Healthcare providers’ attitudes and behaviours related to paediatric mild traumatic brain injury: results from the 2014 DocStyles survey

Abstract

Objective: Explore healthcare providers’ experiences managing mTBI and better understand their use of mTBI assessment tools and guidelines. Cross-sectional Methods: A random sample of 1,760 healthcare providers responded to the web-based DocStyles survey between June 18 and 30, 2014. The sample included family/general practitioners, internists, pediatricians, and nurse practitioners who reported seeing pediatric patients. We examined their experiences with mTBI to identify opportunities to increase preparedness and improve management of mTBI. Results: Fifty-nine percent of healthcare providers reported that they diagnosed or managed pediatric patients with mTBI within the last 12 months. Of those, 44.4% felt ‘very prepared’ to make decisions about when pediatric patients can safety return to activities, such as school and sports after a mTBI. When asked how often they use screening or assessment tools to assess pediatric patients with mTBI, almost half reported that they ‘seldom’ or ‘never’ use those resources (24.6% and 22.0%, respectively). Conclusion: Most healthcare providers reported seeing pediatric patients with mTBI, yet most feel only somewhat prepared to manage this injury in their practise. Broader use of screening tools and guidelines, that include clinical decision support tools, may be useful for healthcare providers who care for pediatric patients with mTBI.

Diagnosing mild traumatic brain injury using saliva RNA compared to cognitive and balance testing

“…In addition, the signs and symptoms of mTBI can be subtle and easily missed in acute care settings 14 . To add to that challenge, many acute care and emergency medicine providers report insufficient training to effectively diagnose and manage mTBI 20 . Thus, a reliable and objective mTBI diagnosis remains a critical unmet need.…”

Psychologists’ Role in Concussion Assessments for Children and Adolescents in Pediatric Practice

“…Pediatricians are often tasked with managing the care of patients who have suffered a concussion; however, in a recent survey, only 45% of health care providers felt "very prepared" about making decisions regarding when to return to learning or return to sports [43]. The Concussion in Sports Group [44] highlighted the importance of using objective neuropsychological assessment results in making return to school and return to play decisions.…”

“…The Concussion in Sports Group [44] highlighted the importance of using objective neuropsychological assessment results in making return to school and return to play decisions. When making return to play and return to sport decisions, 24.6% of healthcare providers reported "seldom" using objective screening or assessment and 22% reported "never" using objective measures [43]. Furthermore, there is wide documentation of healthcare providers providing inadequate education to pediatric patients and their families related to managing concussive events [45,46].…”

“…As part of the BNA, a thorough clinical interview is critical to generate hypotheses about what may be maintaining the child's symptoms, as an mTBI may exacerbate preexisting conditions causing a prolonged recovery [56][57][58]. Due to their sensitivity shortly after an mTBI, the BNA may include tests measure executive functioning, memory and attention, and psychomotor and processing speed, as well as instruments that are insensitive to mTBI [40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59].…”

Injuries and concussions among young children, ages 5-11, playing sports in recreational leagues in Florida

“…Moreover, healthcare providers may need reliable tools to assess head injuries and concussions. In a recent national study of health care national providers who saw pediatric patients in their practice, over half (59%) reported that they diagnosed or managed pediatric patients with a mTBI (or concussion) within the last 12 months, however only 44.4% reported feeling very prepared to make decisions pertaining to the patients’ safe return to school and sports after the mTBI [11]. Some researchers assert that clinical decision support tools, such as computerized neuropsychological tests with baseline and post-concussion assessments, would be useful for healthcare providers to identify symptoms and make management decisions with sports-related concussion [11–13].…”