Changing Healthcare and School Needs in the First Year After Traumatic Brain Injury

Keenan, Heather T.; Clark, Amy; Holubkov, Richard; Ewing‐Cobbs, Linda

doi:10.1097/htr.0000000000000499

Cited by 24 publications

(10 citation statements)

References 43 publications

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“…In contrast to previous research on children’s TBI, which focusses on cognitive, behavioural and social impacts, rather than physical problems, 13 , 27 – 29 we found that the physical impact of injury was a major issue, most notably physical activity restriction and resumption. The injured children often felt bored and wanted to play with their peers and return to their usual activities, but parents prioritised protecting their child from further harm and were much more cautious about the return to activity.…”

Section: Discussioncontrasting

confidence: 99%

The impact of injury: The experiences of children and families after a child’s traumatic injury

et al. 2020

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Objective: To explore the experiences of children and families after a child’s traumatic injury (Injury Severity Score >8). Design: Qualitative interview study. Setting: Two children’s major trauma centres in England. Participants: 32 participants: 13 children with traumatic injuries, their parents/guardians ( n = 14) and five parents whose injured child did not participate. Methods: Semi-structured interviews exploring the emotional, social, practical and physical impacts of children’s injuries, analysed by thematic analysis. Results: Interviews were conducted a median of 8.5 months (IQR 9.3) post-injury. Injuries affected the head, chest, abdomen, spine, limbs or multiple body parts. Injured children struggled with changes to their appearance, physical activity restrictions and late onset physical symptoms, which developed after hospital discharge when activity levels increased. Social participation was affected by activity restrictions, concerns about their appearance and interruptions to friendships. Psychological impacts, particularly post-traumatic stress type symptoms often affected both children and parents. Parents’ responsibilities suddenly increased, which affected family relationships and roles, their ability to work and carry out daily tasks. Rapid hospital discharge was wanted, but participants often felt vulnerable on return home. They valued continued contact with a healthcare professional and practical supports from family and friends, which enabled resumption of their usual lives. Conclusions: Injured children experience changes to their appearance, friendships, physical activity levels and develop new physical and mental health symptoms after hospital discharge. Such challenges can be addressed by the provision of advice about potential symptoms, alternative activities during recovery, strategies to build resilience and how to access services after hospital discharge.

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Section: Discussioncontrasting

confidence: 99%

The impact of injury: The experiences of children and families after a child’s traumatic injury

et al. 2020

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“…Interestingly, participants with extensive educational support needs experienced a more robust, structured approach and expressed greater satisfaction than those children who “merely” needed to catch up and/or had temporary support needs. This concurs with previous research reporting a relationship between injury severity and educational service provision or recognition of needs ( 13 – 15 ). By involving a wide range of injuries in this study, we have shown that that even children with relatively minor and transient educational support needs require similarly robust, effective policies and procedures.…”

Section: Discussionsupporting

confidence: 92%

“…Injured children and their families have limited knowledge or experience of managing their injury and its consequences, and may not know what is needed to optimize their education. The research to date on educational support needs after injury focusses on head injuries (3,(10)(11)(12)(13)(14)(15)(16)(17)(18). This may be because head injuries cause the greatest disability (9), potentially dramatically affecting long-term educational support needs (12).…”

mentioning

confidence: 99%

“…This may be because head injuries cause the greatest disability ( 9 ), potentially dramatically affecting long-term educational support needs ( 12 ). Unmet educational needs for children with head injuries are widely reported, ( 11 , 15 ), but other injuries have received less investigation. Whilst the longterm impacts for such injuries may be less significant than for head injuries, they can cause symptoms and disabilities (such as fatigue and limited mobility), which affect school attendance and psychosocial functioning ( 19 ).…”

mentioning

confidence: 99%

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Educational support needs of injured children and their families after a child’s traumatic injury: A qualitative study

Jones

Tyson²,

Davis³

et al. 2021

JRM

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Objective: To explore the educational support needs of injured children and families. Patients: Thirteen injured children and/or their parents (n = 19) discharged from a major trauma centre within 12 months. Methods: Semi-structured interviews analysed with thematic analysis. Results: Theme 1: communication and information needs. Schools need help to understand the effects of children’s injuries and the adjustments required for their return to school, such as how to involve the children in the more active elements of the curriculum. Thus, effective communication between the injured child, their family, health and education professionals and outside agencies is needed. A specialist key-worker could co-ordinate communication and school return. Theme 2: Educational support needs. Injured children experience changes to their appearance, new symptoms, and altered physical and cognitive abilities. Their absence from school often adversely affects their friendships. Consequently, injured children need continued access to education throughout recovery, support with learning, a flexible timetable, opportunities for social integration, involvement in all aspects of the curriculum, and environmental adaptations to maintain their health and safety. Conclusion: Children with different types of injuries have similar needs for flexible learning and environmental accommodations. Social integration and participation in physical activity should be specific goals for school return.

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“…16 Without the support of inpatient rehabilitation, parents must independently organize and manage their children's care, and children are less likely to be referred for outpatient rehabilitation services. 17 Children with TBI have needs that may change over time 18 and require the care of a variety of specialists (e.g. physiatrists, neurosurgeons, occupational, physical, or speech therapists), necessitating a well-coordinated system of care.…”

Section: Introductionmentioning

confidence: 99%

A scoping review to inform care coordination strategies for youth with traumatic brain injuries: Care coordination tools

Shook

Palusak

Davies

et al. 2021

International Journal of Care Coordination

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Introduction & importance Children with traumatic brain injury (TBI) report unmet needs several years after their injury and may require long-term care. However, this chronic health condition is often only treated and monitored in the short-term. Care for young persons with TBI often relies on parents to manage their child's complex care network. Effective care coordination can close these gaps and facilitate continuity of care for children with TBI. The purpose of this scoping review was to develop a better understanding of tools that improve care coordination for Children with Special Health Care Needs (CSHCN). This, in turn, can inform care for children with TBI. Methods A scoping review was conducted following the PRISMA framework and methodology. OVID/Medline, CINAHL, PsycINFO, EMBASE, and ERIC databases were searched for articles relevant to care coordination tools used with CSHCN. Results 21 articles met the criteria for inclusion in the review, and 6 major categories of care coordination tools were identified: telehealth, online health records and tools, care plans, inpatient discharge protocols, family training, and reminders. Discussion Studies examining telehealth, online tools, care plans, and family training care coordination interventions for CSHCN have shown positive outcomes and would be relevant strategies to improve the care of children with TBI. Future prospective research should investigate these tools to explore whether they might improve communication, reduce unmet needs, increase service access, and improve long-term outcomes for children with TBI.

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Changing Healthcare and School Needs in the First Year After Traumatic Brain Injury

Cited by 24 publications

References 43 publications

The impact of injury: The experiences of children and families after a child’s traumatic injury

The impact of injury: The experiences of children and families after a child’s traumatic injury

Educational support needs of injured children and their families after a child’s traumatic injury: A qualitative study

A scoping review to inform care coordination strategies for youth with traumatic brain injuries: Care coordination tools

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