Sleep and agitation during subacute traumatic brain injury rehabilitation: A scoping review

Poulsen, Ingrid; Langhorn, Leanne; Egerod, Ingrid; Aadal, Lena

doi:10.1016/j.aucc.2020.05.006

Cited by 11 publications

(10 citation statements)

References 49 publications

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“…TBI-SD can hamper the recovery process, as well as potentially increase various comorbidities, including the post-TBI spectrum of neuropsychiatric impairment. [89][90][91] Reciprocally, mood and anxiety disorders can also contribute to the development of sleep disturbances, along with more direct factors such as the degree of injury to regions of the brain involved in sleep, namely the hypothalamus, brainstem, and reticular activating system. 92 Mathias & Alvaro 93 have identified hypersomnia, insomnia, narcolepsy, obstructive sleep apnea, and periodic limb movements as the most common sleep problems encountered after TBI.…”

Section: Discussionmentioning

confidence: 99%

The Frequency of Neuropsychiatric Sequelae After Traumatic Brain Injury in the Global South

Ganesh,

Al-Shamli,

Mahadevan

et al. 2024

Sultan Qaboos Univ Med J

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Countries in the 'global south' are characterized by factors that contribute to the increased incidence of traumatic brain injury (TBI). This systematic review and meta-analysis aimed to assess the prevalence of neuropsychiatric sequelae following a TBI, specifically among the Western Asian, South Asian, and African regions of the global south. A literature review was conducted until August 20, 2021, for publications that measured psychiatric or cognitive impairment after TBI from the 83 countries that constitute the aforementioned regions. The main databases, such as PsycINFO, Scopus, PubMed/MEDLINE, ProQuest (English), Al-Manhal (Arabic) and Google Scholar, were selected for grey literature. Following the evaluation of the articles using the Joanna Briggs Institute guidelines, the random effects model was used to estimate the prevalence of depression, anxiety, posttraumatic stress disorders (PTSD), sleep disturbance related to TBI (TBI-SD), obsessive–compulsive disorder (OCD), and cognitive impairment. Of 56 non-duplicated studies identified by the initial search, 27 studies were eligible for systematic review and 23 for meta-analysis. The pooled prevalence of depression in a total sample of 1882 was 35·35% (95% CI=24·64–46·87%), of anxiety in a total sample of 1211 was 28·64% (95% CI=17·99–40·65%), of PTSD in a total sample of 426 was 19·94% (95% CI=2·35–46·37%), of OCD in a total sample of 313 was 19·48% (95% CI=0·23–58·06%), of TBI–SD in a total sample of 562 was 26·67% (95% CI=15·63–39·44%), and cognitive impairment in a total sample of 941 was 49·10% (95% CI=31·26–67·07%). To date, this is the first critical review that has examined the spectrum of post–TBI neuropsychiatric sequelae in the specified regions. While existing studies lack homogeneous data due to variability in the diagnostic tools and outcome measures utilised, the reported prevalence rates are significant and comparable to statistics from the global north. Keywords: traumatic brain injury; neuropsychiatric sequelae; global south; systematic review; meta-analysis; cognitive impairment; anxiety; depression

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Section: Discussionmentioning

confidence: 99%

The Frequency of Neuropsychiatric Sequelae After Traumatic Brain Injury in the Global South

Ganesh,

Al-Shamli,

Mahadevan

et al. 2024

Sultan Qaboos Univ Med J

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“…Many patients with severe TBI are transferred to the ICU for more effective treatment, especially for those with severe TBI who have undergone craniotomy [ 16 ]. Because of the severe nature of TBI itself, the need for craniotomy and other reasons, these patients often exhibit agitation [ 3 , 17 ]. Once a patient has this condition, it usually needs to be controlled with medication.…”

Section: Discussionmentioning

confidence: 99%

The effect of dexmedetomidine on the postoperative recovery of patients with severe traumatic brain injury undergoing craniotomy treatment: a retrospective study

Deng,

Gu,

Luo

et al. 2024

Eur J Med Res

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Background Traumatic brain injury (TBI) has been a worldwide problem for neurosurgeons. Patients with severe TBI may undergo craniotomy. These patients often require sedation after craniotomy. Dexmedetomidine (DEX) has been used in patients receiving anesthesia and in intensive care units. Not much is known about the postoperative effect of DEX in patients with severe TBIs undergoing craniotomy. The purpose of this study was to explore the effects of postoperative DEX administration on severe TBI patients who underwent craniotomy. Methods Patients who underwent craniectomy for severe TBI at our hospital between January 2019 and February 2022 were included in this study. The patients were admitted to the intensive care unit (ICU) after surgery to receive sedative medication. The patients were then divided into DEX and control groups. We analyzed the sedation, hemodynamics, and other conditions of the patients (hypoxemia, duration of ventilation during endotracheal intubation, whether tracheotomy was performed, and the duration in the ICU) during their ICU stay. Other conditions, such as delirium after the patients were transferred to the general ward, were also analyzed. Results A total of 122 patients were included in this study. Among them, 53 patients received DEX, and the remaining 69 did not. The incidence of delirium in the general ward in the DEX group was significantly lower than that in the control group (P < 0.05). The incidence of bradycardia in the control group was significantly lower than that in the DEX group (P < 0.05). Other data from the DEX group and the control group (hypotension, hypoxemia, etc.) were not significantly different (P > 0.05). Conclusion The use of DEX in the ICU can effectively reduce the incidence of delirium in patients who return to the general ward after craniotomy. DEX had no adverse effect on the prognosis of patients other than causing bradycardia.

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“…13,29,[34][35][36] A lack of communication or information from hospital staff, waiting times, worry and stress, and previous hospital experiences may also exacerbate patient aggression. 37 Violence and aggression could also be caused by relatives or visitors. management, and reduced interaction due to healthcare professionals feeling worried or threatened.…”

Section: Discussionmentioning

confidence: 99%

“…There seems to be a definite correlation between sleep and agitation, and this needs to be explored to reduce the risk of violence toward nurses 13,29,34–36 . A lack of communication or information from hospital staff, waiting times, worry and stress, and previous hospital experiences may also exacerbate patient aggression 37 . Violence and aggression could also be caused by relatives or visitors.…”

Section: Discussionmentioning

confidence: 99%

A Literature Review: Violence and Aggression in Neuroscience Nursing

Woon¹

2023

Journal of Neuroscience Nursing

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BACKGROUND: Violence and aggression is commonly encountered in nursing worldwide and is an increasing concern, although it is largely underreported by staff. Violence and aggression can take many forms, from verbal and physical abuse to sexual assault. This study aims to define agitation, violence, and aggression and to explore the prevalence of violence and aggression among neuroscience patients. This review also examines why violence and aggression occurs for neuroscience patients and to determine the effects on the patients, the environment, and the nursing staff. METHODS: A review of articles was conducted using CINAHL, PubMed, the Cochrane Database, and Google Scholar between 2012 and 2022. DISCUSSION: Agitation can escalate to violence and aggression. The reasons a neuroscience patient may become agitated are multifactorial. An injury to the brain may not cause agitation; however, the effect on the frontal lobe, hypothalamus, and hippocampus may cause a lack of self-control, impulsivity, an inability to control emotions, and an uncontrolled release of hormones, leading to a heightened sympathetic response. The effects of violence and aggression can be detrimental to the patient and include isolation, increased sedation, reduced observations, and even death. The effects on the nurse are profound including a decline in productivity at work, an increased risk of drug errors, and posttraumatic stress disorder or burnout as longer-term consequences. CONCLUSION: Violence and aggression is commonly experienced within neuroscience nursing, and the contributing factors are multifactorial. The effects for the patients and staff can be profound, and this is why prevention of agitation is fundamental to ensure the safety and retention of nursing staff.

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Sleep and agitation during subacute traumatic brain injury rehabilitation: A scoping review

Cited by 11 publications

References 49 publications

The Frequency of Neuropsychiatric Sequelae After Traumatic Brain Injury in the Global South

The Frequency of Neuropsychiatric Sequelae After Traumatic Brain Injury in the Global South

The effect of dexmedetomidine on the postoperative recovery of patients with severe traumatic brain injury undergoing craniotomy treatment: a retrospective study

A Literature Review: Violence and Aggression in Neuroscience Nursing

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