感觉刺激对昏迷者知觉和表现的影响:一项初步研究

Charitha Lewis, D. Lobo
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引用次数: 0

摘要

健康的成年人大脑能够处理各种复杂的感官数据。识别物体和人的面孔,识别物体和人的位置、深度和距离。这些基本和复杂的感知能力可能会受到中风或其他获得性脑损伤(如头部损伤)的影响。对周围环境没有知觉,如睡觉时,或对刺激没有反应,都是无意识的症状。在神经康复领域,感觉刺激方案(SSP)得到了最多的研究。作为感觉刺激的一部分,医疗保健提供者或家庭成员系统地刺激患者的五种感觉模式,这是一种可能改善患者反应性的治疗形式。为分析感觉刺激对昏迷患者知觉及行为的影响,对12例格拉斯哥昏迷评分3 ~ 8分、诊断为外伤性脑损伤及脑血管意外的昏迷患者进行双盲随机临床试验。患者随机分为实验组和对照组。通过随机抽样从芒格洛尔AJ医学科学研究所各重症监护病房招募昏迷患者。实验组给予感官刺激,每天2次,连续7天,每次25分钟。相比之下,对照组只接受医院的常规护理。通过人口统计学和临床形式收集数据,并通过昏迷恢复量表-修订(CRS-R)测量意识水平。统计分析采用独立t检验和方差分析。实验组的CRS-R测试后得分显著提高,说明多模态感觉刺激有效提高了实验组无意识患者的CRS-R得分。护士可以使用这种干预措施来提高重症监护病房无意识患者的感觉评分。
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Impact of Sensory Stimulation on Perception and Performance among the Comatose: A Pilot Study
Adult brains in good health are capable of processing a variety of intricate sensory data. The faces of the object and the people are recognised, and the location, depth, and distance of the object and the people are identified. These basic and complex perceptual abilities may be impacted by a stroke or other acquired brain injury, such as a head injury. Being unaware of one's surroundings, as when sleeping, or being unresponsive to stimulation are both symptoms of being unconscious. In the area of neurorehabilitation, sensory stimulation programmes (SSP) have received the most research. A healthcare provider or a family member systematically stimulates the patient's five sensory modalities as part of sensory stimulation, a form of therapy that may improve the patient's responsiveness. In order to analyse the impact of sensory stimulation on perception and performance among comatose, double- blinded randomized clinical trial was conducted on 12 comatose patients with Glasgow Coma Scale score 3-8 and diagnosed with traumatic brain injury and cerebrovascular accidents. The patients were randomly assigned into two groups of experimental and control. The comatose patients were recruited via random sampling from various Intensive Care Units of AJ Institute of Medical Sciences, Mangalore. The experimental group was given sensory stimulation twice daily for seven consecutive days, with each session lasting 25 minutes. By contrast, the control group only received routine care from the hospital. Data was collected via demographic and clinical proforma and level of conscious was measured by Coma Recovery Scale-Revised (CRS-R). For statistical analysis, independent t test and ANOVA were computed. There was a significant increase in the post-test scores of CRS-R for experimental group which revealed that multimodal sensory stimulation effectively increased the CRS-R scores among unconscious patients in the experimental group.  Nurses can use this intervention to improve sensory scores among unconscious patients in the Intensive Care Unit.
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