ABSTRACT

Objective

To investigate the relationships between (a) the psychological status of the caregiver, (b) the specific features of caregiving as perceived by the cognitive therapist in neuro-rehabilitation, (c) the caregivers’ subjective approach to neuro-rehabilitation, and (d) the functional outcome of the patient.

Methods

Twenty-four patients with severe acquired brain injury and their 24 caregivers participated in this observational study. Caregivers underwent a psychological assessment examining emotional distress, burden and family strain; their subjective approach to neuro-rehabilitation has been evaluated by two specific answers. The patients' cognitive therapists responded to an ad-hoc questionnaire, namely the “Caregiving Impact on Neuro-Rehabilitation Scale” (CINRS), evaluating the features (i.e., amount and quality) of caregiving. Finally, the functional outcome of the patient was assessed through standardized scales of disability and cognitive functioning.

Results

The caregivers’ psychological well-being was associated to the features of caregiving, to the subjective approach to neuro-rehabilitation, and to the functional recovery of their loved ones. A better caregivers’ approach to neuro-rehabilitation was also associated to an overall positive impact of caregiving in neuro-rehabilitation and to a better functional outcome of the patients.

Conclusions

We posited a virtuous circle involving caregivers within the neuro-rehabilitation process, according to which the caregivers’ psychological well-being could be strictly associated to a better level of caregiving and to a better functional outcome of the patients that, in turn, could positively influence the caregivers’ psychological well-being. Although preliminary, these results suggest a specific psycho-educational intervention, aimed at improving the caregivers’ psychological well-being and at facilitating their caring of the loved one.

中文翻译：

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严重后天性脑损伤（ABI）患者神经康复中的心理状况和作用

摘要

目的

为了调查（a）照顾者的心理状态，（b）认知治疗师在神经康复中所感知的照顾的具体特征，（c）照顾者对神经康复的主观方法与（d）之间的关系）患者的功能结局。

方法

24名重度获得性脑损伤患者及其24名护理人员参加了这项观察性研究。护理人员进行了心理评估，以检查情绪困扰，负担和家庭压力。他们对神经康复的主观方法已通过两个具体答案进行了评估。患者的认知治疗师回答了一个临时问卷，即“对神经康复量表的驯化影响”（CINRS），评估了护理的特征（即数量和质量）。最后，通过残疾和认知功能的标准化量表评估患者的功能结局。

结果

照顾者的心理健康与照顾的特征，神经康复的主观方法以及所爱之人的功能恢复有关。更好的照料者进行神经康复的方法还与照料对神经康复的总体积极影响以及患者更好的功能结局有关。

结论

我们提出了一个在神经康复过程中涉及照顾者的良性循环，根据这种良性循环，看护者的心理健康状况可以严格地与更好的照顾水平和更好的患者功能结局相关联，从而可以积极地影响看护者的心理健康。尽管是初步的，但这些结果暗示了一种特殊的心理教育干预措施，旨在改善护理人员的心理健康并促进他们对所爱之人的照顾。