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Assessment and Communication for People with Disorders of Consciousness
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在有沟通缺陷的患者中报告发作的准确性
Kyle Paulk1, Nimit N Desai1, Mathew Gregoski2
1Department of Neurology, Medical University of South Carolina, 96 Jonathan Lucas St, Charleston, SC 29425, USA.
在有沟通缺陷的患者中,发作报告的准确性很差. 护理人员的报告往往与客观的门诊EEG (aEEG) 发现不一致,影响了临床管理.
科学领域:
- 神经学 神经学
- 的研究研究.
- 临床神经生理学 临床神经生理学
背景情况:
- 发作报告的不准确性是的一个已知的问题,自我报告在门诊EEG (aEEG) 上捕获的客观发作不到50%.
- 发育迟缓,语言障碍或神经退行性疾病对报告不准确性的贡献尚不清楚.
- 临床管理决策依赖于护理人员报告的发作频率,在有沟通缺陷的患者中,发作频率可能无法预测.
研究的目的:
- 调查护理人员报告的发作频率与有沟通缺陷的患者的客观门诊EEG (aEEG) 发现相比的准确性.
- 为了确定在这个特定患者群体中报告差异的程度.
主要方法:
- 对两岁以上患者的临床,放射和电生理学数据的回顾性审查,EEG>47小时,的客观EEG证据和沟通缺陷 (2013年1月至2020年2月).
- 从临床文档中对照护理人员报告的发作频率与在EEG上记录的客观发作频率的比较.
主要成果:
- 分析了57名患者;89%有发作和59%没有发作的人报告不准确.
- 45%的患者在EEG期间发生了无EEG变化的事件,其中73%被认为有不准确的报告.
- 78%的脑电图发作患者比报告中的发作多,而22%的患者比报告中的发作少.
结论:
- 门诊EEG (aEEG) 发现与报告的发作频率没有很好的相关性,即使在有沟通缺陷的患者中也是如此.
- 护理人员在EEG期间准确识别发作并不能保证在临床访问中准确报告发作频率.
- 需要使用增强的自我报告方法进行进一步的前性研究,以澄清EEG精度与临床评估的发作相比.
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