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Title: 個案研究:複雜型輕度頭部外傷患者之疾病經驗-復原與調適歷程
The recovery process and psychological adjustment of a patient with complicated mild traumatic brain injury
Authors: 蘇郁琳
Su, Yu-Lin
Contributors: 楊啟正
Yang, Chi-Cheng
Su, Yu-Lin
Keywords: 輕度頭部外傷
Mild traumatic brain injury
Post-concussion syndrome
Cognitive functions
Illness adjustment
Date: 2021
Issue Date: 2021-07-01 19:47:09 (UTC+8)
Abstract: 背景:輕度頭部外傷是台灣常見的公共衛生議題。病人受傷後會經歷生理、認知與情緒行為等腦震盪後症狀,而且部分病人的症狀可能持續數年之久,造成生活功能困擾。腦震盪後症狀則可能源於生理、心理與社會等多重因素,因此在探討此議題時,除了需了解其生理(神經)病理外,亦須考量其它心理社會因素對疾病的影響。有鑑於此,本研究欲透過一位複雜型輕度頭部外傷病人的疾病經歷,探討其在受傷後的認知功能表現與變化、經歷的疾病階段與調適歷程,試圖以「生理-心理-社會」的角度說明輕度頭部外傷患者之疾病復原歷程。
Background: Patients with mild traumatic brain injury (MTBI) experience physical, cognitive and emotional disturbances, which might lead to impaired occupational and daily activity functions. Multiple factors, including neurobiological and psychosocial ones, might result in the persistence of post-concussion symptoms. In this study, we explore the experience of a complicated MTBI patient through the biopsychosocial perspective, trying to capture the cognitive pattern and the adjustment process after MTBI.
Methods: This is a single-case, qualitative study. We collected the patient’s medical information and results of the neuropsychological assessment, and carried out five semi-structured interviews within five years after injury. We analyze the transcript of the interviews with thematic analysis.
Results: Results of the neuropsychological assessment showed relative weakness in the patient’s processing speed, visual information processing and sustained attention. In regards to the patient’s subjective experience and the adjustment process, results indicated a four-stage process of recovery, including “loss”, “retreat”, “explore”, and “liquefy”.
Conclusion: Throughout the course of MTBI recovery, the concept of “brain-behavior relationships” in clinical neuropsychology and the concept of “psychosocial adjustment” in health psychology would work collectively, forming an integrative biopsychosocial framework for the unfolding process of recovery.
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