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Previous issue date: 2015-03-02 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / This dissertation contains two empirical articles which investigated the communication skills and executive functions of adults with traumatic brain injury (TBI) upon hospital admission (inpatients) and after hospital discharge (outpatients). The aim of the first study was to compare discursive, pragmatic, lexical-semantic, reading and writing skills between inpatients with TBI (iTBI) and adults with no neurological damage. Our results showed between-group differences on all parameters evaluated, with control participants outperforming the iTBI group across all measures used in the study. The aim of the second investigation was to identify differences between outpatients with mild or severe TBI (oTBI) and healthy adults on communicative and executive functions, as well as to investigate associations and dissociations between patterns of impairment in the oTBI sample. The two groups differed in their performance on conversational and narrative discourse tasks, as well as on the following executive functions: planning, cognitive flexibility, working memory, processing speed and inhibitory control. Overall, the findings suggested that even subjects with relatively mild lesions and a theoretically good prognosis may experience impairments in discourse processing. The patient group was then further divided according to TBI severity, and differences in executive functions were identified between these two subgroups, as well as between each of these categories and the control group. Patients with severe TBI performed worse than control participants and subjects with mild TBI, and differences between patients with mild and severe TBI were identified in both studies. Lastly, the TBI groups showed dissociations between impairments in rule maintenance and processing speed, and associations between cognitive performance on planning tasks. These findings contributed to the current literature on the continuum of communicative and executive impairment profiles across all levels of TBI severity. The analyses performed in this dissertation may be used in public health services to perform a more accurate assessment of patients with TBI and improve prognostic accuracy, since some impairments may have an impact on global functioning and affect the length of the post-TBI recovery period. / A presente disserta??o de mestrado compreende dois artigos emp?ricos que pretendem explorar a avalia??o dos processamentos comunicativos e executivos de pacientes adultos com traumatismo cranioencef?lico (TCE) em dois momentos ap?s a les?o cerebral: no momento da interna??o (inpatients) e ap?s alta hospitalar (outpatients). O primeiro estudo objetiva comparar os processamentos discursivo, pragm?tico, l?xico-sem?ntico, de leitura e de escrita de pacientes adultos p?s TCE do tipo inpatients (TCEi), comparando o desempenho com indiv?duos sem les?o cerebral. Os resultados indicaram que os participantes se diferenciaram nos quatro processamentos comunicativos sendo que o grupo com TCE teve pior desempenho. O segundo estudo teve como objetivo verificar se existem diferen?as entre pacientes p?s-TCE - do tipo outpatients com gravidades leve e grave - e indiv?duos saud?veis, quanto ao desempenho nos processamentos comunicativos e executivos, al?m de identificar se associa??es e dissocia??es existem na amostra de TCE. Encontraram-se diferen?as entre grupos nos escores do discurso conversacional e narrativo e nas habilidades executivas de planejamento, flexibilidade cognitiva, mem?ria de trabalho, velocidade de processamento e inibi??o. Tais achados, de forma geral, indicam que pacientes com menor les?o e teoricamente melhor progn?stico, podem apresentar desempenho discursivo abaixo do esperado. Al?m disso, as tarefas indicaram diferen?as nas habilidades executivas entre os tr?s grupos. pacientes com TCE grave tiveram pior desempenho do que controles e pacientes com TCE leve, ainda TCE leve diferenciou-se dos graves nos dois estudos. Por ?ltimo, dissocia??es entre os grupos de TCE foram encontradas nos itens de manuten??o de regras e velocidade de processamento e associa??es encontradas nos itens de planejamento. Os resultados dos dois estudos emp?ricos contribuem para a comunidade cient?fica em entender um perfil cont?nuo de dificuldades mesmo em pacientes com o menor ?ndice de gravidade de les?o.
As an?lises apresentadas nessa disserta??o de mestrado s?o poss?veis de serem implementadas nos servi?os p?blicos para avalia??o mais apurada desses pacientes e para identificar melhor progn?stico j? que algumas dificuldades podem afetar globalmente o funcionamento dos pacientes e dificultar, inclusive, o per?odo de recupera??o p?s les?o cerebral.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/6440 |
| Date | 02 March 2015 |
| Creators | Pereira, Natalie |
| Contributors | Fonseca, Rochele Paz |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Psicologia, PUCRS, Brasil, Faculdade de Psicologia |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 2588426296948062698, 600, 600, 600, 600, 2599381623216554467, 3411867255817377423, 2075167498588264571 |
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