\u201cImmediately following injury and during the rehabilitation and recovery period, patients and their families must make ongoing and often complex medical decisions, including treatment of brain trauma and orthopedic injuries, choice of rehabilitation programming and treatment of neuropsychiatric problems,\u201d said Daniel C. Marson, J.D., Ph.D., professor of Neurology, director of the UAB Division of Neuropsychology and senior author of a study published in the April 11, 2012, issue of Neurology<\/em>, the medical journal of the American Academy of Neurology.<\/p>\n The severity of the injury directly corresponds to the amount of impairment<\/strong>, according to findings. Patients with mild TBI showed little impairment one month after injury, while those with more severe injury were significantly impaired<\/strong>.<\/p>\n The UAB investigators say there has been little research on the effects of TBI on an individual\u2019s ability to make complicated decisions. The findings have importance for both medical professionals and family members as they help patients make important medical decisions in the aftermath of a head injury.<\/p>\n Marson and his team studied 86 patients with TBI, divided into three classifications of severity \u2014 mild, complicated mild and moderate\/severe \u2014 and 40 healthy controls. Patients were evaluated using a standardized measure of medical decision-making capacity developed by Marson that assesses five consent standards: expressing choice, reasonable choice, appreciation, reasoning and understanding.<\/p>\n \u201cOne month after injury, medical decision-making capacity was mostly intact for those classified with mild TBI, but significantly impaired for those classified with complicated mild TBI and those with moderate\/severe TBI,\u201d said Kristen Triebel, Psy.D., assistant professor of neuropsychology and first author of the study. \u201cUntil we know more about the time required for return to normal decision-making capabilities, physicians need to carefully assess decisional capacity in their TBI patients, particularly those with complicated, moderate or severe TBI.\u201d<\/p>\n The group with moderate-to-severe TBI performed significantly worse than controls on the three of the five complex consent standards: appreciation, reasoning and understanding. Those with complicated mild TBI scored below controls on the understanding standard but not on appreciation or reasoning. Mild TBI patients performed the same as controls on all five consent standards.<\/p>\n \u201cThis suggests that one month following injury, consent capacity has returned to normal for people with mild TBI, but the structural brain changes characteristic of complicated mild cases may contribute to more significant impairments in decisional capacity that have not resolved 30 days after injury,\u201d said Marson.<\/p>\n \u201cThis study strongly suggests that impaired medical decision-making capacity is prevalent in acute TBI and is related to injury severity<\/strong>,\u201d said Marson. \u201cLongitudinal studies are needed to better assess the time required for recovery of decisional capacity across varying levels of injury severity.\u201d<\/p>\n The study was funded by the National Institute on Child Health and Human Development. Additional authors are Roy Martin, Ph.D.; Thomas Novack, Ph.D.; Laura Dreer, Ph.D.; Crystal Turner and Patrick Pritchard, M.D., from UAB and Rema Ramon, Ph.D., University of California San Diego.<\/p><\/blockquote>\n","protected":false},"excerpt":{"rendered":" From the University of Alabama at Birmingham press release via Newswise: A traumatic brain injury can negatively affect a patient\u2019s medical decision-making ability at a time when patients or their… Read more »<\/a><\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[6],"tags":[42,127,28,65],"_links":{"self":[{"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/posts\/2326"}],"collection":[{"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/comments?post=2326"}],"version-history":[{"count":1,"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/posts\/2326\/revisions"}],"predecessor-version":[{"id":2327,"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/posts\/2326\/revisions\/2327"}],"wp:attachment":[{"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/media?parent=2326"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/categories?post=2326"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/tags?post=2326"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![\"\"](\"http:\/\/therapytoronto.ca\/images\/blogpics\/HeadTrauma.jpg\" "\\"head")
A traumatic brain injury can negatively affect a patient\u2019s medical decision-making ability at a time when patients or their families must make myriad complex decisions<\/strong>, say researchers from the University of Alabama at Birmingham.<\/p>\n