Unmet Rehabilitation Needs After Hospitalization for Traumatic Brain Injury
| Autor: | Jin Wang, Keith Owen Yeates, Dennis R. Durbin, Frederick P. Rivara, Juliet Haarbauer-Krupa, Kenneth M. Jaffe, Mark R. Zonfrillo, Nancy R. Temkin, Molly Fuentes, Hilary Bertisch, David S. Tulsky |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Mental Health Services Occupational therapy medicine.medical_specialty Adolescent Traumatic brain injury medicine.medical_treatment MEDLINE Speech Therapy Article 03 medical and health sciences 0302 clinical medicine Occupational Therapy 030225 pediatrics Brain Injuries Traumatic medicine Humans Longitudinal Studies Child Prospective cohort study Physical Therapy Modalities Retrospective Studies Service (business) Health Services Needs and Demand Trauma Severity Indices Rehabilitation business.industry Retrospective cohort study medicine.disease Mental health Hospitalization Education Special Pediatrics Perinatology and Child Health Emergency medicine Female business 030217 neurology & neurosurgery |
| Zdroj: | Pediatrics. 141 |
| ISSN: | 1098-4275 0031-4005 |
| DOI: | 10.1542/peds.2017-2859 |
| Popis: | OBJECTIVES: In this study, we describe unmet service needs of children hospitalized for traumatic brain injury (TBI) during the first 2 years after injury and examine associations between child, family, and injury-related characteristics and unmet needs in 6 domains (physical therapy, occupational therapy, speech therapy, mental health services, educational services, and physiatry). METHODS: Prospective cohort study of children age 8 to 18 years old admitted to 6 hospitals with complicated mild or moderate to severe TBI. Service need was based on dysfunction identified via parent-report compared with retrospective baseline at 6, 12, and 24 months. Needs were considered unmet if the child had no therapy services in the previous 4 weeks, no physiatry services since the previous assessment, or no educational services since injury. Analyses were used to compare met and unmet needs for each domain and time point. Generalized multinomial logit models with robust SEs were used to assess factors associated with change in need from pre-injury baseline to each study time point. RESULTS: Unmet need varied by injury severity, time since injury, and service domain. Unmet need was highest for physiatry, educational services, and speech therapy. Among children with service needs, increased time after TBI and complicated mild TBI were associated with a higher likelihood of unmet rather than met service needs. CONCLUSIONS: Children hospitalized for TBI have persistent dysfunction with unmet needs across multiple domains. After initial hospitalization, children with TBI should be monitored for functional impairments to improve identification and fulfillment of service needs. |
| Databáze: | OpenAIRE |
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