This study highlights the limits of Peristeen's long-term using and suggests the interest of a specific therapeutic education to Peristeen and of a systematic control consultation within the 3 first months of treatment.
First created in 1996, the French evaluation, retraining, social and vocational orientation units (UEROS) now play a fundamental role in the social and vocational rehabilitation of patients with brain injury. As of today, there exist 30 UEROS centers in France. While their care and treatment objectives are shared, their means of assessment and retraining differ according to the experience of each one. The objective of this article is to describe the specific programs and the different tools put to work in the UEROS of Limoges. The UEROS of Limoges would appear to offer a form of holistic rehabilitation management characterized by the importance of psycho-education and its type of approach towards vocational reintegration.
Objectives: to retrace the care pathways and the academic pathways of brain-damaged children supported a Mobile Unit of School Reintegration (MUSR) and to identify factors associated with their long-term outcome. Patients and methods: Retrospective study from the medical files of 53 children followed by the MUSR, conducted between November 2018 and April 2019. Results: The cerebro-lesions were mainly caused by a craniocerebral trauma (83% of cases), with an average age of onset of 9.8 years. The duration of the initial hospitalization was 39 days on average. The mean length of follow-up was 37 months. Long-term medical outcome was marked by 18.5% of medical complications, 29.6% of behavioral disorders and 9.2% of judiciary complications. The factors associated with long-term behavioral disorders were the age of onset (p = 0.015), the initial Glasgow score (p = 0.025), a head trauma related to a traffic accident (p = 0.046), a poor therapeutic alliance with the parents (p <0.001), the absence of psychological follow-up (p = 0.040) and the existence of legal complications (p = 0.001). The factor associated with long-term legal complications was a poor therapeutic alliance with the parents (p = 0.017). All the children followed were reintegrated into school, after an average of 6.4 months. A school reorientation was necessary in 49.9% of cases, associated with initial complications (p = 0.035), the existence of secondary brain aggressions of systemic origin (p <0.001), the existence of antecedents (p = 0.040), and the autonomy level (p = 0.023). Conclusion: The MUSR offers multidisciplinary, integrative and mobile cares, based on coordination of the care pathway and the academic pathway of children victims of acquired brain injuries.
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