Subject and Family Perspectives from the Central Thalamic Deep Brain Stimulation Trial for Traumatic Brain Injury: Part II.
This is the second paper in a two-part series describing subject and family perspectives from the CENTURY-S (CENtral Thalamic Deep Brain Stimulation for the Treatment of Traumatic Brain InjURY-Safety) first-in-human invasive neurological device trial to achieve cognitive restoration in moderate to s...
| Publicado en: | Cambridge Quarterly of Healthcare Ethics Vol. 33; no. 4; pp. 449 - 473 |
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| Autores principales: | , , , , |
| Formato: | research Journal Article |
| Publicado: |
Cambridge University Press
Oct2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=181287898&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 181287898 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09631801 7XO jtl: Cambridge Quarterly of Healthcare Ethics issn: 09631801 maglogo: N pubinfo: dt: Oct2024 vid: 33 iid: 4 pid: 15979 pub: Cambridge University Press artinfo: ui: 181287898 181287898 181287898 10.1017/S0963180123000518 181287898 ppf: 449 ppct: 24 formats: tig: atl: Subject and Family Perspectives from the Central Thalamic Deep Brain Stimulation Trial for Traumatic Brain Injury: Part II. aug: au: Fins, Joseph J. Wright, Megan S. Shulman, Kaiulani S. Henderson, Jaimie M. Schiff, Nicholas D. affil: Division of Medical Ethics, Weill Cornell Medical College, New York, NY, USA sug: subj: Brain Injuries Therapy Deep Brain Stimulation Methods Patient Attitudes Family Attitudes Human Secondary Analysis Decision Making Consent Quality Improvement Executive Function Narratives Cognition Emotional Regulation Interpersonal Relations Community Reintegration Counseling Adaptation, Psychological Recovery Semi-Structured Interview Postoperative Complications Reflection Thematic Analysis Social Identity Support, Psychosocial Descriptive Statistics Neuropsychological Tests Funding Source ab: This is the second paper in a two-part series describing subject and family perspectives from the CENTURY-S (CENtral Thalamic Deep Brain Stimulation for the Treatment of Traumatic Brain InjURY-Safety) first-in-human invasive neurological device trial to achieve cognitive restoration in moderate to severe traumatic brain injury (msTBI). To participate, subjects were independently assessed to formally establish decision-making capacity to provide voluntary informed consent. Here, we report on post-operative interviews conducted after a successful trial of thalamic stimulation. All five msTBI subjects met a pre-selected primary endpoint of at least a 10% improvement in completion time on Trail-Making-Test Part B, a marker of executive function. We describe narrative responses of subjects and family members, refracted against that success. Interviews following surgery and the stimulation trial revealed the challenge of adaptation to improvements in cognitive function and emotional regulation as well as altered (and restored) relationships and family dynamics. These improvements exposed barriers to social reintegration made relevant by recoveries once thought inconceivable. The study's success sparked concerns about post-trial access to implanted devices, financing of device maintenance, battery replacement, and on-going care. Most subjects and families identified the need for supportive counseling to adapt to the new trajectory of their lives. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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