Positive Behavioral Support to a Patient with Traumatic Brain Injury and His Family from the Acute Stage

摘要

The impairments caused by traumatic brain injury (TBI) are sometimes too difficult to understand for patients and their families. Especially in the acute stage, there is often much discrepancy in the awareness of the impairments among patients, their families and medical and rehabilitation staff. Such misunderstanding obstructs introduction of chronic-stage rehabilitation. Positive behavioral support (PBS) provided to TBI patients and their families could improve their quality of life in the chronic stage. However, there has been no report concerning acute-stage PBS (APBS). The patient was a 22-year old male with acute-stage TBI who was admitted with coma. After recovery from coma, he had significant cognitive problems that included, for example, neurofatigue, disinhibition and attention disturbance. At first, there was much discrepancy in the understanding of his impairments among the patient, his family and staff. We provided both patient and family APBS from the beginning of the rehabilitation process. After APBS by our rehabilitation team, the discrepancy in understanding among the patient, family and staff was reduced. This case suggests that APBS could help patients achieve self-awareness and gain trust from family, which could then allow for the appropriate introduction of chronic-stage rehabilitation.