Qualitative Examination of Adolescent Health-Related Quality of Life at 1 Year Postconcussion

Iadevaia, Cheree; Roiger, Trevor; Zwart, Mary Beth

doi:10.4085/1062-6050-50.11.02

Cited by 51 publications

(53 citation statements)

References 35 publications

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“…In addition to interference with school, adolescents reported that the symptoms interfered with other aspects of their lives. Consistent with previous research, the symptoms have been shown to limit participation in physical and social activities (Iadevaia, Roiger, & Zwart, ; Valovich McLeod, Wagner, & Bacon, ). In other studies, adolescents have reported that they wanted to return to activities as soon as possible because social interactions are an important part of their lives (Colver & Longwell, ).…”

Section: Discussionsupporting

confidence: 86%

The symptom experience of adolescents with concussion

Hodges

Ameringer

2019

Specialist Pediatric Nursing

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Purpose The incidence of concussions in adolescents has increased in recent years. Concussion causes an array of symptoms that can interfere with the daily life of an adolescent, yet the symptoms and recovery vary greatly. Concussion management is based on expert consensus guidelines but they are not specific for adolescents and it is unclear how adolescents actually manage their symptoms. This study aimed to describe the symptom experience of adolescents with a concussion and their self‐management strategies. Design and Methods The study used a qualitative design to explore the symptom experiences of adolescents. Ten adolescents aged 14–17 years were recruited from a concussion clinic. Using a semi‐structured interview, adolescents were asked about their concussion symptoms, the interference with their daily life, and their symptom self‐management strategies. Data were analyzed using descriptive statistics and content analysis. Results Adolescents reported 17 different symptoms they experienced following their concussion. All of the adolescents reported a headache but descriptions varied. The symptoms interfered with many aspects of their daily life including school and activities. The majority of the school responses were related to difficulties attending school and learning (n = 21). The self‐management strategies were organized into 11 categories. The most common strategies fell under three categories: rest (n = 20), controlling the environment (n = 20), and using motivational thoughts and activities (n = 9). Practice Implications This study indicates that adolescents experience multiple symptoms after their concussion and use a variety of strategies to manage the symptoms. Each adolescent had a unique symptom experience, highlighting the need for developing personalized concussion management plans. Nurses can coordinate the development of management plans and provide education about managing concussion symptoms and promoting recovery.

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Section: Discussionsupporting

confidence: 86%

The symptom experience of adolescents with concussion

Hodges

Ameringer

2019

Specialist Pediatric Nursing

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“…Recent qualitative studies examining recovery have described the removal of patients following concussion from their daily social interactions along with the sudden decrease in aerobic fitness may negatively affect their quality of life. 20,21 Early aerobic exercise, even while the patient is symptomatic, may help to decrease some of these sudden changes while improving the overall mood state of the individual 22 and potentially reducing the risk of prolonged recovery. 14 However, clinician supervision is essential in early controlled aerobic exercise to ensure the initiation of activity does not exacerbate symptoms and patients participate at a subsymptom threshold.…”

Section: Resultsmentioning

confidence: 99%

Early Controlled Exercise and Timing of Treatment Following Concussion: A Critically Appraised Topic

Hattrup¹,

Gray²,

Krumholtz³

et al. 2020

Journal of Sport Rehabilitation

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Clinical Scenario: Recent systematic reviews have shown that extended rest may not be beneficial to patients following concussion. Furthermore, recent evidence has shown that patient with postconcussion syndrome benefit from an active rehabilitation program. There is currently a gap between the ability to draw conclusions to the use of aerobic exercise during the early stages of recovery along with the safety of these programs. Clinical Question: Following a concussion, does early controlled aerobic exercise, compared with either usual care or delayed exercise, improve recovery as defined by symptom duration and severity? Summary of Key Findings: After a thorough literature search, 5 studies relevant to the clinical question were selected. Of the 5 studies, 1 study was a randomized control trial, 2 studies were pilot randomized controlled trials, and 2 studies were retrospective. All 5 studies showed that implementing controlled aerobic exercise did not have an adverse effect on recovery. One study showed early aerobic exercise had a quicker return to school, and another showed a 2-day decrease in symptom duration. Clinical Bottom Line: There is sufficient evidence to suggest that early controlled aerobic exercise is safe following a concussion. Although early aerobic exercise may not always result in a decrease in symptom intensity and duration, it may help to improve the psychological state resulting from the social isolation of missing practices and school along with the cessation of exercise. Although treatments continue to be a major area of research following concussion, management should still consist of an interdisciplinary approach to individualized patient care. Strength of Recommendation: There is grade B evidence to support early controlled aerobic exercise may reduce the duration of symptoms following recovery while having little to no adverse events.

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“…The consequence is that people with mTBI may hear mixed messages, becoming confused and potentially losing confidence in care providers. 61,62 OVERCOMING KNOWLEDGE BARRIERS Sports concussion and athletic training professions benefit from regular updates to published guidelines; documents are developed specifically for dissemination to practitioners with the intent of providing concise literature updates to inform clinical practice. Sports concussion guidelines were last updated in 2017 50 and guidelines for athletic training in 2014.…”

Section: Flexible Updates: Balancing Rest and Activity After Mtbimentioning

confidence: 99%

Overcoming Knowledge Barriers for Inclusion of School-Based Speech-Language Pathologists in the Management of Students with Mild Traumatic Brain Injury

O’Brien

2020

Semin Speech Lang

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School-based speech-language pathologists (SLPs) can play an important role in the recovery of children who have sustained a mild traumatic brain injury (mTBI). Two types of knowledge barriers are described here that impact the beliefs and ability of SLPs to respond to the needs of these students. Foundational knowledge is relatively stable over time, and encompasses basic definitions and understanding of the injury. In contrast, flexible knowledge addresses clinical management, including assessment and treatment, and should be regularly updated to align with current best practice recommendations. Clinicians are sensitive to this difference, seeking clinically applicable continuing education. However, general poor understanding of pediatric mTBI paired with rapidly advancing research in the field has led to widespread inaccuracies in both foundational and flexible knowledge. Suggestions are provided for educational initiatives and for advocacy of the role of SLPs in the care of students with mTBI.

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Qualitative Examination of Adolescent Health-Related Quality of Life at 1 Year Postconcussion

Cited by 51 publications

References 35 publications

The symptom experience of adolescents with concussion

The symptom experience of adolescents with concussion

Early Controlled Exercise and Timing of Treatment Following Concussion: A Critically Appraised Topic

Overcoming Knowledge Barriers for Inclusion of School-Based Speech-Language Pathologists in the Management of Students with Mild Traumatic Brain Injury

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