Objective:To synthesise the current best evidence on both pharmacological and non-pharmacological behaviour management interventions for adult patients in the acute hospital setting with traumatic brain injury (TBI) or post-traumatic amnesia (PTA).Data Sources:A comprehensive search of 10 electronic databases was completed.Study Selection:Systematic reviews (SRs) published in English before September 2018 were included. Initial search resulted in 4604 citations, 2916 for title and abstract screening with duplicates removed, and 2909 articles failed to meet the inclusion criteria leaving seven reviews for inclusion. Five reporting pharmacological management approaches, two reporting non-pharmacological management approaches, and one reporting both pharmacological and non-pharmacological management approaches.Data Extraction:Methodological quality was assessed independently by two reviewers using the Critical Appraisal Skills Programme Tool for SRs. Data were extracted from the studies based on the recommendations of the Joanna Briggs Institute (JBI) Methodology for JBI Umbrella Reviews.Data Synthesis:The SRs were of low-to-moderate quality overall. High-quality SRs were characterised by low numbers of studies and significant biases. The evidence relating to pharmacological interventions demonstrates low level and variable quality. The evidence relating to non-pharmacological interventions was limited and of low quality.Conclusions:The current evidence for the management of challenging behaviours in patients with acute TBI/PTA is generally equivocal, potentially reflecting the heterogeneity of patients with TBI and their clinical behaviours. More studies with rigorous methodologies are required to investigate the most suitable pharmacological and non-pharmacological behavioural interventions for the acute phase of TBI or PTA.

中文翻译：

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急性创伤性脑损伤或创伤后失忆症患者挑战性行为管理的证据：综合评价

目的：综合目前关于创伤性脑损伤 (TBI) 或创伤后失忆症 (PTA) 急性医院环境中成人患者的药物和非药物行为管理干预措施的最佳证据。数据来源：综合搜索 10电子数据库已完成。研究选择：纳入2018年9月之前以英文发表的系统评价（SRs）。初步搜索结果为 4604 篇引文，2916 篇标题和摘要筛选并删除了重复项，2909 篇文章未能满足纳入标准，留下 7 篇评论供纳入。五种上报药理管理办法，两种上报非药理管理办法，一种上报药理和非药理管理办法。数据提取：方法学质量由两名评审员使用 SR 的关键评估技能计划工具独立评估。数据是根据 Joanna Briggs 研究所 (JBI) 对 JBI Umbrella 审查方法的建议从研究中提取的。数据综合：总体而言，SR 的质量为低到中等。高质量的 SR 的特点是研究数量少和显着偏倚。与药物干预有关的证据表明水平低且质量参差不齐。与非药物干预相关的证据有限且质量低下。结论：目前管理急性 TBI/PTA 患者挑战性行为的证据通常是模棱两可的，这可能反映了 TBI 患者及其临床行为的异质性。