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幼儿创伤性脑损伤后的康复与学校服务。

Rehabilitation and school services following traumatic brain injury in young children.

作者信息

Haarbauer-Krupa Juliet, Lundine Jennifer P, DePompei Roberta, King Tricia Z

机构信息

Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.

School of Speech and Hearing Science, The Ohio State University, Columbus, OH, USA.

出版信息

NeuroRehabilitation. 2018;42(3):259-267. doi: 10.3233/NRE-172410.

Abstract

BACKGROUND

Preschool children have the highest incidence of emergency department visits for traumatic brain injury (TBI) with the majority discharged home without a single point of entry into follow-up services. This paper describes families' experience with service access following TBI.

OBJECTIVES

To describe parent reported service utilization following preschool TBI and examine predictors of service access.

METHODS

Participants (N = 80) were drawn from the first visit of a longitudinal study examining elementary school outcomes following TBI. Parents were interviewed about their service history. Descriptive statistics analyzed sample demographics. Logistic regression examined associations between injury related factors and service utilization.

RESULTS

TBI participants had mild injuries (83%) and were either discharged to home or spent less than a week in the hospital. No TBI participants received inpatient rehabilitation and only a portion of the sample (26%) received outpatient treatment. Length of hospital stay was a significant predictor of service access (Wald = 4.33, df = 1, p = 0.040). All children were enrolled in preschool without accommodations.

CONCLUSION

Currently no systematic continuum of care exists for children with TBI injured prior to elementary school, despite availability of healthcare, education and state based resources. Healthcare professionals in contact with young children can help with follow-up by educating parents about TBI effects on learning.

摘要

背景

学龄前儿童因创伤性脑损伤(TBI)前往急诊科就诊的发生率最高,大多数患儿出院后回家,没有单一的后续服务接入点。本文描述了家庭在TBI后获得服务的经历。

目的

描述家长报告的学龄前TBI后的服务利用情况,并检查服务接入的预测因素。

方法

参与者(N = 80)来自一项纵向研究的首次就诊,该研究考察TBI后的小学学业成果。对家长进行了关于他们服务史的访谈。描述性统计分析了样本人口统计学特征。逻辑回归分析了损伤相关因素与服务利用之间的关联。

结果

TBI参与者受轻伤(83%),要么出院回家,要么在医院住院不到一周。没有TBI参与者接受住院康复治疗,只有一部分样本(26%)接受了门诊治疗。住院时间是服务接入的一个重要预测因素(Wald = 4.33,df = 1,p = 0.040)。所有儿童均在没有特殊安排的情况下进入学前班。

结论

尽管有医疗保健、教育和基于州的资源,但目前对于小学前受伤TBI儿童不存在系统的连续护理。与幼儿接触的医疗保健专业人员可以通过向家长宣传TBI对学习的影响来帮助进行后续跟进。

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