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Titre : | Trajectories of Fatigue, Psychological Distress, and Coping Styles After Mild Traumatic Brain Injury: A 6-Month Prospective Cohort Study (2021) |
Auteurs : | Sandra E. Rakers ; Marieke E. Timmerman ; Myrthe E. Scheenen ; Myrthe E. de Koning ; Harm Van der horn ; Joukje van der Naalt |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (Vol. 102, n° 10, 2021) |
Article en page(s) : | p. 1965-1971.e2 |
Note générale : |
https://doi.org/10.1016/j.apmr.2021.06.004
Under a Creative Commons license |
Langues: | Anglais |
Descripteurs : |
HE Vinci Commotion de l'encéphale ; Fatigue ; Réadaptation ; Stress psychologique ; Traumatismes de la moelle épinière |
Résumé : |
Objective
To analyze fatigue after mild traumatic brain injury (TBI) with latent class growth analysis (LCGA) to determine distinct recovery trajectories and investigate influencing factors, including emotional distress and coping styles. Design An observational cohort study design with validated questionnaires assessing fatigue, anxiety, depression, posttraumatic stress, and coping at 2 weeks and 3 and 6 months postinjury. Setting Three level 1 trauma centers. Participants Patients with mild TBI (N=456). Interventions Not applicable. Main Outcome Measures Fatigue was measured with the fatigue severity subscale of the Checklist Individual Strength, including 8 items (sum score, 8-56). Subsequently, 3 clinical categories were created: high (score, 40-56), moderate (score, 26-38), and low (score, 8-25). Results From the entire mild TBI group, 4 patient clusters with distinct patterns for fatigue, emotional distress, and coping styles were found with LCGA. Clusters 1 and 2 showed favorable recovery from fatigue over time, with low emotional distress and the predominant use of active coping in cluster 1 (30%) and low emotional distress and decreasing passive coping in cluster 2 (25%). Clusters 3 and 4 showed unfavorable recovery, with persistent high fatigue and increasing passive coping together with low emotional distress in cluster 3 (27%) and high emotional distress in cluster 4 (18%). Patients with adverse trajectories were more often women and more often experiencing sleep disturbances and pain. Conclusions The prognosis for recovery from posttraumatic fatigue is favorable for 55% of mild TBI patients. Patients at risk for chronic fatigue can be signaled in the acute phase postinjury based on the presence of high fatigue, high passive coping, and, for a subgroup of patients, high emotional distress. LCGA proved to be a highly valuable and multipurpose statistical method to map distinct courses of disease-related processes over time. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999321004627#! |