认知康复评估与治疗

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1、认知康复∶评估与治疗中山大学附属第三医院康复医学科窦祖林E-mail:douzul@hotmail.com1讲课内容Contentoflecture慨念Concept评估EvaluationandAssessment康复方式、方法、手段与场所Rehabilitationapproaches、modesandsettings訓練方法Training注意事項PointstoNote2慨念Concept3認知定义DefinitionofCognition認知(cognition)是認識和知曉事物過程的總稱：包括感知、識別、記憶、慨念形成、思維、推理及表象過程Cognit

2、ioniscommonlydefinedasthe“theprocessofknowing”Itinvolvedinperceiving,discrimination,memory,attention,learning,understanding,reasoningandjudgingetc.实际上認知是大腦為解決問題而攝取、儲存、重整和處理信息的基本功能4认知障碍Cognitivedeficit認知障礙有多方面的表現，如判斷、記憶、注意、推理、抽象思維、排列順序的障礙等Thecognitivedeficitisanimpairmenttooneormoreoft

3、heprocesses,forexample:…..resultinginaloseofefficiencyorreductionoffunction.5脑损伤后常见认知障碍表现Descriptionofcognitiveimpairmentcommonly一般说来，脑损伤后认知障碍常见有6个方面。Ingeneral,therearesixbroadareasofcognitioncommonlyimpairedfollowingbraininjury:6注意力损害Attention/concentrationdeficitsA.当进行一项工作时，不能持续注意，常

4、是脑损伤的后遗症。aninabilitytosustainattentionisoftenaconsequenceofbraininjurywhilecarryingoutatask;B.比较基本水平的问题是不能充分地注意，对简单刺激有反应如声音或物体(在恢复早期更常见)canbeatamorebasiclevelwhereapersonisunabletoadequatelyattendandrespondtosimplestimuli,suchassoundsorobjects(moreoftenseenintheearlystagesofrecovery)7

5、C.较高级水平的注意问题包括不能把注意力从一件事上转到另一件事上，或分别注意同时发生的两件事情上。higherlevelofattentionproblemsincludetheinabilitytoshiftattentionfromonetasktoanotherordividedattentionbetweentwosimultaneousoccurringevents.注意力代表了基本的思维水平，这个过程的破坏对其他认知领域有负面影响Attention/concentrationrepresentsabasiclevelofthinking,anddisr

6、uptionofthisprocessmaynegativelyimpactallotherareasofcognition8注意类型Typesofconcentration3Stringer,A.Y.(1996).Aguidetoadultneurologicaldiagnosis.Philadelphia:F.A.Davis.Divided&alternatingconcentrationcapacitytorespondontwoormoretaskssimultaneously(dividedattention,mentaltracking)capacit

7、ytomoveflexiblybetweentasks(alternating,shiftingattention)Focusedconcentrationcapacitytoconcentrateonarelevanttaskandignoreirrelevantstimuli.distractibilitySustainedconcentrationcapacitytoconcentrateonacontinuoustaskattentionspan/vigilance9记忆过程MemoryprocessImmediatememoryShorttermmemo

8、ryLon