Telephone Problem Solving for Service Members with Mild Traumatic Brain Injury: A Randomized, Clinical Trial
| Autor: | Murray B. Stein, Jef St. De Lore, Karin Ernstrom, Jesse R. Fann, Nancy R. Temkin, J. E. Machamer, Kathleen R. Bell, Wesley R Cole, Ariel J. Lang, Mark A. Reger, Nigel Bush, Gerald A. Grant, Sonia Jain, Rema Raman, Sureyya Dikmen, Jo Ann Brockway, Tessa Hart, Gregory A. Gahm |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Washington medicine.medical_specialty Traumatic brain injury Psychological intervention Poison control Suicide prevention Occupational safety and health law.invention Young Adult 03 medical and health sciences 0302 clinical medicine Patient Education as Topic Randomized controlled trial law Injury prevention North Carolina medicine Humans 030212 general & internal medicine Iraq War 2003-2011 Brain Concussion Problem Solving Afghan Campaign 2001 Post-Concussion Syndrome business.industry food and beverages Original Articles medicine.disease Telephone Clinical trial Military Personnel Physical therapy Female Neurology (clinical) business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Journal of Neurotrauma. 34:313-321 |
| ISSN: | 1557-9042 0897-7151 |
| DOI: | 10.1089/neu.2016.4444 |
| Popis: | Mild traumatic brain injury (mTBI) is a common injury for service members in recent military conflicts. There is insufficient evidence of how best to treat the consequences of mTBI. In a randomized, clinical trial, we evaluated the efficacy of telephone-delivered problem-solving treatment (PST) on psychological and physical symptoms in 356 post-deployment active duty service members from Joint Base Lewis McChord, Washington, and Fort Bragg, North Carolina. Members with medically confirmed mTBI sustained during deployment to Iraq and Afghanistan within the previous 24 months received PST or education-only (EO) interventions. The PST group received up to 12 biweekly telephone calls from a counselor for subject-selected problems. Both groups received 12 educational brochures describing common mTBI and post-deployment problems, with follow-up for all at 6 months (end of PST), and at 12 months. At 6 months, the PST group significantly improved on a measure of psychological distress (Brief Symptom Inventory; BSI-18) compared to the EO group (p = 0.005), but not on post-concussion symptoms (Rivermead Post-Concussion Symptoms Questionnaire [RPQ]; p = 0.19), the two primary endpoints. However, these effects did not persist at 12-month follow-up (BSI, p = 0.54; RPQ, p = 0.45). The PST group also had significant short-term improvement on secondary endpoints, including sleep (p = 0.01), depression (p = 0.03), post-traumatic stress disorder (p = 0.04), and physical functioning (p = 0.03). Participants preferred PST over EO (p 0.001). Telephone-delivered PST appears to be a well-accepted treatment that offers promise for reducing psychological distress after combat-related mTBI and could be a useful adjunct treatment post-mTBI. Further studies are required to determine how to sustain its effects. (Trial registration: ClinicalTrials.gov Identifier: NCT01387490 https://clinicaltrials.gov ). |
| Databáze: | OpenAIRE |
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