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Executive functioning in TBI from rehabilitation to social reintegration: COMPASS^(goal), a randomized controlled trial(grant: 1I01RX000637-01A3 by the VA ORD RR&D, 2013–2016)

引用

Military Medical Research 2015年第4期3卷 181-200页

作者： Alexander V.Libin Joel Scholten Manon Maitland Schladen Ellen Danford Nawar Shara Walter Penk jordan grafman Linda Resnik Dwan Bruner Samantha Cichon Miriam Philmon Brenda Tsai Marc Blackman Alexander Dromerick Mental Health Service Washington DC VA Medical Center Med Star National Rehabilitation Hospital Med Star Health Research Institute Physical Medicine and Rehabilitation Service Washington DC VA Medical Center Research Service Washington DC VA Medical Center Texas A&M College of Medicine Rehabilitation Institute of Chicago Research Service Providence VA Medical Center

Background: Traumatic brain injury is a major health problem that frequently leads to deficits in executive function. Self-regulation processes, such as goal-setting, may become disordered after traumatic brain injury, particularly when the frontal regions of the brain and their connections are involved. Such impairments reduce injured veterans' ability to return to work or school and to regain satisfactory personal lives. Understanding the neurologically disabling effects of brain injury on executive function is necessary for both the accurate diagnosis of impairment and the individual tailoring of rehabilitation processes to help returning service members recover independent ***/design: The COMPASSgoal(Community Participation through Self-Efficacy Skills Development) program develops and tests a novel patient-centered intervention framework for community reintegration psychosocial research in veterans with mild traumatic brain injury. COMPASSgoal integrates the principles and best practices of goal self-management. Goal setting is a core skill in self-management training by which persons with chronic health conditions learn to improve their status and decrease symptom effects. Over a three-year period, COMPASSgoal will recruit 110 participants with residual executive dysfunction three months or more post-injury. Inclusion criteria combine both clinical diagnosis and standardized scores that are >1 SD from the normative score on the Frontal Systems Rating Scale. Participants are randomized into two groups: goal-management(intervention) and supported discharge(control). The intervention is administered in eight consecutive, weekly sessions. Assessments occur at enrollment, post-intervention/supported discharge, and three months post-treatment ***: Goal management is part of the "natural language" of rehabilitation. However, collaborative goal-setting between clinicians/case managers and clients can be hindered by the cognitive deficits

关键词： Executive function Traumatic brain injury Goal-setting Community reintegration Veterans Randomized controlled trial Manualized psychosocial intervention

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