Relations between concussion symptoms and depression among patients with mild traumatic brain injury: A moderated mediation model

IF 2.4 3区医学 Q1 NURSING

Journal of Nursing Scholarship Pub Date : 2023-11-22 DOI:10.1111/jnu.12944

Ching-Yuan Ma MSN, Ya-Wen Hsiao MSN, Hsin-Ya Tzeng MSN, Dueng-Yuan Hueng MD, PhD, Hui-Hsun Chiang PhD, RN

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引用次数: 0

Abstract

Introduction

Concussion symptoms following a traumatic accident are both common and known to adversely affect mental health and recovery in patients with traumatic brain injury. Depression, highly prevalent among patients with traumatic brain injury, is also associated with the important factors of sleep quality and resilience. However, the mediator and moderator roles of depression following concussion in patients with traumatic brain injury have been underexplored. The aims of this study were to investigate the mediating role of sleep quality in the relation between concussion symptoms and depression and to examine the moderating effect of resilience on this mediated model.

Design

Cross-sectional pretest data analysis of a randomized controlled trial.

Methods

A total of 249 adult patients with mild traumatic brain injury (Glasgow Coma Scale 13–15) at admission following brain injury were surveyed at a medical center in Taipei, Taiwan. The outcome variables were concussion symptoms (Rivermead Post-Concussion Symptom Questionnaire), sleep quality (Pittsburgh Sleep Quality Index), resilience (Resilience Scale for Adults), and depression (Beck Depression Inventory II). These data were analyzed using moderated mediation regressions with the SPSS PROCESS macro.

Results

In patients with mild traumatic brain injury, there was a significant positive relation between concussion symptoms and depression, of which sleep quality was a significant mediator. Additionally, resilience had a negative moderating effect on the relations between sleep quality and depression. Patients with less resilience showed a stronger negative effect of sleep quality on depression.

Conclusion

Our findings suggest that ameliorating both concussion symptoms and sleep disturbance is important for reducing the risk of depression in patients with mild traumatic brain injury, especially in those patients with less resilience.

Clinical Relevance

It is essential for clinical nurses to develop interventions for patients with mild traumatic brain injury that will improve their sleep quality, while strengthening their resilience, to alleviate depression.

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轻度创伤性脑损伤患者脑震荡症状与抑郁的关系:一个有调节的中介模型

简介:创伤性事故后的脑震荡症状既常见又已知会对创伤性脑损伤患者的心理健康和康复产生不利影响。抑郁症在创伤性脑损伤患者中非常普遍，它也与睡眠质量和恢复力等重要因素有关。然而，创伤性脑损伤患者脑震荡后抑郁的调节和调节作用尚未得到充分的探讨。本研究旨在探讨睡眠质量在脑震荡症状与抑郁关系中的中介作用，并探讨心理弹性在这一中介模型中的调节作用。设计:随机对照试验的横断面测前数据分析。方法:对台湾省台北市某医疗中心收治的249例轻度外伤性脑损伤(格拉斯哥昏迷量表13-15分)患者进行调查。结果变量为脑震荡症状(Rivermead脑震荡后症状问卷)、睡眠质量(匹兹堡睡眠质量指数)、心理弹性(成人心理弹性量表)和抑郁(贝克抑郁量表II)。这些数据使用SPSS PROCESS宏进行有调节的中介回归分析。结果:在轻度颅脑损伤患者中，脑震荡症状与抑郁呈显著正相关，其中睡眠质量是显著中介。此外，弹性对睡眠质量和抑郁之间的关系有负向调节作用。韧性较差的患者睡眠质量对抑郁症的负面影响更大。结论:我们的研究结果表明，改善脑震荡症状和睡眠障碍对降低轻度创伤性脑损伤患者的抑郁风险很重要，特别是对那些恢复能力较差的患者。临床意义:临床护理人员有必要针对轻度创伤性脑损伤患者制定干预措施，改善其睡眠质量，同时增强其适应能力，以减轻抑郁。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Nursing Scholarship 医学-护理

CiteScore

6.30

自引率

5.90%

发文量

审稿时长

6-12 weeks

期刊介绍： This widely read and respected journal features peer-reviewed, thought-provoking articles representing research by some of the world’s leading nurse researchers. Reaching health professionals, faculty and students in 103 countries, the Journal of Nursing Scholarship is focused on health of people throughout the world. It is the official journal of Sigma Theta Tau International and it reflects the society’s dedication to providing the tools necessary to improve nursing care around the world.