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创伤性脑损伤患儿医疗保健和教育系统中的服务提供:护理差距

Service Delivery in the Healthcare and Educational Systems for Children Following Traumatic Brain Injury: Gaps in Care.

作者信息

Haarbauer-Krupa Juliet, Ciccia Angela, Dodd Jonathan, Ettel Deborah, Kurowski Brad, Lumba-Brown Angela, Suskauer Stacy

机构信息

Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Haarbauer-Krupa); Department of Psychological Sciences, Program in Communication Sciences, Cleveland, Ohio (Dr Ciccia); Department of Psychology, St Louis Children's Hospital, and Washington University School of Medicine, St Louis, Missouri (Dr Dodd); Education Support Services, Eugene School District #4J, Oregon (Dr Ettel); Division of Physical Medicine and Rehabilitation, Cincinnati Children's Hospital Medical Center, Department of Pediatrics and Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Ohio (Dr Kurowski); Pediatric Emergency Medicine, Washington University School of Medicine, St Louis Children's Hospital, Missouri (Dr Lumba-Brown); and Kennedy Krieger Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland (Dr Suskauer).

出版信息

J Head Trauma Rehabil. 2017 Nov/Dec;32(6):367-377. doi: 10.1097/HTR.0000000000000287.

Abstract

OBJECTIVE

To provide a review of evidence and consensus-based description of healthcare and educational service delivery and related recommendations for children with traumatic brain injury.

METHODS

Literature review and group discussion of best practices in management of children with traumatic brain injury (TBI) was performed to facilitate consensus-based recommendations from the American Congress on Rehabilitation Medicine's Pediatric and Adolescent Task Force on Brain Injury. This group represented pediatric researchers in public health, medicine, psychology, rehabilitation, and education.

RESULTS

Care for children with TBI in healthcare and educational systems is not well coordinated or integrated, resulting in increased risk for poor outcomes. Potential solutions include identifying at-risk children following TBI, evaluating their need for rehabilitation and transitional services, and improving utilization of educational services that support children across the lifespan.

CONCLUSION

Children with TBI are at risk for long-term consequences requiring management as well as monitoring following the injury. Current systems of care have challenges and inconsistencies leading to gaps in service delivery. Further efforts to improve knowledge of the long-term TBI effects in children, child and family needs, and identify best practices in pathways of care are essential for optimal care of children following TBI.

摘要

目的

对创伤性脑损伤儿童的医疗保健和教育服务提供情况进行基于证据和共识的描述,并给出相关建议。

方法

开展了关于创伤性脑损伤(TBI)儿童管理最佳实践的文献综述和小组讨论,以促进美国康复医学大会脑损伤儿科及青少年特别工作组基于共识提出建议。该小组代表了公共卫生、医学、心理学、康复和教育领域的儿科研究人员。

结果

医疗保健和教育系统中对TBI儿童的护理协调和整合不佳,导致不良后果风险增加。潜在的解决办法包括在TBI后识别高危儿童,评估他们对康复和过渡服务的需求,以及提高对支持儿童一生的教育服务的利用率。

结论

TBI儿童有遭受长期后果的风险,受伤后需要进行管理和监测。当前的护理系统存在挑战和不一致之处,导致服务提供存在差距。进一步努力提高对儿童TBI长期影响、儿童及家庭需求的认识,并确定护理途径中的最佳实践,对于TBI儿童的最佳护理至关重要。

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