Abstract：
UNASSIGNED: Clinical practice guideline (CPG) recommendations for the management of challenging behaviours after traumatic brain injury (TBI) in hospital and inpatient rehabilitation settings are sparse. This systematic review aims to identify and appraise CPGs, and report high-quality recommendations for challenging behaviours after TBI in hospital and rehabilitation settings.
UNASSIGNED: A three-step search strategy was conducted to identify CPGs that met inclusion criteria. Two reviewers independently scored the AGREE II domains. Guideline quality was assessed based on CPGs adequately addressing four out of the six AGREE II domains. Data extraction was performed with a compilation of high-quality CPG recommendations.
UNASSIGNED: Seven CPGs out of 408 identified records met the inclusion criteria. Two CPGs were deemed high-quality. High-quality CPG recommendations with the strongest supporting evidence include behaviour management plans; beta-blockers for the treatment of aggression; selective serotonin reuptake inhibitors for moderate agitation; adamantanes for impaired arousal/attention in agitation; specialised, multi-disciplinary TBI behaviour management services.
UNASSIGNED: This systematic review identified and appraised the quality of CPGs relating to the management of challenging behaviours after TBI in acute hospital and rehabilitation settings. Further research to rigorously evaluate TBI behaviour management programs, investigation of evidence-practice gaps, and implementation strategies for adopting CPG recommendations into practice is needed.Implications for rehabilitationTwo clinical practice guidelines appraised as high-quality outline recommendations for the management of challenging behaviours after traumatic brain injury in hospital and inpatient rehabilitation settings.High-quality guideline recommendations with the strongest supporting evidence for non-pharmacological treatment include behaviour management plans considering precipitating factors, antecedents, and reinforcing events.High-quality guideline recommendations with the strongest supporting evidence for pharmacological management include beta blockers for aggression in traumatic brain injury.Few guidelines provide comprehensive detail on the implementation of recommendations into clinical care which may limit adoption.
UNASSIGNED: A three-step search strategy was conducted to identify CPGs that met inclusion criteria. Two reviewers independently scored the AGREE II domains. Guideline quality was assessed based on CPGs adequately addressing four out of the six AGREE II domains. Data extraction was performed with a compilation of high-quality CPG recommendations.
UNASSIGNED: Seven CPGs out of 408 identified records met the inclusion criteria. Two CPGs were deemed high-quality. High-quality CPG recommendations with the strongest supporting evidence include behaviour management plans; beta-blockers for the treatment of aggression; selective serotonin reuptake inhibitors for moderate agitation; adamantanes for impaired arousal/attention in agitation; specialised, multi-disciplinary TBI behaviour management services.
UNASSIGNED: This systematic review identified and appraised the quality of CPGs relating to the management of challenging behaviours after TBI in acute hospital and rehabilitation settings. Further research to rigorously evaluate TBI behaviour management programs, investigation of evidence-practice gaps, and implementation strategies for adopting CPG recommendations into practice is needed.Implications for rehabilitationTwo clinical practice guidelines appraised as high-quality outline recommendations for the management of challenging behaviours after traumatic brain injury in hospital and inpatient rehabilitation settings.High-quality guideline recommendations with the strongest supporting evidence for non-pharmacological treatment include behaviour management plans considering precipitating factors, antecedents, and reinforcing events.High-quality guideline recommendations with the strongest supporting evidence for pharmacological management include beta blockers for aggression in traumatic brain injury.Few guidelines provide comprehensive detail on the implementation of recommendations into clinical care which may limit adoption.
摘要：
UNASSIGNED：在医院和住院康复环境中，针对创伤性脑损伤（TBI）后挑战性行为的管理的临床实践指南（CPG）建议很少。本系统综述旨在识别和评估CPG，并报告针对TBI后在医院和康复环境中的挑战性行为的高质量建议。
UNASSIGNED：进行了三步搜索策略，以确定符合纳入标准的CPG。两名审阅者对AGREEII域进行了独立评分。指南质量是根据CPG评估的，该CPG充分解决了六个AGREEII领域中的四个。数据提取是根据高质量的CPG建议进行的。
未经评估：408条确定的记录中有7条符合纳入标准。两个CPG被认为是高质量的。具有最强支持证据的高质量CPG建议包括行为管理计划；用于治疗侵略的β受体阻滞剂；用于中度躁动的选择性5-羟色胺再摄取抑制剂；金刚烷胺用于躁动中受损的唤醒/注意力；专门，多学科TBI行为管理服务。
UNASSIGNED：本系统评价确定并评估了与急性医院和康复环境中TBI后挑战性行为管理相关的CPG质量。进一步研究以严格评估TBI行为管理计划，调查证据-实践差距，并需要实施战略，将CPG建议付诸实践。
两项临床实践指南被评估为在医院和住院康复环境中管理创伤性脑损伤后挑战性行为的高质量大纲建议。对于非药物治疗具有最有力支持证据的高质量指南建议包括考虑诱发因素的行为管理计划。前身，加强事件。高质量的指南建议具有最有力的药物治疗支持证据，包括β受体阻滞剂用于创伤性脑损伤的侵袭性。很少有指南提供有关将建议实施到临床护理中的全面细节，这可能会限制采用。
UNASSIGNED：进行了三步搜索策略，以确定符合纳入标准的CPG。两名审阅者对AGREEII域进行了独立评分。指南质量是根据CPG评估的，该CPG充分解决了六个AGREEII领域中的四个。数据提取是根据高质量的CPG建议进行的。
未经评估：408条确定的记录中有7条符合纳入标准。两个CPG被认为是高质量的。具有最强支持证据的高质量CPG建议包括行为管理计划；用于治疗侵略的β受体阻滞剂；用于中度躁动的选择性5-羟色胺再摄取抑制剂；金刚烷胺用于躁动中受损的唤醒/注意力；专门，多学科TBI行为管理服务。
UNASSIGNED：本系统评价确定并评估了与急性医院和康复环境中TBI后挑战性行为管理相关的CPG质量。进一步研究以严格评估TBI行为管理计划，调查证据-实践差距，并需要实施战略，将CPG建议付诸实践。
两项临床实践指南被评估为在医院和住院康复环境中管理创伤性脑损伤后挑战性行为的高质量大纲建议。对于非药物治疗具有最有力支持证据的高质量指南建议包括考虑诱发因素的行为管理计划。前身，加强事件。高质量的指南建议具有最有力的药物治疗支持证据，包括β受体阻滞剂用于创伤性脑损伤的侵袭性。很少有指南提供有关将建议实施到临床护理中的全面细节，这可能会限制采用。
