None listed
Conditions
Brief summary
Mild traumatic brain injury (mTBI) is a common problem, crossing all socioeconomic circumstances and age groups. In children and young adults, concussions account for 90% of all traumatic brain injuries, with one in five children experiencing a concussion by the age of 10 years. Post-concussion syndrome (PCS) is a collection of symptoms including physical (i.e., headaches, dizziness), cognitive (i.e., difficulties with attention, and memory), and behavioural (i.e., sleep difficulties, depression, anxiety) symptoms. Most children have recovered from their concussion injury within a month, but 11% continue to experience symptoms at three or more months, with 2% still having symptoms at twelve months or longer. Multiple clinical practice guidelines and position statements exist to guide the management of concussion in children but have information gaps in the provision of discharge advice and continuation of care. The benefits of clear and consistent discharge information and routine follow-up care are known, but practice variation occurs in clinical settings. This purpose of this research is to adapt clinical pathways to be used in local ambulatory care settings. Clinical pathways tools will include discharge Fact Sheets and eHealth applications. A prospective study of clinical and process centred outcomes prior to implementation of the amended clinical pathway will be performed, followed by an evaluation of the clinical pathway post-intervention. It is hoped that this research will improve follow-up care for children after a concussion injury including facilitating those with ongoing symptoms to seek appropriate care.
Interventions
This study will involve a pre- and post- intervention design to evaluate the implementation of a mobile app eHealth tool. This intervention will guide participants through recovery after a concussion injury. In order to design an effective eHealth intervention, the following processes will be undertaken;
1.An audit of concussion presentations to the Queensland Children's Hospital (QCH) Emergency Department (ED) will provide demographic information and the number of paediatric concussion diagnose
This study will involve a pre- and post- intervention design to evaluate the implementation of a mobile app eHealth tool. This intervention will guide participants through recovery after a concussion injury. In order to design an effective eHealth intervention, the following processes will be undertaken; 1.An audit of concussion presentations to the Queensland Children's Hospital (QCH) Emergency Department (ED) will provide demographic information and the number of paediatric concussion diagnoses in this location within a set period. 2. Semi-structured qualitative interviews will be conducted by the Research Assistant at the QCH, Centre for Children's Health Research, or via telephone or videoconferencing with the following groups; i. Up to 10 patients/families who have sustained a concussion. Patients will be recruited from the Mild Traumatic Brain Injury service ii. Up to 15 ED Health Care Professionals. These will be volunteers recruited via workplace newsletter and flyers. iii. Up to 10 other important stakeholders involved the management of concussion within QCH and the community. eg. GPs, Trauma Service, physiotherapy. These participants will be recruited by directly approaching staff known within clinical networks. Interviews with patients/families will include demonstration of a similar app, static website and information website to understand the type and format of e-information that patients and families would find useful during the recovery process. Information gained from all of these interviews will be used to modify and implement a post-concussion clinical pathway. The interviews will be done over a period of three months The pre-intervention phase of the study will recruit 150 participants who register for the project on the study's informational website via the project flyer provided during their ED visit. The Research Assistant will initiate these surveys by entering participant's email address into REDCap. The intervention phase of the study will commence once 150 participants have enrolled in the pre-intervention phase. 150 participants will register for the intervention phase via a specific project flyer provided during their ED visit which will include instructions on how to download a mobile app. In both the pre-intervention and intervention phases, participants will complete surveys received either via email (pre-intervention) or on the app (intervention). These surveys will track and monitor their concussion symptoms and recovery for up to 3 months following enrolment. The surveys will include; fortnightly Post Concussion Symptom Inventory, one Satisfaction with Care survey, and two Quality of Life questionnaires. Adherence in both phases will the data collected on REDCap (from both survey completion and app engagement)
Sponsors
Associate Professor Karen Barlow
Study design
Allocation
Non-randomised trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
0 to 16 Years
Healthy volunteers
No
Inclusion criteria
Children between the ages of 0-16 seen in Queensland Children's Hospital Emergency Department who have been diagnosed with a concussion injury and discharged home
Exclusion criteria
Participants over the age of 16 Participants admitted to hospital for their concussion injury Patients not seen at Queensland Children's Hospital Emergency Department
Outcome results
None listed