Center for Pediatric Trauma Research (Mss Lever, Caupp, and Wheeler and Drs Lundine, Sribnick, and Xiang), Center for Injury Research and Policy (Mss Lever, Caupp, and Wheeler and Dr Xiang), and Research Information Solutions and Innovation (Dr Peng) at The Research Institute at Nationwide Children's Hospital, Columbus, Ohio; Department of Neurosurgery (Dr Sribnick) at Nationwide Children's Hospital, Columbus, Ohio; Department of Speech and Hearing Science, The Ohio State University, Columbus, Ohio (Dr Lundine); and The Ohio State University College of Medicine, Columbus, Ohio (Dr Xiang).
J Head Trauma Rehabil. 2019 Mar/Apr;34(2):E21-E34. doi: 10.1097/HTR.0000000000000433.
To examine barriers and facilitators for follow-up care of children with traumatic brain injury (TBI).
Urban children's hospital.
Caregivers of children (aged 2-18 years) discharged from an inpatient unit with a TBI diagnosis in 2014-2015.
Survey of caregivers.
Caregiver-reported barriers and facilitators to follow-up appointment attendance.
The sample included 159 caregivers who completed the survey. The top 3 barriers were "no need" (38.5%), "schedule conflicts" (14.1%), and "lack of resources" (10.3%). The top 5 identified facilitators were "good hospital experience" (68.6%), "need" (37.8%), "sufficient resources" (35.8%), "well-coordinated appointments" (31.1%), and "provision of counseling and support" (27.6%). Caregivers with higher income were more likely to report "no need" as a barrier; females were less likely to do so. Nonwhite caregivers and those without private insurance were more likely to report "lack of resources" as a barrier. Females were more likely to report "good hospital experience" and "provision of counseling and support" as a facilitator. Nonwhite caregivers were more likely to report "need" but less likely to report "sufficient resources" as facilitators.
Care coordination, assistance with resources, and improvements in communication and the hospital experience are ways that adherence might be enhanced.
探讨儿童创伤性脑损伤（TBI）随访的障碍和促进因素。
城市儿童医院。
2014-2015 年从住院部出院的 TBI 诊断儿童（2-18 岁）的照顾者。
照顾者调查。
照顾者报告的随访就诊的障碍和促进因素。
样本包括 159 名完成调查的照顾者。前 3 大障碍为“无需”（38.5%）、“日程冲突”（14.1%）和“缺乏资源”（10.3%）。前 5 大促进因素为“良好的医院体验”（68.6%）、“需要”（37.8%）、“充足的资源”（35.8%）、“协调良好的预约”（31.1%）和“提供咨询和支持”（27.6%）。收入较高的照顾者更有可能报告“无需”作为障碍；女性则不太可能这样做。非白人照顾者和没有私人保险的照顾者更有可能报告“缺乏资源”作为障碍。女性更有可能报告“良好的医院体验”和“提供咨询和支持”作为促进因素。非白人照顾者更有可能报告“需要”，但不太可能报告“充足的资源”作为促进因素。
协调护理、资源援助，改善沟通和医院体验都是提高依从性的方法。
