Understanding the needs of children and young people (CYP) with acquired brain injuries (ABI) is essential in delivering pathways of care and providing effective rehabilitation.Aim: To identify relevant literature and key themes relating to the nature and extent of needs (met, unmet or unrecognised) of CYP with ABI and their families.Method: Scoping review. Sixteen electronic bibliographic databases were searched using terms relating to children, brain injury and need. Papers were screened against eligibility criteria by two independent reviewers. No date limits were applied. Data was extracted by the lead author regarding the needs of CYP with ABI and their families and thematic analysis conducted to identify the key themes. Methodological quality was not assessed.Results: A total of 28 articles were identified including three systematic reviews, one scoping review, two practice recommendation articles and 22 original research studies. Participants included CYP with ABI, parents, siblings and professionals. Four key themes were identified; CYP-related impairment needs, support needs, return to school and long-term aftercare.Conclusion: CYP with ABI and their families report extensive needs, many of which are often unmet or unrecognised by those supporting the CYP. Needs transcend the health, social care and education domains.
Intrathecal baclofen is a cornerstone in the treatment of spasticity in children. However, further research is required to set criteria for treatment. This paper offers insight into the national act on baclofen and the experience at the Nottingham University Hospital.
Aim
To evaluate an innovative paediatric neurorehabilitation model in relation to improving quality of neurorehabilitation and reducing length of stay (LOS) for children with acquired brain injury.
Method
A process evaluation approach was conducted in line with Medical Research Council evaluation of complex interventions guidance. Analysis was conducted on routinely collected patient data from 2017 to 2018, including LOS and family feedback. Descriptive and inferential statistics were used for quantitative analysis and qualitative data was analysed thematically.
Results
Outcomes for 70 children (0–16y, median age 5y, IQR 1–11y, 46 males, 24 females) referred to the service indicated improved function and reduced complexity of need. The mean LOS was 10.6 days compared to baseline mean LOS of 41 days (2011–2012). High satisfaction from the families was recorded; however, ongoing needs and service gaps regarding long‐term support were identified.
Interpretation
This service model is effective in delivering quality paediatric neurorehabilitation, demonstrating a sustained impact on LOS, and positive patient outcome data and family feedback for this group of patients.
Investment in early intensive neurorehabilitation and supported discharge impacts length of stay (LOS) for children with acquired brain injury.
Early intensive neurorehabilitation and supported discharge is effective.
This is demonstrated by a sustained reduction in LOS, positive patient outcomes, and family feedback.
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