ABSTRACT
Objective To explore an assessment tool for releasing physical restraints of patients in neurosurgical intensive care unit (NICU).Methods Totally 70 patients in NICU with physical restraints whose Glasgow Coma Scale (GCS)scores were 13 to 15 were assessed by Johns Hopkins Adapted Cognitive Exam (ACE).After assessment,patients were divided into the normal orientation group and the abnormal orientation group according to the results.Then we removed physical constraints of patients in the normal orientation group.We analyzed occurrence of unplanned extubation and overall cognitive function of two groups.Results There was no unplanned extubation after removal of physical restraints in the normal orientation group,whereas there were five cases of unplanned extubation in the abnormal orientation group (P＜0.05).With regards to overall cognitive function,scores of other subtests and total scores in the normal orientation group were significantly higher than those in the abnormal orientation group (P＜0.05).Conclusion ACE can be used as assessment tool for orientation among patients in NICU,and normal orientation can serve as an indication of removal of physical restraints in patients with GCS scores of 13 to 15 in NICU.
ABSTRACT
Objective To choose a better version of Rivermead Behavioral Memory Test(RBMT)to assess memory function of patients with mild traumatic brain injury(TBI).Methods From April,2015 to Febrary,2017,40 mild TBI patients and 40 healthy people were re-cruited as TBI group and control group respectively.Both groups completed the Chinese version of RBMT-II first,and 24 hours to 48 hours later,completed the Chinese version of RBMT-III.The raw score of each test and the number of perfect scores and floor performance were scored and compared.Results Compared with the control group,TBI group got lower scores in six subtests of RBMT-II(F>2.131,P<0.05) and twelve subtests of RBMT-III(F>2.035,P<0.05).Administration of the RBMT-III resulted in less participants performing at or near indi-vidual subtest's ceiling than RBMT-II,mainly in the picture recognition,face recognition,the line instant memories,the line delay memo-ries,letters delayed recall and orientation date(Z>2.117,P<0.05).Also administration of the RBMT-III resulted in less floor performance than those of RBMT-II,mainly in remembering the name and the appointment(Z>2.138,P<0.05).Conclusion RBMT-III has substantial im-provement over the original RBMT-II,as it reduces the problem of ceiling and floor performance and the number of misclassifications.