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Tytuł:
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Trajectories of Fatigue, Psychological Distress, and Coping Styles After Mild Traumatic Brain Injury: A 6-Month Prospective Cohort Study.
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Autorzy:
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Rakers SE; Departments of Clinical Neuropsychology. Electronic address: .
Timmerman ME; Psychometrics and Statistics.
Scheenen ME; Departments of Clinical Neuropsychology.
de Koning ME; Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
van der Horn HJ; Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
van der Naalt J; Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Spikman JM; Departments of Clinical Neuropsychology.
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Źródło:
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Archives of physical medicine and rehabilitation [Arch Phys Med Rehabil] 2021 Oct; Vol. 102 (10), pp. 1965-1971.e2. Date of Electronic Publication: 2021 Jul 01.
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Typ publikacji:
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Journal Article; Multicenter Study; Observational Study; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Original Publication: Philadelphia, PA : W.B. Saunders
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MeSH Terms:
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Adaptation, Psychological*
Psychological Distress*
Brain Injuries, Traumatic/*physiopathology
Brain Injuries, Traumatic/*psychology
Fatigue/*physiopathology
Fatigue/*psychology
Adult ; Aged ; Brain Injuries, Traumatic/classification ; Cohort Studies ; Fatigue/classification ; Female ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; Prospective Studies ; Surveys and Questionnaires
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Contributed Indexing:
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Keywords: Brain concussion; Fatigue; Psychological distress; Rehabilitation; Traumatic brain injury
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Entry Date(s):
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Date Created: 20210704 Date Completed: 20211011 Latest Revision: 20211011
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Update Code:
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20240105
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DOI:
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10.1016/j.apmr.2021.06.004
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PMID:
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34217729
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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.
(Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)
