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

• Authors: Douglas Gomez, University of Oregon; Ann Glang, University of Oregon; Juliet Haarbauer-Krupa, Emory University; Rachel Bull, Emory University; Paula Tucker, Emory University; Jonathan J. Ratcliff, Emory University; Alex Hall, Emory University; Gerard A. Gioia, George Washington University; Shabnam Jain, Emory University; Usha Sathian, Emory University; Harold K Simon, Emory University; David W Wright, Emory University
• Journal Title: NeuroRehabilitation
• Volume: Volume 52, Number 4
• Publisher: IOS Press | 2023-09-06, Pages 605-612
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.3233/NRE-220220
• Subjects: Health Sciences, General; Health Sciences, Rehabilitation and Therapy
• Keywords: Qualitative; brain injury; school; healthcare

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.