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| Title: | 腦震盪後症狀的影響因子與處預方案—前瞻性之療效分析研究
Influencing Factors and Brief Intervention Programs for Post-concussion Symptoms--A Prospective Study |
| Authors: | 楊啟正;黃勝堅 |
| Contributors: | 心理系 |
| Date: | 2017-09 |
| Issue Date: | 2025-05-28 14:06:38 (UTC+8) |
| Abstract: | 背景：輕度頭部外傷病人常會產生明顯的腦震盪後症狀。雖然大部分的症狀，於受傷後三個月即可改善；但有少部分病人會產生持續性的腦震盪後症狀（Persistent Post-Concussion Symptoms, PPCS），而這樣的狀況常會進一步造成病人的社會職業功能顯著下降。過去學者已發現，憂鬱與焦慮等情緒因素，常是影響症狀發生的重要原因；除此之外，亦有少數學者針對PCS設計出有效的短期處預方案，以解決病人因症狀而導致的生活與工作障礙；然而，一方面方法學上的疏漏，使得過去學者試圖找出PPCS的影響因素，常無法得到一致的結論。另一方面，國內至今亦仍無有效處理PPCS方案的發展。有鑑於此，本研究試圖分析PCS的重要影響因素，同時並驗證特定PCS處預方案(長庚大學腦震盪症候群簡短處遇方案，Chang-Gung University Brief Intervention for Post-Concussion Syndrome, CGU-BIPCS)之有效性；並進一步運用手機軟體將其行動化，嘗試比較該方案以不同處預型式應用之有效性。
方法：本研究欲分為三階段，並為期三年，預計收集200位受試者，包括50位接受紙本方案、50位接受行動方案，以及50位接受一般常規治療之頭部外傷受試者；另外則有50位健康受試者加入。本研究第一階段為檢驗PCS的重要影響因素，主要為憂鬱與焦慮情緒；另一方面並驗證CGU-BIPCS的有效性。第二階段，檢驗憂鬱與焦慮等因素，影響PCS呈現得穩定性，並且比較CGU-BIPCS紙本與行動方案之有效性。第三階段則檢驗並追蹤CGU-BIPCS紙本與行動方案的效果是否具持續性。受試者除了接受CGU-BIPCS的紙本或行動方案、常規治療之外，亦會接受完整的神經行為評估。
預期結果：病人有明顯的腦震盪後症狀，其中有約10%的病人具PPCS。相較於憂鬱，焦慮更能解釋病人症狀的表現。在CGU-BIPCS方面，本研究結果顯示，無論是紙本或行動方案皆對病人之PCS有顯著改善效果，且該效果具持續性；除此之外，行動方案之改善效果較紙本方案與常規治療更佳。
Background: Post concussion symptoms (PCS) are not uncommon after mild traumatic brain injury (mTBI). Although most PCS has gradually recovered at 3 months post-injury, few patients still reported persistent PCS (PPCS), which significantly interfered with their social and occupational capacities, even one year after injuries. Even though some researchers have shown the specific influencing factors on PCS manifestations after mTBI, methodological drawbacks may still weaken the representativeness of those studies. On the other hand, no effective programs were developed to reduce the PCS in Eastern societies. This study thus has three specific aims: (1) to examine the potential influencing factors, such as depression and anxiety, on PCS manifestations; (2) to examine the effectiveness of a developed brief intervention program for PCS; (3) to establish a mobilized intervention program for PCS, and to evaluate the effectiveness of the mobilized program for the PCS.
Methods：This will be a 3-phase study during a period of 3 years. Two hundred participants, who include 50 patients with mTBI received paper version of intervention program, 50 patients received mobilized program, 50 patients received regular therapy for the PCS, and another 50 healthy participants, will be recruited. The PCS will be evaluated by the modified Checklist for Post-Concussion Symptoms (mCPCS), and all participants will be also evaluated for their neurobehavioral functions, which include intelligence, memory, executive functions, psychomotor speed, and emotional disturbances. During the first phase, the influencing factors of PCS will be revealed and the effectiveness of the paper version of the intervention program will be examined. During the second, the mobilized intervention program will be established. Meanwhile, the influencing factors of PPCS will be revealed and the effectiveness of the paper and mobilized versions of intervention program was compared. During the last phase, the persistent effectiveness of both programs was further evaluated.
Expected Results：Patients with mTBI reported significant PCS, and 10% of the patients suffered from the PPCS. Anxiety will be the main influencing factor on the PCS manifestations rather than depression. Our results further revealed that both the paper and mobilized versions of intervention program will be effective to reduce the PCS. In addition, the reduction of PCS after the mobilized intervention program will be significantly greater than other treatment methods. |
| Relation: | 科技部, MOST104-2410-H004-218-MY2, 104.08-106.07 |
| Data Type: | report |
| Appears in Collections: | [心理學系] 國科會研究計畫
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