Purpose Renewal in Adults With Persisting Symptoms After Concussion: Results of a Non-Randomized Feasibility Trial.

IF 2.4 3区 医学 Q2 CLINICAL NEUROLOGY
Natalie V Covington, Mary Vining Radomski, Alisa Kocian, Sandra Castro-Pearson, Amanda A Herrmann, Kristina Kath, Libby Lindenfelser, Sandy Arntson Schwalbe, Sharon Gowdy Wagener, Joette Zola
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引用次数: 0

Abstract

Background: Living with a sense of purpose in life is associated with numerous health benefits; however, some individuals with persisting symptoms after concussion are at risk for purpose disruption. The Compass Course is a group-based tele-practice intervention that supports purpose renewal after major health transitions.

Objectives: To assess the feasibility, acceptability, and implementability of the Compass Course for adults with persisting symptoms after concussion, in preparation for a future randomized controlled trial.

Setting: Large healthcare system in the Midwestern United States.

Participants: Convenience sample of 37 adults with persisting symptoms after concussion.

Design: Non-randomized pilot prospective cohort design.

Intervention: Compass Course purpose renewal intervention delivered in a group setting via Zoom by an interdisciplinary team of allied health clinician-researchers (occupational therapy, speech-language pathology, psychology).

Main outcome measures: Participants completed Likert scales to rate acceptability of the Compass Course intervention. Treatment fidelity was assessed by tracking the number of key intervention elements presented in each treatment session. Potential benefits of the intervention were assessed using validated measures of purpose and meaning in life.

Results: Acceptability ratings were strong across the vast majority of participants. Treatment fidelity was strong with nearly perfect adherence to prespecified intervention elements. Participants who completed the intervention had gains across all purpose in life outcomes, with improvements maintained at 2-month follow-up.

Conclusions: The Compass Course was highly acceptable to participants who completed the intervention; however, there was significant attrition suggesting a need for adaptations to the intervention and to trial procedures. Future work includes further intervention development, and a controlled feasibility trial to estimate treatment effects for a future well-powered clinical trial.

目的:一项非随机可行性试验的结果:脑震荡后持续症状的成人康复。
背景:生活中有目标感对健康有很多好处;然而,一些脑震荡后症状持续的人有目的中断的风险。指南针课程是一种以小组为基础的远程实践干预,支持重大健康转变后的目标更新。目的:评估罗盘课程对脑震荡后持续症状的成人的可行性、可接受性和可实施性,为未来的随机对照试验做准备。背景:美国中西部的大型医疗保健系统。参与者:37名脑震荡后持续症状的成年人的方便样本。设计:非随机试验前瞻性队列设计。干预:指南针课程目的更新干预通过Zoom在小组设置中由联合健康临床医生-研究人员(职业治疗,言语语言病理学,心理学)组成的跨学科团队提供。主要结果测量:参与者完成李克特量表来评估指南针课程干预的可接受性。通过跟踪每次治疗中出现的关键干预元素的数量来评估治疗保真度。使用生活目的和意义的有效测量来评估干预的潜在益处。结果:绝大多数参与者的可接受性评分都很高。治疗忠实度强,几乎完美地遵守预先规定的干预要素。完成干预的参与者在生活结果的所有目的方面都有所改善,并在2个月的随访中保持改善。结论:罗盘课程对完成干预的参与者是高度可接受的;然而,有显著的磨损表明需要适应干预和试验程序。未来的工作包括进一步的干预开发,以及一项控制可行性试验,以估计未来良好的临床试验的治疗效果。
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
CiteScore
4.80
自引率
4.20%
发文量
153
审稿时长
6-12 weeks
期刊介绍: The Journal of Head Trauma Rehabilitation is a leading, peer-reviewed resource that provides up-to-date information on the clinical management and rehabilitation of persons with traumatic brain injuries. Six issues each year aspire to the vision of “knowledge informing care” and include a wide range of articles, topical issues, commentaries and special features. It is the official journal of the Brain Injury Association of America (BIAA).
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