摘要:

Traumatic brain injury (TBI) is the principal cause of death and disability for young Americans, with an estimated societal cost of over $39 billion per year. The Defense and Veterans Head Injury Program (DVHIP) represents a close collaboration among the Departments of Defense (DoD) and Veterans Affairs (DVA), the Brain Injury Association (BIA), and the International Brain Injury Association (IBIA). Its principal mission is to ensure that military and veteran patients with head injury receive TBI-specific evaluation, treatment, rehabilitation, and follow-up, while at the same time addressing the readiness mission of the military and helping to define optimal care for victims of TBI nationwide. Defense and Veterans Head Injury Program activities can be grouped into three broad classes: (1) TBI education, community service, and primary prevention projects; (2) combined TBI clinical treatment, rehabilitation, and clinical research projects; and (3) clinically linked TBI laboratory research projects. It is thus based on a prudent integration of clinical care and follow-up with programmatic clinical and clinically related laboratory research, TBI prevention, and education. This previously nonexistent clinical infrastructure now offers a valuable base for ongoing TBI clinical research.

ISSN:0885-9701    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

We have recently reported the results of a prospective controlled randomized trial comparing home versus inpatient cognitive rehabilitation for patients with moderate to severe head injury. That study showed no overall difference in outcomes between the two groups.1In this article, we provide further details of the home program arm of the study. All patients in the home program received medical treatment as needed, a multidisciplinary in-hospital evaluation, and TBI counseling before entering the eight-week home program, which then included guidance on home activities, as well as weekly telephone calls from a psychiatric nurse.

ISSN:0885-9701    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Studies of mild traumatic brain injury (MTBI) suggest that most individuals recover rapidly and return to their everyday activities. However, a percentage of MTBI patients report persistent problems with cognitive, physical, and emotional symptoms. There is also evidence that some experience changes in occupational functioning following MTBI. The current study used a stepwise discriminant function analysis (DFA) to examine the role of injury severity variables, cognitive performance, and ratings of symptoms of TBI in predicting work status following MTBI. Subjects included 121 MTBI patients who were all active-duty military personnel. The stepwise DFA revealed that age and three cognitive variables (verbal memory, verbal fluency, and a speed test of planning and strategy) were predictive of work status 3–15 months following a documented MTBI, correctly classifying work status 68.8% of the time. A cross-validation DFA was conducted, with a 66.1% correct classification rate. These findings highlight the importance of cognitive impairments in identifying those at risk for occupational impairment following MTBI.

ISSN:0885-9701    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Family stress following traumatic brain injury (TBI) is well documented. Previous studies have shown that family adaptation and the use of coping strategies moderate the stresses of TBI in the long term. However, relatively little is known about the impact on the family and family response during the acute stage of recovery. The present study used Olson's Circumplex Model to examine acute changes in family structure and examined changes in coping responses pre- and post-TBI. Wives of 20 male TBI survivors completed the Couples Version of the Family Adaptability and Cohesion Evaluation Scales-II (FACES-II) and the Coping Responses Inventory (CRI). These questionnaires were completed retrospectively for a stressful event that occurred six months prior to the TBI, then for the current period following the TBI. Results found that 60% of all families experienced a significant change in structure following TBI. As predicted by the Circumplex Model, balanced families changed most, with 70% changing to the extreme type post-TBI. Focus of coping (problem versus emotion) and coping techniques (cognitive versus behavioral) also changed significantly from pre- to post-TBI and differed, depending on post-TBI family structure. Family interventions based on these differences in family structure and coping are presented.

ISSN:0885-9701    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Changes in the level of agreement (concordance) between self and family or friend reporting on the Katz Adjustment Scale (KAS) from 6 to 12 months postinjury were assessed in 55 individuals with traumatic brain injury (IwTBI). Although the concordance between self and family/friend reports significantly increased over the course of recovery, possibly reflecting improvements in awareness, the concordance showed limited relationship to measures of injury severity and neuropsychological functioning. Concordance did not significantly relate to clinicians' ratings of inaccurate insight and self-appraisal on the awareness item from the Neurobehavioral Rating Scale (NBRS). Clinicians' ratings of awareness demonstrated only limited relationship to measures of injury severity and neuropsychological functioning, as well. Although similar results in the literature have been interpreted as demonstrating that awareness, defined as concordance, is possibly a unique construct separate from injury severity and neuropsychological functioning, an alternative hypothesis is presented concerning other, noninjury factors that may affect the level of agreement in problem reporting between IwTBI and family/friend informants.

ISSN:0885-9701    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

The present investigation examined the psychometric properties of the Wisconsin HSS Quality of Life Inventory (WI HSS QOL) when used in the study of traumatic brain injury (TBI). The WI HSS QOL is a theoretically based measure that assesses QOL via level of need satisfaction as conceptualized in Maslow's theory of human needs. Both internal consistency and test-retest reliability were demonstrated in a group of individuals with moderate to severe TBI. The demonstrated consistency of the participants' self-reports indicates that QOL can be reliably assessed from the survivor's perspective. Cluster analytic results generally supported the construct validity of the measure's use in TBI. The cluster solution reflected four of the five theoretical need categories; however, the fifth category, “self-actualization” needs, did not emerge as a single cluster as expected. This deviation from the theoretical model may relate to participants' difficulties in understanding the relatively abstract items designed to assess the concept of self-actualization. Overall, the WI HSS QOL holds significant promise as a measure of QOL in TBI.

ISSN:0885-9701    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Traumatic injury of the brain in man is normally followed by little or no recovery of function by the lesioned tissue. Neuroprotective strategies employed in the acute period after traumatic CNS injury attempt to use pharmacological tools to reduce the progressive secondary injury processes that follow after the initial lesion occurs to limit overall tissue damage. Results from experimental animal studies using a variety of drugs that modulate neurotransmitter function, scavenge free radicals, or interfere with cell death cascades point toward many new opportunities for pharmacological intervention in the acute and subacute period after traumatic brain injury.

ISSN:0885-9701    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0885-9701    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0885-9701    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0885-9701    

出版商:OVID    

年代:2000

数据来源: OVID