Stakeholder perspectives on navigating the pediatric concussion experience: Exploring the needs for improved communication across the care continuum

Issue title: Pediatric Educational Re-Entry After TBI

Guest editors: Melissa McCart and Susan Davies

Article type: Research Article

Authors: Gomez, Douglas^{a; *} | Glang, Ann^a | Haarbauer-Krupa, Juliet^b | Bull, Rachel^c | Tucker, Paula^d | Ratcliffe, Jonathan^c | Hall, Alex^c | Gioia, Gerard A.^e | Jain, Shabnam^f | Sathian, Usha^g | Simon, Harold K.^h | Wright, David^c

Affiliations: [a] Center on Brain Injury Research and Training, Department of Psychology, University of Oregon, Eugene, OR, USA | [b] Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC) Atlanta, GA, USA | [c] Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA | [d] Department of Emergency Medicine, Nell Hodgson Woodruff School of Nursing, Emory University School of Medicine, Atlanta, GA, USA | [e] Division of Pediatric Neuropsychology, Children’s National Hospital, George Washington University School of Medicine Washington, DC, USA | [f] Pediatric Emergency Medicine, Children’s Healthcare of Atlanta, Emory University Atlanta, GA, USA | [g] Pediatric Urgent Care, Children’s Healthcare of Atlanta, Atlanta, GA, USA | [h] Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA

Correspondence: [*] Address for correspondence: Douglas Gomez, PhD, Center on Brain Injury Research and Training, Department of Psychology, University of Oregon, 1244 Walnut St., Suite 220, Eugene 97403, OR, USA. E-mail: [email protected].

Abstract: BACKGROUND:For children, the post-concussion return to school process is a critical step towards achieving positive health outcomes. The process requires integration between healthcare professionals, parents, and school personnel. OBJECTIVE:This research team conducted focus groups with stakeholders including parents, education personnel, school nurses, external healthcare providers (nurses) and athletic trainers to identify communication patterns between healthcare providers outside of the school setting and school personnel. METHODS:Data from focus groups were analyzed using a Thematic Analysis approach. Researchers used an inductive (bottom-up) coding process to describe semantic themes and utilized a critical realist epistemology. RESULTS:We identified four key themes within focus group data: (1) lack of effective communication between hospital and outpatient healthcare providers to school personnel; (2) parents who were strong advocates had improved communication with healthcare professionals and garnered more accommodations for their children; (3) non-school professionals and families were often confused about who the point of contact was at a given school; and (4) differing experiences for athletes vs. non-athletes. CONCLUSION:This study suggests gaps in communication between healthcare and school professionals when children return to school following a concussion. Improving communication between healthcare providers and school staff will require a multi-faceted approach.

Keywords: Qualitative, brain injury, school, healthcare

DOI: 10.3233/NRE-220220

Journal: NeuroRehabilitation, vol. 52, no. 4, pp. 605-612, 2023