Feasibility investigation of cognitive rehabilitation service after traumatic brain injury in community

Abstract

目的: 了解认知康复服务的需求,有关专业人士的认知康复知识水平以及他们对创新性认知康复的态度和接受程度,以便帮助制定认知障碍社区康复计划。 方法: 采用自行设计的结构式问卷调查表,155名神经外科医生、康复科医生、康复治疗师、护士等接受了问卷调查。 结果: 95.4%的调查对象认为在中国有必要开展脑外伤后的认知障碍康复。按康复的重要性需要优先考虑的前4个问题为∶语言能力、记忆力、定向力、注意力;脑外伤后康复场所的重要性依次为∶家庭、医院、社区;三种康复训练方法的重要性依次为∶面对面方式、电脑辅助方式、网上远程指导方式。家庭是首选的康复场所、“面对面”是主要康复方式。康复训练方式与康复场所之间存在良好的相关关系,即相对于其他训练方式,在家庭或医院人们更愿意选择“面对面”训练;对于远程指导而言,在家中则比医院能更好地发挥作用。 结论: ①认知康复服务正在快速发展并获得有关专业人士的大力支持;②“面对面”训练仍是认知康复主要服务方式;③在家中开展认知康复远程指导也是一项合适的服务选择,以家庭为基础的康复是社区康复的重要内容,网上和/或远程指导的认知康复服务值得大力提倡;④需进一步探讨创新性认知康复服务方式的有效性和实用性。 Objective: To explore the cognitive rehabilitation services(CRS)needs;to understand healthcare profession-al’s knowledge level and attitude on cognitive rehabilitation and their acceptances of innovative CRS in community. Method: 155medical and allied health professionals responded to a self-administered questionnaire that was de-signed to survey the needs of CRS.They were neurosurgeons, physiatrists, nurses, therapists. Result: 95.4%of the re-spondents agreed with the need to develop CRS in China.The top4specific CRSs suggested in relative importance were rehabilitation in language(mean=5.44±1.08)memory,orientation,attention,the settings for CRS delivery in rela-tive importance were family,hospital,and community,respectively.In prioritizing the mode of CRS,they suggested face to face,computer-assisted,and online/web based,respectively.Family is top setting(字 2 =39.10,P<0.01)and the face to face is mainly mode 2 =122.05,P<0.01).The healthcare professionals preferred the face to face mode to other modes of CRS delivery both in family setting and in hospital setting;They also preferred the on-line mode to be conducted in family settings rather than in the hospital setting. Conclusion: ①CRS is rapidly developing and well supported by healthcare professionals in TBI;②Healthcare professionals generally consider that face to face therapy is still a crucial service mode;③The online cognitive rehabilitation is also a suitable service option,e.g.,for home-based programmes.The CRS of home-based and thus fully online/remote service delivery should be underpinned.④Further studies are required to investigate the applicability of innovative service mode of CRS.