School of Health and Rehabilitation Sciences, Sports Medicine Research Institute, and Chronic Brain Injury Program, The Ohio State University, Columbus (Dr Quatman-Yates); Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital, Cincinnati, Ohio (Drs Quatman-Yates and Hugentobler); Departments of Pediatrics (DrsWade, Rhine, and Kurowski) and Neurology and Rehabilitation Medicine (Dr Kurowski), University of Cincinnati College of Medicine, Cincinnati, Ohio; Divisions of Pediatric Rehabilitation Medicine (Ms Miley and Drs Morrison, Wade, and Kurowski) and Emergency Medicine (Dr Rhine), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; and Department of Psychology, University of Cincinnati, Cincinnati, Ohio (Dr Wade).
J Head Trauma Rehabil. 2022;37(4):E280-E291. doi: 10.1097/HTR.0000000000000725. Epub 2021 Sep 23.
To explore adolescent and parent perceptions of the impact of a concussion/mild traumatic brain injury (mTBI) on family functioning and activity levels in the first 4 weeks of recovery.
Outpatient research setting.
Twenty-seven adolescents (aged of 13-17 years) within 1 week of a concussion/mTBI and a parent/guardian were enrolled in the study.
Prospective ecological study with qualitative, semistructured interviews.
Adolescents reported symptoms electronically every 2 days for 28 days via the Post-Concussion Symptom Inventory. Semistructured interviews were completed with each adolescent-parent dyad at the end of the 28-day period. Interview questions focused on perceptions of recovery progress and study procedures.
Symptom trajectories were variable across participants. Three main themes emerged from thematic analysis, including: (1) disruption of routines and activities, (2) injury management considerations, and (3) positive and negative influential factors (eg, school and coach support, timing of injury, and recovery expectations). Results highlighted nuances of recovery challenges that families specifically face and help emphasize the potential benefits of shared decision-making and where more guidance would be appreciated such as more specific self-management of symptoms and physical activity reintegration strategies.
Study findings support a shared decision-making approach with the identified themes as potential topics to help consider social and environmental influences on recovery. The themes presented in the results could be topics emphasized during intake and follow-up visit processes to help guide plans of care and return-to-activity decisions.
探讨青少年和家长对脑震荡/轻度创伤性脑损伤（mTBI）在康复的头 4 周内对家庭功能和活动水平影响的认知。
门诊研究环境。
27 名青少年（年龄在 13-17 岁之间）在脑震荡/mTBI 后 1 周内，以及他们的一位家长/监护人被纳入研究。
前瞻性生态研究，采用定性、半结构化访谈。
青少年通过 Post-Concussion Symptom Inventory 电子报告症状，每 2 天报告一次，共 28 天。在 28 天结束时，对每个青少年-家长二人组进行半结构化访谈。访谈问题集中在对康复进展和研究程序的看法上。
症状轨迹在参与者之间各不相同。主题分析得出了三个主要主题，包括：（1）日常生活和活动的中断，（2）受伤管理考虑，（3）积极和消极的影响因素（例如，学校和教练的支持、受伤时间和康复期望）。结果突出了家庭在康复过程中面临的具体挑战的细微差别，并强调了共同决策的潜在好处，以及在哪些方面需要更多的指导，例如更具体的症状自我管理和身体活动再融入策略。
研究结果支持采用共同决策方法，将确定的主题作为潜在的话题，以帮助考虑康复过程中的社会和环境影响。结果中提出的主题可以作为在接待和随访过程中强调的话题，以帮助指导护理计划和重返活动的决策。
