 8-item SFs of FIM, MDS, and FIM-MDS motor item bank.Results
Six SFs were generated with 4 and 8 items across a range of difficulty levels from the FIM-MDS motor item bank. The three 8-item SFs all had higher correlations with the item bank (r=.82-.95), higher person strata, and less test error than the corresponding 4-item SFs (r=.80-.90). The three 4-item SFs did not meet the criteria of SE <0.3 for any theta values.Conclusions
Eight-item SFs could improve clinical use of the item bank composed of existing instruments across the continuum of care in veterans. We also found that the number of items, not test specificity, determines the precision of the instrument. 相似文献17.
Colin M. Bosma Nashwa Mansoor Chiara S. Haller 《Archives of physical medicine and rehabilitation》2018,99(8):1576-1583
Objective
To investigate the relation between posttraumatic stress (PTS) symptom severity and health-related quality of life (HRQoL) after severe traumatic brain injury (TBI).Design
Longitudinal prospective multicenter, cohort study on severe TBI in Switzerland (2007–2011).Setting
Hospital, rehabilitation unit, and/or patient’s living facility.Participants
Patients with severe TBI (N=109) were included in the analyses. Injury severity was determined using the Abbreviated Injury Score of the head region after clinical assessment and initial computed tomography scan.Interventions
Not applicable.Main Outcome Measures
HRQoL (Medical Outcomes Study 12-Item Short-Form Health Survey Physical and Mental Component Summaries) and self-reported emotional, cognitive, and interpersonal functioning (Patient Competency Rating Scale for Neurorehabilitation).Results
Multilevel models for patients >50 and ≤50 years of age revealed significant negative associations between PTS symptom severity and interpersonal functioning (P<.001 and P=.002), respectively. Among patients ≤50 years of age, PTS symptom severity was significantly associated with total functioning (P=.001) and emotional functioning (P<.001). Among all patients, PTS symptom severity was significantly associated with cognitive functioning (P<.001) and mental HRQoL (P=.01).Conclusions
Findings indicate that PTS symptoms after severe TBI are negatively associated with HRQoL and emotional, cognitive, and interpersonal functioning. 相似文献18.
Alex W.K. Wong Stephen C.L. Lau Mandy W.M. Fong David Cella Jin-Shei Lai Allen W. Heinemann 《Archives of physical medicine and rehabilitation》2018,99(9):1763-1775
Objective
To determine the extent to which the content of the Quality of Life in Neurological Disorders (Neuro-QoL) covers the International Classification of Functioning, Disability and Health (ICF) Core Sets for multiple sclerosis (MS), stroke, spinal cord injury (SCI), and traumatic brain injury (TBI) using summary linkage indicators.Design
Content analysis by linking content of the Neuro-QoL to corresponding ICF codes of each Core Set for MS, stroke, SCI, and TBI.Setting
Three academic centers.Participants
None.Interventions
None.Main Outcome Measures
Four summary linkage indicators proposed by MacDermid et al were estimated to compare the content coverage between Neuro-QoL and the ICF codes of Core Sets for MS, stroke, MS, and TBI.Results
Neuro-QoL represented 20% to 30% Core Set codes for different conditions in which more codes in Core Sets for MS (29%), stroke (28%), and TBI (28%) were covered than those for SCI in the long-term (20%) and early postacute (19%) contexts. Neuro-QoL represented nearly half of the unique Activity and Participation codes (43%–49%) and less than one third of the unique Body Function codes (12%?32%). It represented fewer Environmental Factors codes (2%?6%) and no Body Structures codes. Absolute linkage indicators found that at least 60% of Neuro-QoL items were linked to Core Set codes (63%?95%), but many items covered the same codes as revealed by unique linkage indicators (7%?13%), suggesting high concept redundancy among items.Conclusions
The Neuro-QoL links more closely to ICF Core Sets for stroke, MS, and TBI than to those for SCI, and primarily covers activity and participation ICF domains. Other instruments are needed to address concepts not measured by the Neuro-QoL when a comprehensive health assessment is needed. 相似文献19.
Moriah J. Brier Rhonda M. Williams Aaron P. Turner Alison W. Henderson Ann Marie Roepke Daniel C. Norvell Helene Henson Joseph M. Czerniecki 《Archives of physical medicine and rehabilitation》2018,99(3):452-458
Objective
To describe the relationship between caregiver-specific support and conflict, and psychosocial outcomes among individuals experiencing their first dysvascular lower extremity amputation (LEA).Design
Cross-sectional cohort study using self-report surveys.Setting
Department of Veterans Affairs, academic medical center, and level I trauma center.Participants
Individuals undergoing their first major LEA because of complications of peripheral arterial disease (PAD) or diabetes who have a caregiver and completed measures of caregiver support and conflict (N=137; 94.9% men).Interventions
Not applicable.Main Outcome Measures
The Patient Health Questionnaire-9 to assess depression and the Satisfaction With Life Scale to assess life satisfaction.Results
In multiple regression analyses, controlling for global levels of perceived support, self-rated health, age, and mobility, caregiver-specific support was found to be associated with higher levels of life satisfaction and caregiver-specific conflict was found to be associated with lower levels of life satisfaction and higher levels of depressive symptoms.Conclusions
The specific relationship between individuals with limb loss and their caregivers may be an important determinant of well-being. Conflict with caregivers, which has received little attention thus far in the limb loss literature, appears to play a particularly important role. Individuals with limb loss may benefit from interventions with their caregivers that both enhance support and reduce conflict. 相似文献20.
Olivia A. Bernal Heather F. McClintock Jibby E. Kurichi Pui L. Kwong Dawei Xie Joel E. Streim Liliana E. Pezzin Hillary R. Bogner 《Archives of physical medicine and rehabilitation》2019,100(2):289-299