Mild Traumatic Brain Injury: What We Can Learn From a Qualitative Study of Patient Perceptions Following Emergency Department Discharge
Keywords:Mild traumatic brain injury, Post-concussion syndrome, Perception, Qualitative Research, Health Knowledge, Attitudes, Practice
INTRODUCTION: Mild traumatic brain injuries (mTBI) are common; however, patients often fall into a grey zone of care following acute treatment. Research increasingly shows that despite the initial clearance of traumatic symptoms, patients often suffer from lack of standardised care and return with increased symptoms. Both physical and psychological symptoms are prevalent, with patients reporting symptoms years afterwards. There is little support in Ireland for patients until chronic diagnosis (>2.5 months after the incident) leaving a large gap in care after Emergency Department (ED) discharge. This study investigated the experiences of patients with mTBI to identify barriers and suggest clinically relevant areas for improvement in the current system of care.
METHODS: 16 patients with a clinical diagnosis of mTBI were recruited from the Cork University Hospital ED for participation in this study. Semi-structured phone interviews were conducted at approximately 2.5-3 months post-discharge. Reflexive thematic analysis with an inductive and realist approach was used to code and inductively analyse the data. The most frequently occurring themes and their relationship to subthemes are reported.
RESULTS: A total of 16 mTBI adult patients were interviewed (mean age: 50.5 (18-85)). Major themes identified in the experience of mTBI patients were: lack of clarity in diagnosis and treatment, poor access to information, and ongoing symptoms. 87.5% of participants reported being uncertain about their diagnosis of mTBI and 93.8% of participants did not seek further information regarding their head injury. 43.8% of the participants reported prolonged recovery with two participants (12.5%) reporting ongoing symptoms. Headache, photophobia, and difficulty with thinking and memory were the predominant symptoms reported.
CONCLUSION: Several overarching themes were identified in the qualitative self-reported experiences of mTBI patients following ED discharge. Participants reported persistent symptoms, lack of clarity, and a lack of access to information regarding their mTBI diagnosis and treatment. Suggested recommendations for future practice include adding psychoeducational resources and increasing awareness and training among staff to provide timely patient education.
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Copyright (c) 2022 Kate Ziqiu Wang, Marcia Ward, John Macfarlane
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