Case Management for People with Acquired Brain Injury with Complex Problems (Part 1): Outcomes of a One-group Trial.

IF 2.6 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
International Journal of Integrated Care Pub Date : 2025-07-07 eCollection Date: 2025-07-01 DOI:10.5334/ijic.8649
Annemarie P M Stiekema, Bjorn Winkens, Desiree Bierlaagh, Mireille Donkervoort, Natska Jansen, Kitty H M Jurrius, Judith Zadoks, Caroline M van Heugten
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Abstract

Introduction: Many people with acquired brain injury (PwABI) and their family face long-term psychosocial problems and unmet needs. Currently, there are no structural and integrated health care services supporting life after brain injury. We evaluated Case Management (CM) for PWABI which aims to facilitate access to and integration of health care and social services for people with complex problems.

Methods: One-group repeated measures study including 62 PwABI and 36 caregivers in the Netherlands. Assessments were conducted every six months for 18-24 months. Primary outcome was psychosocial well-being (Hospital Anxiety and Depression Scale). Secondary outcomes were self-efficacy, participation, life satisfaction, and needs for PwABI and caregivers; and caregiver burden.

Results: Anxiety reduced significantly in both PwABI and their caregivers. Over time, PwABI reported significantly fewer unmet needs, but more participation restrictions. Caregivers reported significantly less caregiver burden and more self-efficacy over time.

Discussion: CM seems promising for reducing unmet needs in PwABI and improving some psychosocial outcomes in PwABI and caregivers. Lifelong CM may however be necessary. A randomized controlled study is needed to confirm whether the positive outcomes are due to CM.

Conclusion: This study warrants further research to establish the effectiveness of CM for PWABI.

Abstract Image

Abstract Image

复杂问题获得性脑损伤患者的病例管理(第一部分):一组试验的结果
许多获得性脑损伤患者及其家庭面临长期的社会心理问题和未满足的需求。目前,没有结构性和综合性的保健服务来支持脑损伤后的生活。我们评估了pwai的病例管理(CM),其目的是促进有复杂问题的人获得和整合医疗保健和社会服务。方法:在荷兰进行一组重复测量研究,包括62名PwABI和36名护理人员。每6个月进行一次评估,持续18-24个月。主要结局是社会心理健康(医院焦虑和抑郁量表)。次要结局为自我效能、参与、生活满意度和PwABI和照顾者的需求;以及照顾者的负担。结果:pwai及其照顾者的焦虑均显著减轻。随着时间的推移,pwai报告的未满足需求明显减少,但参与限制增多。随着时间的推移,照顾者的负担明显减轻,自我效能感提高。讨论:CM似乎有望减少PwABI患者未满足的需求,并改善PwABI患者和护理者的一些社会心理结果。然而,终身CM可能是必要的。需要一项随机对照研究来确认阳性结果是否由CM引起。结论:本研究值得进一步研究,以确定中药治疗pwai的有效性。
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来源期刊
International Journal of Integrated Care
International Journal of Integrated Care HEALTH CARE SCIENCES & SERVICES-
CiteScore
3.80
自引率
8.30%
发文量
887
审稿时长
>12 weeks
期刊介绍: Established in 2000, IJIC’s mission is to promote integrated care as a scientific discipline. IJIC’s primary purpose is to examine critically the policy and practice of integrated care and whether and how this has impacted on quality-of-care, user experiences, and cost-effectiveness. The journal regularly publishes conference supplements and special themed editions. To find out more contact Managing Editor, Susan Royer. The Journal is supported by the International Foundation for Integrated Care (IFIC).
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