Acquired Brain Injury and Neurorehabilitation: the Influence of Psychological Characteristics
Trial Snapshot
- Phase
- Not Applicable
- Status
- Not yet recruiting
- Sponsor
- Enrollment
- 200
- Locations
- 1
- Primary Endpoint
- Illness perception
Study Overview
Brief Summary
Acquired brain damage generates motor, cognitive, behavioral and emotional deficits. Neurorehabilitation aims to reduce these deficits and develop compensatory strategies that increase the person's functionality. However, the success of neurorehabilitation process varies and is influenced by the type of injury, the characteristics of the patient or the treatment received. Despite all the studies about patient characteristics, psychological aspects currently continue to be a field to be explored.
The main objective of the study is to study the psychological characteristics of people with brain damage. Secondary objectives include analyzing its link with other indicators, exploring possible differences depending on the etiology of brain damage, assessing its evolution during neurorehabilitation and exploring its prognostic value.
To carry out this prospective longitudinal observational study, adult patients with acquired brain damage to less than 6 months of evolution who present an objective cognitive alteration will be selected. Patients with a neurological or psychiatric history will be excluded.
Patients included in the study will be administered computerized questionnaires at the beginning of the neurorehabilitation program. The same questionnaires will be administered again 2 months later. In those hospitalized patients who subsequently continue outpatient treatment, a third administration will be performed (2 months after the second administration).
Detailed Description
The neurorehabilitative process can be influenced by different factors. Among the most studied are those related to the characteristics of the patient (age, level of education...), the injury (nature, location, magnitude...) or the treatment received (early, intensive...). In contrast, the possible influence of the patient's psychological characteristics on the neurorehabilitation process has been little studied.
Published research on the role of psychological characteristics in the neurorehabilitation process has focused on populations with mild brain damage, using cross-sectional methodologies. The researchers that use longitudinal methodologies study its influence in the chronic phase or once the intensive neurorehabilitation process is completed. There is, therefore, a field to explore in relation to the psychological characteristics of adult patients with moderate-severe acquired brain damage. Furthermore, longitudinal methodology has not been previously used to analyze possible changes in psychological variables during the neurorehabilitation process, nor the influence it may have on its prognosis.
Research Hypothesis:
Psychological characteristics, such as emotional well-being, self-esteem, and motivation, influence neurorehabilitation outcomes in patients with moderate-severe acquired brain damage.
It is expected that:
Study Design
- Study Type
- Observational
- Observational Model
- Cohort
- Time Perspective
- Prospective
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Age over 18 years
- •Present acquired brain damage (stroke, head trauma, encephalopathy, brain tumor, or anoxia) after less than 6 months of evolution.
- •Participants must present a cognitive alteration objectified through a neuropsychological examination.
- •Be correctly oriented in person, space and time (assessed by psychometric tests).
- •Have a good command of Spanish.
Exclusion Criteria
- •Presenting a neurological or psychiatric history.
- •Presenting a language disorder or severe visual-perceptive disorder - hemineglect - that prevents participation in the study (does not allow for correct administration of the questionnaire).
- •A posteriori criterion (once the study has begun): Answering incorrectly to any of the validity items included in the questionnaire. This situation leads to automatic exclusion from studies.
- •The initial neuropsychological examination will be used to check whether participants meet inclusion criteria 3 and 4, as well as exclusion criterion
- •This examination includes orientation tests (subtest of the Barcelona Orientation Test), language tests (subtests of the Barcelona Word Repetition Test, Word Naming and Command Comprehension Test) and visual-perception tests (subtests of the Barcelona Superimposed Figures Test). Only those participants who correctly answer all the items will be selected.
Outcomes
Primary Outcomes
Illness perception
Time Frame: 4 months
The Brief Illness Perception Questionnaire (BIPQ) 9 items. 1-10 score range for each item. Higher scores describe a higher degree of accord with the correspondent parameter of perception.
Motivation towards rehabilitation
Time Frame: 4 months
Motivation in stroke patients for rehabilitation scale (MORE) 17 items. 17-119 score range. Higher scores describe a higher degree of motivation towards rehabilitation.
Personal values
Time Frame: 4 months
Valued Living Questionnaire - Adapted (22 items) Part A: 11 items. 1-10 score range for each item. Higher scores describe a higher degree of identification towards the specific value. Part B: 11 items. 1-4 score range for each item. Higher scores describe a worse perceived impact in the specific value described after the brain injury.
Coping strategies
Time Frame: 4 months
Coping Orientation to Problems Experienced Inventory - Abbreviated (Brief COPE) 28 items. 28-112 score range. Higher scores describe a higher use of coping strategies.
Depressive symptomatology
Time Frame: 4 months
Depressive symptomatology measured by Patient Health Questionnaire-9 (PHQ-9) 9 items. 0-27 score range. Higher scores describe higher depressive symptomatology
Anxiety symptomatology
Time Frame: 4 months
Anxiety symptomatology measured by General Anxiety Disorder Questionnaire (GAD-7) 7 items. 0-21 score range. Higher scores describe higher anxiety symptomatology
Anosognosia
Time Frame: 4 months
Ad-hoc Anosognosia Questionnaire. 5 Items. 1-20 score range. Higher scores describe a higher perceived cognitive impairment.
Self-Esteem
Time Frame: 4 months
Rosenberg Self-Esteem scale (RSE) 10 items. 0-30 score range. Higher scores describe a higher degree of Self-Esteem.
Locus of control
Time Frame: 4 months
Sense of Control Scale. 8 items. 4 subscales with a range of -4 to +4. Locus of control refers to the perception of where control lies within their life and the causes of the events. A higher "internal good" subscale describes a higher tendency to attribute success towards oneself. A higher "external good" subscale describes a higher tendency to attribute success towards elements independent of oneself. A higher "internal bad" subscale describes a higher tendency to attribute failure towards oneself. A higher "external bad" subscale describes a higher tendency to attribute failure towards elements independent of oneself.
Self-Compassion
Time Frame: 4 months
Self-Compassion Scale Short Form (SCS-SF) 12 items. 12-60 score range. Higher scores describe a higher degree of Self-Compassion.
Injustice Experience
Time Frame: 4 months
Injustice Experience Questionnaire; IEQ 12 items. 0-48 score range. Higher scores describe a higher perception of injustice.
Dispositional hope
Time Frame: 4 months
Life Orientation Test (LOT-R): 6 items. 0-24 score range. Higher scores describe a higher degree of dispositional hope.
Posttraumatic Growth
Time Frame: 4 months
Posttraumatic Growth Inventory Short Form (PTGI-SF) 8 items. 0-40 score range. Higher scores describe a higher degree of Posttraumatic Growth.
Personality traits
Time Frame: 4 months
Big Five Inventory -2 (BFI-2-S) 30 items. 15 subscales with a 2-10 score range. 5 Personality traits with varying ranges of scores. Higher scores describe a higher intensity in that specific personality trait.
Secondary Outcomes
No secondary outcomes reported