EVALUERING AF TVÆRFAGLIG INTERVENTION TIL PERSONER MED LÆNGEREVARENDE FØLGER EFTER HJERNERYSTELSE – AALBORG KOMMUNES ”TIDLIG INDSATS”

Forfattere

  • Camilla Vejle Sørensen
  • Nana Isberg Nielsen
  • Jonna Pólsdóttir Houen
  • Chalotte Glintborg

DOI:

https://doi.org/10.7146/pl.v44i1.141124

Nøgleord:

Hjernerystelse, rehabilitering, neuropsykologi, rehabiliteringspsykologi

Resumé

Når personer rammes af en hjernerystelse, anbefales tidlig intervention. Aalborg Kommune har udviklet et otteugers tværfagligt
forløb kaldet ”Tidlig Indsats” med inspiration fra et dansk manualbaseret behandlingsprogram (GAIN; Thastum et al., 2018, 2019). Et kvalitetssikringsstudie har været koblet på denne indsats, og resultaterne herfra fremlægges i nærværende artikel. Artiklen præsenterer data fra i alt 29 personer. Deltagerne udfyldte målinger vedrørende hjernerystelsessymptomer, psykisk belastning og træthed før og efter forløbet. Resultaterne viste en nedgang i oplevede hjernerystelsessymptomer (RPQ: gennemsnitsscore fra 33 til 25, p < .00), psykisk belastning (SCL-90-R GSI: gennemsnitsscore fra 57 til 53, p < 0.0004) og træthed ved afslutning af forløbet (MFIS: gennemsnitsscore fra 54 til 41, p < 0.000). Derudover indhentedes deltagernes kvalitative evalueringer af indsatsen ved afslutning af forløb. Resultaterne diskuteres i forhold til tidligere forskning, øvrige faktorers indflydelse, implikationer i forhold til studiets metodologiske begrænsninger samt implementering i praksis. Studiet bidrager med praksisnær viden om udbyttet af én tværfaglig indsats iværksat i kommunalt regi rettet mod den tidlige fase efter hjernerystelse. Ydermere er studiet et eksempel på, hvorledes eksisterende forskning på området kan operationaliseres og omsættes til drift.

Referencer

Bell, K.R., Hoffman, J.M.., Temkin, N.R., Powell, J.M., Fraser, R.T., Esselman, P.C… Dikmen, S. (2008). The effect of telephone counselling on reducing posttraumatic symptoms after mild traumatic brain injury: A randomised trial. Journal of Neurology, Neurosurgery & Psychiatry, 79, 1275-1281. https://jnnp.bmj.com/content/79/11/1275.

Carroll, L.J., Cassidy, J.D., Peloso, P.M., Borg, J., von Holst, H., Holm … Pépin, M. (2004). Prognosis for mild traumatic brain injury: Results of the WHO collaborating centre task force on mild traumatic brain injury. Journal of Rehabilitation Medicine, 84-105. https://doi.org/10.1080/16501960410023859

Cassidy, J.D., Carroll, L., Peloso, P., Borg, J., Von Holst, H., Holm, L. & Coronado, V. (2004). Incidence, risk factors and prevention of mild traumatic brain injury: Results of the WHO collaborating centre task force on mild traumatic brain injury. Journal of Rehabilitation Medicine, 36, 28-60. https://doi.org/10.1080/16501960410023732

Choi, B.C. & Pak, A.W. (2005). Peer reviewed: A catalog of biases in questionnaires. Preventing Chronic Disease, 2(1). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1323316

Cnossen, M.C., van der Naalt, J., Spikman, J.M., Nieboer, D., Yue, J.K., Winkler, E.A … Steyerberg, E.W. (2018). Prediction of persistent post-concussion symptoms after mild traumatic brain injury. Journal of Neurotrauma, 35(22), 2691-8. https://doi.org/10.1089/neu.2017.5486

Elsass, P. (2006). Assessmentmetoder – håndbog for psykologer og psykiatere (1. udg.). Dansk Psykologisk Forlag.

Graff, H.J., Siersma, V., Møller, A., Kragstrup, J., Andersen, L.L., Egerod, I. & Rytter,

H.M. (2019). Labour market attachment after mild traumatic brain injury: Nationwide cohort study with 5-year register follow-up in Denmark. BMJ Open, 11(9), e026104. http://dx.doi.org/10.1136/bmjopen-2018-026104

Hou, R., Moss-Morris, R., Peveler, R., Mogg, K., Bradley, B.P. & Belli, A. (2012). When a minor head injury results in enduring symptoms: A prospective investigation of risk factors for postconcussional syndrome after mild traumatic brain injury. Journal of Neurology, Neurosurgery and Psychiatry, 83(2), 217-223. https://doi.org/10.1136/jnnp-2011-300767

King, N.S. (2014). A systematic review of age and gender factors in prolonged post-concussion symptoms after mild head injury. Brain Injury, 28(13-14), 1639-1645. https://doi.org/10.3109/02699052.2014.954271

King, N.S., Crawford, S., Wenden, F.J., Moss, N.E.G. & Wade, D.T. (1995). The rivermead post concussion symptoms questionnaire: A measure of symptoms commonly experienced after head injury and its reliability. Journal of Neurology, 242(9), 587-592. https://doi.org/10.1007/BF00868811

Langer, L., Levy, C. & Bayley, M. (2020). Increasing incidence of concussion: True epidemic or better recognition? The Journal of Head Trauma Rehabilitation, 35(1), E60-E66. https://doi.org/10.1097/HTR.0000000000000503

Larson, R.D. (2013). Psychometric properties of the modified fatigue impact Scale. International Journal of MS Care, 15(1), 15-20. https://doi.org/10.7224/1537-2073.2012-019

Losoi, H., Silverberg, N.D., Waljas, M., Turunen, S., Rosti-Otajarvi, E., Helminen, M … Öhman, J. (2016). Recovery from mild traumatic brain injury in previously healthy adults. Journal of Neurotrauma, 33(8), 766-76. https://doi.org/10.1089/neu.2015.4070

Mah, K., Hickling, A. & Reed, N. (2018). Perceptions of mild traumatic brain injury in adults: A scoping review. Disability and Rehabilitation, 40(8), 960-973. https://doi.org/10.1080/09638288.2016.1277402

Marshall, S., Bayley M., McCullagh, S., Velikonja, D., Berrigan, L., Ouchterlony, D. & Weegar, K. (2015). Updated clinical practice guidelines for concussion/mild traumatic brain injury and persistent symptoms. Brain Injury, 29(6), 688-700. https://doi.org/10.3109/02699052.2015.1004755

Matuseviciene, G., Borg, J., Stålnacke, B.M., Ulfarsson, T. & de Boussard, C. (2013). Early intervention for patients at risk for persisting disability after mild traumatic brain injury: A randomized, controlled study. Brain Injury, 27(3), 318-324. https://doi.org/10.3109/02699052.2012.750740

Medvedev, O.N., Theadom, A., Barker-Collo, S. & Feigin, V. (2018). Distinguishing between enduring and dynamic concussion symptoms: Applying generalisability theory to the rivermead post concussion symptoms questionaire (RPQ). PeerJ, 6, e5676. https://doi.org/10.7717/peerj.5676

Möller, M.C., Lexell, J. & Wilbe Ramsay, K. (2021). Effectiveness of specialized rehabilitation after mild traumatic brain injury: A systematic review and meta-analysis. Journal of Rehabilitation Medicine, 5;53(2), https://doi.org/10.2340/16501977-2791

Olsen, L.R., Mortensen, E.L. & Bech, P. (2007). SCL-90-R Vejledning til administration og scoring. Dansk Psykologisk Forlag.

Pinner, M., Børgesen, S.E., Jensen, R., Birket-Schmidt, M., Gade, A. & Riis, J.Ø. (2002). Konsensusrapport om commotio cerebri (hjernerystelse) og det postcommotionelle syndrom. Videnscenter for Hjerneskade.

Ponsford, J., Willmott, C., Rothwell, A., Cameron, P., Kelly, A-M, Nelms, R. & Curran, C. (2002). Impact of early intervention on outcome following mild head injury in adults. Journal of Neurology, Neurosurgery and Psychiatry, https://doi.org/10.1136/jnnp.73.3.330

Ponsford, J., Cameron, P., Fitzgerald, M., Grant, M., Mikocka-Walus, A. & Schönberger, M. (2012). Predictors of postconcussive symptoms 3 months after mild traumatic brain injury. Neuropsychology, 26(3), 304. https://doi.org/10.1037%2Fa0027888

Rytter, H.M., Westenbaek, K., Henriksen, H., Christiansen, P. & Humle, F. (2019). Specialized interdisciplinary rehabilitation reduces persistent post-concussive symptoms: A randomized clinical trial. Brain Injury, 33(3), 266-281. https://doi.org/10.1080/02699052.2018.1552022

Rytter, H.M., Graff, H.J., Henriksen, H.K., Aaen, N., Hartvigsen, J., Hoegh M … Nisted, I. (2021). Nonpharmacological treatment of persistent postconcussion symptoms in adults: A systematic review and meta-analysis and guideline recommendation. JAMA Netw Open [Internet], 4(11). https://doi.org/10.1001/jamanetworkopen.2021.32221

Scheenen, M.E., Visser-Keizer, A.C., van der Naalt, J. & Spikman, J.M. (2017a). Description of an early cognitive behavioral intervention (UPFRONT-intervention) following mild traumatic brain injury to prevent persistent complaints and facilitate return to work. Clinical rehabilitation, 31(8), 1019-1029. https://doi.org/10.1177/0269215516687101

Scheenen, M.E., Visser-Keizer, A.C., de Koning, M.E., van der Horn, H.J., van de Sande, P., van Kessel, M … Spikman, J.M. (2017b). Cognitive behavioral intervention compared to telephone counseling early after mild traumatic brain injury: A randomized trial. Journal of Neurotrauma, 34(19), 2713-2720. https://doi.org/10.1089/neu.2016.4885

Silverberg, N.D., Iaccarino, M.A., Panenka, W.J., Iverson, G.L., McCulloch, K.L., Dams-O’Connor, K. & Jamora, C.W. (2020). Management of concussion and mild traumatic brain injury: A synthesis of practice guidelines. Archives of Physical Medicine and Rehabilitation, 101(2), 382-393. https://doi.org/10.1016/j.apmr.2019.10.179

Silverberg, N.D. & Iverson, G.L. (2013). Is rest after concussion ”the best medicine?”: Recommendations for activity resumption following concussion in athletes, civilians, and military service members. The Journal of Head Trauma Rehabilitation, 28(4), 250-259. https://doi.org/10.1097/HTR.0b013e31825ad658

Thastum, M.M. & Riis, J.Ø. (2021). Hjernerystelse. I: R. Starrfelt, C. Gerlach & A. Gade (red), Klinisk Neuropsykologi (2. udg.) (s. 256-279). Frydenlund.

Thastum, M.M., Rask, C.U., Naess-Schmidt, E.T., Tuborgh, A., Jensen, J.S., Svendsen, S.W… Schröder, A. (2019). Novel interdisciplinary intervention, GAIN, vs. enhanced usual care to reduce high levels of post-concussion symptoms in adolescents and young adults 2-6 months post-injury: A randomised trial. EClinicalMedicine, 17, 100214. Published online 2019 Dec 16. https://doi.org/10.1016/j.eclinm.2019.11.007

Thastum, M.M, Rask, C.U, Naess-Schmidt, E.T., Jensen, J.S., Frederiksen, O.-V., Tuborgh, A … Schröder, A. (2018). Design of an early intervention for persistent post-concussion symptoms in adolescents and young adults: A feasibility study. NeuroRehabilitation (43),155-167. https://doi.org/10.3233/NRE-172391

Vikane, E., Hellstrøm, T., Røe, C., Bautz-Holter, E., Aßmus, J. & Skouen, J.S. (2017). Multidisciplinary outpatient treatment in patients with mild traumatic brain injury: A randomised controlled intervention study. Brain Injury, 31(4), 475-484. https://doi.org/10.1080/02699052.2017.1280852

Voormolen, D.C., Haagsma, J.A., Polinder, S., Maas, A.I.R., Steyerberg, E.W., Vuleković, P. … Sewalt, C.A. (2019). Post-concussion symptoms in complicated vs. uncomplicated mild traumatic brain injury patients at three and six months post-injury: Results from the CENTER-TBI Study. Journal of Clinical Medicine, 8(11). https://doi.org/10.3390/jcm8111921

Yang, C.C., Chiu, H.C., Xiao, S.H., Tsai, Y.H., Lee, Y.C., Ku, Y.T. … Huang, S.J. (2018). Iatrogenic effect? Cautions when utilizing an early health education for post-concussion symptoms. Archives of Clinical Neuropsychology, 33(2), 131-142. https://doi.org/10.1093/arclin/acx060.

National klinisk retningslinje for non-farmakologisk behandling af længerevarende symptomer efter hjernerystelse. Dansk Center for Hjernerystelse, København, Danmark. https://dcfh.dk/retningslinjer-for-behandling-af-hjernerystelse/national-klinisk-retningslinje

https://www.dst.dk/da/Statistik/emner/borgere/befolkning/befolkningstal.

https://www.statistikbanken.dk/LIGEHB7.

https://www.retsinformation.dk/eli/lta/2019/1509.

Publiceret

2023-10-02

Citation/Eksport

Vejle Sørensen, C., Isberg Nielsen, N., Pólsdóttir Houen, J., & Glintborg, C. (2023). EVALUERING AF TVÆRFAGLIG INTERVENTION TIL PERSONER MED LÆNGEREVARENDE FØLGER EFTER HJERNERYSTELSE – AALBORG KOMMUNES ”TIDLIG INDSATS”. Psyke & Logos, 44(1), 89–105. https://doi.org/10.7146/pl.v44i1.141124