摘要:

Some method of assessing self-awareness of deficits in patients with traumatic brain injury TBI is required to increase our understanding of the phenomenon, and to then evaluate strategies for clinical intervention with patients who lack such self-awareness. Options for the assessment of self-awareness of deficits following TBI are reviewed. The most commonly used method is comparison of patients' self-rating on questionnaires of functional abilities with ratings by relatives or staff on the same questionnaires. An additional method of assessment, an interviewer-rated semi-structured interview is proposed the Self-Awareness of Deficits Interview, and some preliminary inter-rater reliability data are presented. However, quantitative methods of evaluating self-awareness have shortcomings, and qualitative research may be more appropriate in some circumstances. An approach which makes use of multiple measures to evaluate self-awareness of deficits is recommended.

ISSN:0269-9052    

DOI:10.1080/026990596124674

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

This case study describes rehabilitation efforts with a 24-year-old woman who exhibited dense amnesia secondary to status epilepticus following a motor vehicle accident. She was 20 months post-injury upon entry into our day treatment programme. The functional severity of her amnesia was reflected in numerous ways, including no recall of what she wore from day to day and an inability to find the toilet after 2 weeks in the programme. A multidisciplinary comprehensive programme of external cueing was established to exploit her preserved procedural memory. Objective measures of functional compliance were gathered over time and contrasted with both standard neuropsychological test scores and early levels of functioning in rehabilitation. Results demonstrated enhanced functioning via utilization of procedural memory. In addition, the patient actually demonstrated increased independent generalization of strategies and techniques over time. Practical treatment implications are reviewed and discussed.

ISSN:0269-9052    

DOI:10.1080/026990596124683

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

There is general agreement between researchers and clinicians alike that relatives of people with head injuries experience heightened stress as a result of the injury and its consequences. In the present study a single structured interview, including both verbally administered and written response questionnaires, was completed by 18 parents and 11 partners. Measures included the Daily Hassles and Uplifts Scale, the Arizona Social Support Interview Schedule and questions regarding role change and health problems. The combined parents and partners group indicated that they experienced moderate levels of stress and role change. A relatively small proportion of participants reported experiencing health problems. Partners indicated a slightly higher degree of stress and a greater degree of role change than parents, and a larger proportion of partners indicated the presence of health problems. Qualitative differences between the two groups were found in terms of sources of stress. There was little quantitative or qualitative difference between the two groups in sources, utilization of and satisfaction with social support. Positive correlations were found between stress and role change and stress and health problems.

ISSN:0269-9052    

DOI:10.1080/026990596124692

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

The incidence and course of aphasia, and its impact on vocational outcome, were determined in a group of 351 patients with severe traumatic brain injury TBI. Aphasia was found in 111, the common forms being amnestic 56, 22 39, expressive 10 3, 4 39 and receptive 10 5, 8 39, as found on the first language assessment. No age difference was found between the aphasic and nonaphasic patients. Coma was more common in the aphasics than the non-aphasics 95 and 82, respectively, although its mean duration was shorter. Aphasics had more severe locomotor deficits p 0 01, Fisher test and tended towards more severe cognitive disorders p 0 07, Fisher test. There was no difference between the groups in incidence of behavioural disturbances or occupational outcome. Most of the aphasic patients improved after therapy, and two recovered completely. The presence of aphasia did not have negative prognostic implications for occupational outcome.

ISSN:0269-9052    

DOI:10.1080/026990596124700

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

The 1991 National Health Interview Survey was analysed to describe the incidence of mild and moderate brain injury in the United States. Data were collected from 46761 households and weighted to reflect all non-institutionalized civilians. The report of one or more occurrences of head injury resulting in loss of consciousness in the previous 12 months was the main outcome measure. Each year an estimated 1 5 million non-institutionalized US civilians sustain a non-fatal brain injury that does not result in institutionalization, a rate of 618 per 100000 person-years. Motor vehicles were involved in 28 of the brain injuries, sports and physical activity were responsible for 20, and assaults were responsible for 9. Medial care was sought by 75 of those with brain injury; 14 were treated in clinics or offices, 35 were tretaed in emergency departments, and 25 were hospitalized. The risk of medically attended brain injury was highest among three subgroups: teens and young adults, males, and persons with low income who lived alone. The incidence of mild and moderate brain injury in the United States is substantial. The National Health Interview Survey is an important national source of current outpatient brain-injury data.

ISSN:0269-9052    

DOI:10.1080/026990596124719

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

An increasing number of recent reports has pointed to the underlying neuropathological substrate for obsessive-compulsive disorder OCD. Neuropsychological tseting may suggest underlying organicity even though the neuroimaging studies and the neurological examination may be normal. Earlier reports are not in agreement about the laterality of deficits. Abnormalities in frontal regions, limbic areas and basal ganglia are noted in functional neuroimaging and neuropsychological studies. In closed head injury the damage tends to be diffuse, and it is not easy to clearly localize deficits or to determine their laterality. In this paper we review the various theories and literature on OCD and organicity, and report on four individuals who developed OCD symptoms after closed head injury. We also discuss their neuroimaging and neuropsychological testing results.

ISSN:0269-9052    

DOI:10.1080/026990596124728

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

During the early stages of recovery from severe brain injury many patients are comatose or minimally responsive. Rehabilitation for these low-functioning survivors traditionally includes acute medical care and transfer to a skilled nursing facility or acute rehabilitation. Concerns have been expressed that customary treatment options are ineffective, costly, or both. In response, 'intermediate'-level programmes designed to provide effective, cost-efficient rehabilitation have emerged. The purpose of this paper is to provide information regarding outcome of severe brain injury and the early rehabilitation needs of survivors. Common characteristics, advantages, and disadvantages of various intermediate programmes, including 'subacute' and 'transitional' rehabilitation, are discussed and contrasted.

ISSN:0269-9052    

DOI:10.1080/026990596124737

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor