TBI patients

TBI and its Effects

TBI sufferers suffer from unanticipated brain damage caused by a jolt or a hard hit to the head. Assaults, sports injuries, falls, or car accidents are the most common causes of brain injury, which can result in death or disability in extreme circumstances. The brain crashes inside the skull during the hit, causing nerve fibers to be scratched, tearing, bruising, and profuse bleeding (Nizamutdinov & Shapiro, 2017). The patient may lose consciousness, have hazy vision, lose memory, and feel confused or dizzy after the injury. From severe and lasting brain damage to moderate concussions, brain injuries range in severity. Unfortunately, brain injury can negatively affect all the aspects of a patient’s life including personality, emotions, mental and physical abilities (Nizamutdinov & Shapiro, 2017). Nonetheless, despite the immense dangers posed by TBI, there are different viable nursing strategies like cognitive training and pharmacological interventions which can help the patients to progressively recover from the injury.

Cognitive Training (CT)

Cognitive damage in TBI commonly interferes with visuospatial skills, language, memory processing speeds, executive functions, the memory of past events, and concentration (Harry et al., 2016). Studies point out that cognitive rehabilitation for TBI that involves different therapeutic interventions and strategies is favorable in enhancing the above skills as well as boosting social skills. CT includes activities like counseling, goal-setting, education, and external and internal compensation techniques that focus on explicit cognitive areas. Additionally, CT main goal is to restore some of the compromised skills and explore compensatory approaches. CT includes applied mnemonic strategies, practical exercises, and drills (Harry et al., 2016). For example, a therapist can use a training kitchen where the patient is required to plan for a meal safely, follow preparation guidelines, list the ingredients and follow the recipe as a strategy of enhancing their cognition among many other simple approaches.

Pharmacological Intervention

To adequately treat TBI, input from different professionals and disciplines is necessary starting from the injury time all the way to the rehabilitation phase (Williamson et al., 2016). Despite the prevalence of TBI in the country, there is inadequate research focusing on the modern pharmacological interventions for the condition. However, pharmacotherapy is increasingly being applied as a viable TBI intervention approach. A pharmacological intervention strategy demands a lot of planning especially in tracking outcomes and adverse events to ensure that ineffective medications or those causing adverse effects are discontinued immediately. As a result, the patient or the substitute decision maker must be involved in deciding whether the intervention should be started as well as input from other experts. Also, selecting the most appropriate drugs is influenced by the time that has passed since the injury, nature of the injury, and study of the existing neurological disability. The common drugs used for the intervention include psychostimulants, anticonvulsants, and antidepressants (Williamson et al., 2016).

Recommendation and Conclusion

From the above analysis, it is evident that CT is easier and more effective than pharmacological intervention which demands a lot of planning, tracking and the drugs used could also be expensive (Williamson et al., 2016). Some drugs used could lead to negative effects, and therefore only the very experienced medical experts are in a position to execute the intervention successfully. Also, there is limited literature on field of modern pharmacological interventions for TBT. On the other hand, the simple strategies applied in CT improve the patients cognitive, interpersonal functioning, emotional and psychological deficits gradually with some being applicable even in the home setting. As a result, CT as an intervention for TBI is widely applicable, easy to use and effective since it does not have any likely negative effects as compared to pharmacological intervention.

References

Harry Hallock, Daniel Collins, Amit Lampit, Kiran Deol, Jennifer Fleming, & Michael Valenzuela. (October 01, 2016). Cognitive Training for Post-Acute Traumatic Brain Injury: A Systematic Review and Meta-Analysis. Frontiers in Human Neuroscience, 10

Nizamutdinov, D., & Shapiro, L. A. (January 01, 2017). Overview of Traumatic Brain Injury: An Immunological Context. Brain Sciences, 7, 1.)

Williamson, D. R., Frenette, A. J., Burry, L., Perreault, M. M., Charbonney, E., Lamontagne, F., Potvin, M. J., ... Bernard, F. (January 01, 2016). Pharmacological interventions for agitation in patients with traumatic brain injury: protocol for a systematic review and meta-analysis. Systematic Reviews, 5, 1.)