生態化執行功能訓練對腦傷病人之治療：病例報告

Ecological Executive Function Training in Patient with Brain Injury: A Case Report

何曉婷(Hsiao-Ting Ho) ； 吳玉欣(Yu-Hsin Wu) ； 黃茂雄(Mao-Hsiung Huang) ； 郭乃文(Nai-Wen Guo)

《台灣復健醫學雜誌》 39卷1期 (2011/03) Pp. 31-38

https://doi.org/10.6315/2011.39(1)05

摘要

腦傷後的衝動控制困難常會引發許多令人困擾的行爲與認知／社會功能障礙，有學者認爲這是病患無法適當建立與使用目標清單的緣故；而「目標管理訓練計畫」即是一個專爲這些抑制功能不佳、目標管理能力受損，且日常行爲混亂的患者所設之神經心理復健方案。本文所報告的，是對一位因腦傷而出現衝動控制困難的55歲男性病患，所進行之以目標管理概念爲基礎的生態化執行功能訓練；訓練係以提升社會適應能力爲目標，並以簡短式智能評估、盧－尼神經心理測驗組－篩檢測驗與神經行爲評估量表等工具評估療效。經過爲期兩個禮拜的訓練，從多方面心智功能表現都可發現相較於訓練前，病患的抑制衝動能力已有明顯改善，包括：配合復健治療的動機較強、認知表現較佳，且社會功能較好等。本案結果顯示，即便只有兩星期的短期介入，生態化執行功能訓練仍可對病患產生良好效益。

關鍵字

目標管理訓練計畫 ； 執行功能 ； 復健心理 ； 生態化訓練

並列摘要

It has been reported that inappropriate behavior and cognitive/social dysfunction might be the result of poor impulse control after brain injury. A disorganized condition can be attributed to a failure to use a goal list. Goal management training (GMT), a neuropsychological rehabilitation program, was therefore designed for patients with poor inhibition, impaired goal- management and disorganized daily behavior. In this report, Ecological Executive Function Training (EEFT), based on the GMT model, was applied to a 55 year-old male patient with poor impulse control that was secondary to brain injury. The treatment lasted for two weeks and aimed to improve his psychosocial adaptation. Mini-Mental State Examination (MMSE), Luria-Nebraska Neuropsychological Battery-Screening Test (LNNB-S) and Neurobehavioral Rating Scale (NRS) were used to evaluate the effectiveness of the intervention. The outcome was improved inhibition and better impulse control, which were manifested in the dimensions of better motivation cooperation in terms of the rehabilitation process, better cognitive ability and improved social functioning. It is concluded that EEFT can be helpful to a patient even when the treatment time is as short as two weeks.

並列關鍵字

goal management training ； executive function ； rehabilitation psychology ； ecological training