Construction and Application of a Non-Pharmacological Management Protocol for Paroxysmal Sympathetic Hyperactivity Syndrome after Traumatic Brain Injury Based on the Symptom Management Theory

INTERVENTION: Intervention group:On top of the conventional interventions used in the control group, a non‐pharmacological management approach based on symptom management theory was employed for intervention.;Control group:Received conventional treatment and nursing care; CONDITION: Paroxysmal sympathetic hyperactivity syndrome PRIMARY OUTCOME: PSH‐AM clinical symptom scale score; SECONDARY OUTCOME: Frequency of episodes;Occurrence of complications: unplanned extubation, pressure injury, hemodynamic instability, nerve injury, and gastrointestinal intolerance,;Coma Recovery Scale‐Revised score; Acute Physiology and Chronic Health Evaluation score;Length of hospital stay; INCLUSION CRITERIA: Here is the English translation of the revised inclusion criteria (items 1 to 4), with the numbering and symbols (‐, >, >=) preserved. Each sentence starts with a capital 1. Meets the diagnostic criteria for traumatic brain injury [41]. 2. Age 18‐75 years. 3. Acute Physiology and Chronic Health Evaluation (APACHE II) score 0‐27.5. 4. PSH diagnosis is established using the internationally recognized *PSH Assessment Measure (PSH‐AM)* (2014) [42], which includes two components: the Clinical Feature Scale (CFS) and the Diagnosis Likelihood Tool (DLT). The CFS comprises 6 items (heart rate, respiratory rate, systolic blood pressure, temperature, sweating, and dystonia), each scored 0‐3. The DLT includes 11 diagnostic criteria (e.g., brain injury, sudden onset of clinical symptoms, symptoms occurring simultaneously, sympathetic overactivity triggered by non‐noxious stimuli, absence of parasympathetic response features during episodes, symptoms persisting for >