无错性学习对脑损伤患者记忆障碍的影响

The effect of errorless learning on memory process for patients with brain injury:An initial study

目的评价无错性学习对脑损伤患者记忆过程的影响及其作用。方法将符合入选标准的117例脑损伤患者随机分为3组,完成本研究的有84例患者：(1)计算机辅助训练组(电脑组,n=30)；(2)治疗师主导的面对面训练组(面对面组,n=24)；(3)对照组(n=30)。电脑组和面对面组均采用无错性学习的方法,接受4周具有同样内容的记忆障碍训练课程,但分别以软件版和画册版形式进行,对照组不接受任何记忆训练。3组均随访1个月。用Rivermead行为记忆测试-中文版(RBMT-CV)和香港文字记忆学习测试量表-中文版(HKLLT)进行相应的评价。结果电脑组、面对面组在训练后,随访与训练前相比,组内比较RBMT-CV和HKLLT均具有良好的增长效应和延续效应,分值的提高有统计学意义(P＜0．01或P＜0．05),电脑组和面对面组组间比较,HKLLT除提取过程外,编码与保存在训练后和随访期间随时间变化的趋势差异有统计学意义(P＜0．01或P＜0．05)。结论无错性学习是一个改善脑损伤后记忆功能的有效方法,这种学习模式可以影响记忆的全过程；电脑组、面对面组对记忆的编码与保存效果比对照组更好,并且训练效果可持续1个月。

Objective To evaluate the effect of errorless learning on memory processes. Methods Eighty-four participants were randomly divided into three groups： a group which received computer-assisted memory training （ CAMG, n = 30） , a therapist-administered memory training group （ TAMG, n = 24） and a control group （ CG, n = 30）. A 20-session training course with a Chinese cultural background was tailor-made for Chinese subjects with memory disorders. It was administered over the course of one month to the test groups with a similar course structure and content but different delivery modes. The control group had no training. The Rivermead Behavioral Memory Test-Chinese Version （RBMT-CV） and the Hong Kong List Learning Test （HKLLT） were used to assess memory ability and process at the start and end of the training, and one month later. A repeated measures analysis of variance was used to compare differences across the three groups. Results Comparing pre-training with post-training and followup, RBMT-CV and HKLLT scores improved significantly. The CAMG group demonstrated better progress encoding and storage on the H KLLT （including the random and blocked conditions） than the TAM G group. Conclusions Errorless learning is likely to be an effective technique for improving memory function in patients with traumatic brain injury. Its effects last for at least one month. Computer-administered training was more effective than therapist-administered face to face training, especially in improving encoding and storage memory processes.