Abstract:
:This study created a framework incorporating provider perspectives of best practices for early psychosocial intervention to improve caregiver experiences and outcomes after severe pediatric traumatic brain injury (TBI). A purposive sample of 23 healthcare providers from the emergency, intensive care, and acute care departments, was selected based on known clinical care of children with severe TBI at a level 1 trauma center and affiliated children's hospital. Semistructured interviews and directed content analysis were used to assess team and caregiver communication processes and topics, prognostication, and recommended interventions. Providers recommended a dual approach of institutional and individual factors contributing to an effective framework for addressing psychosocial needs. Healthcare providers recommended interventions in three domains: (1) presenting coordinated, clear messages to caregivers, (2) reducing logistical and emotional burden of care transitions, and (3) assessing and addressing caregiver needs and concerns. Specific family-centered and trauma-informed interventions included: (1) creating and sharing interdisciplinary plans with caregivers, (2) coordinating prognostication meetings and communications, (3) tracking family education, (4) improving institutional coordination and workflow, (5) training caregivers to support family involvement, (6) performing biopsychosocial assessment, and (7) using systematic prompts for difficult conversations and to address family needs at regular intervals. Healthcare workers from a variety of disciplines want to incorporate certain trauma-informed and family-centered practices at each stage of treatment to improve experiences for caregivers and outcomes for pediatric patients with severe TBI. Future research should test the feasibility and effectiveness of incorporating routine psychosocial interventions for these patients.
journal_name
J Neurotraumajournal_title
Journal of neurotraumaauthors
Erlick MR,Vavilala MS,Jaffe KM,Blayney CB,Moore Mdoi
10.1089/neu.2020.7323subject
Has Abstractpub_date
2020-11-09 00:00:00eissn
0897-7151issn
1557-9042pub_type
杂志文章abstract::Clinicians are often faced with the challenging task of distinguishing between accidental and inflicted pediatric head trauma. There is currently a disparity in the anecdotal case study literature as to what kinds of injuries can occur in children from low height falls. There is also a paucity of material property dat...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2006.23.1222
更新日期:2006-08-01 00:00:00
abstract::Hippocampal-dependent deficits in learning and memory formation are a prominent feature of traumatic brain injury (TBI); however, the role of the hippocampus in cognitive dysfunction after concussion (mild TBI) is unknown. We therefore investigated functional and structural changes in the swine hippocampus following T...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2016.4848
更新日期:2017-07-15 00:00:00
abstract::The aims of this study were to assess the trajectories of community integration in individuals with traumatic brain injury (TBI) through one, two, and five years post-injury and to examine whether those trajectories could be predicted by demographic and injury characteristics. A longitudinal cohort study was conducted...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2014.3844
更新日期:2016-01-01 00:00:00
abstract::Large-scale network analysis characterizes the brain as a complex network of nodes and edges to evaluate functional connectivity patterns. The utility of graph-based techniques has been demonstrated in an increasing number of resting-state functional MRI (rs-fMRI) studies in the normal and diseased brain. However, to ...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2016.4649
更新日期:2017-03-15 00:00:00
abstract::Accumulating evidence suggests that the extent of brain injury and the clinical outcome after traumatic brain injury (TBI) are modulated, to some degree, by genetic variants. Aquaporin-4 (AQP4) is the predominant water channel in the central nervous system and plays a critical role in controlling the water content of ...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2014.3347
更新日期:2014-12-01 00:00:00
abstract::Task-specific rehabilitation has been shown to promote functional recovery after acute spinal cord injury (SCI). Recently, the omega-3 polyunsaturated fatty acid, docosahexaenoic acid (DHA), has been shown to promote neuroplasticity after SCI. Here, we investigated whether the combination of a single bolus of DHA with...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2016.4556
更新日期:2017-05-01 00:00:00
abstract::Traumatic brain injury (TBI) induces vascular changes that may influence neurological outcome by causing the brain to be more susceptible to secondary ischemic insults. In rat models of TBI, L-arginine administration has been shown to restore cerebral blood flow and improve neurological outcome. The purpose of this st...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/089771502753594891
更新日期:2002-03-01 00:00:00
abstract::The majority of patients with traumatic brain injury (TBI) sustain a mild injury (mTBI). One out of 4 patients experiences persistent complaints, despite their often normal neuropsychological test results and the absence of structural brain damage on conventional neuroimaging. Susceptibility to develop persistent comp...
journal_title:Journal of neurotrauma
pub_type: 杂志文章,评审
doi:10.1089/neu.2015.3905
更新日期:2016-01-01 00:00:00
abstract::Over the last decade, biomarker research has identified potential biomarkers for the diagnosis, prognosis, and management of traumatic brain injury (TBI). Several cerebrospinal fluid (CSF) and serum biomarkers have shown promise in predicting long-term outcome after severe TBI. Despite this increased focus on identify...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2012.2578
更新日期:2013-06-01 00:00:00
abstract::Fluid percussion brain injury is associated with an immediate rise in mean arterial pressure (MAP). However, the cerebral morphologic basis for this response is still not clear. Thirty-four anesthetized rats were injured using a lateral craniotomy preparation. In 19 rats, impact level was set at 1.73 +/- 0.04 atm, and...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.1991.8.219
更新日期:1991-10-01 00:00:00
abstract::Traumatic brain injury (TBI) is associated with loss of autoregulation due to impaired responsiveness to cerebrovascular dilator stimuli, which leads to cerebral hypoperfusion and neuronal impairment or death. Upregulation of tissue plasminogen activator (tPA) post-TBI exacerbates loss of cerebral autoregulation and N...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2012.2328
更新日期:2012-06-10 00:00:00
abstract::Central nervous system (CNS) axons recover poorly following injury because of the expression of myelin-derived inhibitors of axonal outgrowth such as Nogo, myelin-associated glycoprotein (MAG), and oligodendrocyte-myelin glycoprotein (OMgp), all of which bind to the Nogo-66 receptor 1 (NgR1). Herein we examine the rol...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2012.2493
更新日期:2013-02-15 00:00:00
abstract::After experimental traumatic brain injury (TBI), calcineurin is upregulated; blocking calcineurin is associated with improved outcomes. In humans, variation in the calcineurin A-gamma gene (PPP3CC) has been associated with neuropsychiatric disorders, though any role in TBI recovery remains unknown. This study examines...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2015.4343
更新日期:2017-01-01 00:00:00
abstract::Dementia pugilistica (DP) is associated with chronic traumatic brain injury (CTBI), and leads to a "punch drunk" syndrome characterized by impairments in memory and executive function, behavioral changes, and motor signs. Microscopic features include the accumulation of neurofibrillary tangles (NFTs), beta-amyloid (Aβ...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2011.1957
更新日期:2012-04-10 00:00:00
abstract::We explored the effects of recombinant human growth hormone (rhGH) replacement on physical and cognitive functioning in subjects with a moderate-to-severe traumatic brain injury (TBI) with abnormal growth hormone (GH) secretion. Fifteen individuals who sustained a TBI at least 12 months prior to study enrollment were ...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2016.4552
更新日期:2017-02-15 00:00:00
abstract::Acute subdural hemorrhage (ASDH) is common and associated with severe morbidity and mortality. To date, the role of spontaneous cortical spreading depression (sCSD) in exaggerating secondary injury after ASDH, is poorly understood. The present study contains two experimental groups: First, we investigated and characte...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2018.5657
更新日期:2019-01-15 00:00:00
abstract::Clinical trials aimed at developing therapies for traumatic brain injury (TBI) require outcome measures that are reliable, validated, and easily administered. The most widely used of these measures, the Glasgow Outcome Scale (GOS) and the GOS-Extended (GOS-E), have been criticized as suffering from ceiling effects. In...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2005.22.1319
更新日期:2005-11-01 00:00:00
abstract::The present study evaluated the survival and integration of human postmitotic neurons (hNT) following transplantation into the traumatically injured rodent brain. Anesthetized male Sprague-Dawley rats (n = 47) were subjected to lateral fluid percussion brain injury of moderate severity (2.4-2.6 atm). Sham animals (n =...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.1999.16.403
更新日期:1999-05-01 00:00:00
abstract::Collaboration among investigators, centers, countries, and disciplines is essential to advancing the care for traumatic brain injury (TBI). It is thus important that we "speak the same language." Great variability, however, exists in data collection and coding of variables in TBI studies, confounding comparisons betwe...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2010.1617
更新日期:2011-02-01 00:00:00
abstract::The current lack of diagnostic and prognostic biomarkers for traumatic brain injury (TBI) confounds treatment and management of patients and is of increasing concern as the TBI population grows. We have generated plasma proteomic profiles from mice receiving TBI by controlled cortical impact at either 1.3 mm or 1.8 mm...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2011.1789
更新日期:2012-01-20 00:00:00
abstract::A single dose of an alpha1-noradrenergic antagonist transiently reinstates hemiplegia after recovery from brain injury, which suggests that noradrenaline (NA) is required to maintain recovery. No systematic studies have determined the postinjury duration of this vulnerability. This study used a within-subject, dose-re...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/08977150151070955
更新日期:2001-03-01 00:00:00
abstract::The rate of paroxysmal sympathetic hyperactivity (PSH) was retrospectively assessed using the Paroxysmal Sympathetic Hyperactivity-Assessment Measure (PSH-AM) scale in patients with disorders of consciousness attributed to traumatic and non-traumatic acquired brain injury during the rehabilitation phase. These results...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2018.5963
更新日期:2019-08-15 00:00:00
abstract::In human diffuse axonal injury (DAI), axons are exposed to transient tensile strain. Over the ensuing several hours, injured axons enter a "pathological cascade" of events that lead to secondary axotomy. Use of animal models of traumatic axonal injury (TAI) has allowed description of a number of pathological changes b...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.1999.16.1225
更新日期:1999-12-01 00:00:00
abstract::Traumatic spinal cord injury (SCI) elicits a complex cascade of cellular and molecular inflammatory events. Although certain aspects of the inflammatory response are essential to wound healing and repair, post-SCI inflammation is, on balance, thought to be detrimental to recovery by causing "bystander damage" and the ...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2019.6952
更新日期:2020-08-26 00:00:00
abstract::The EPO-TBI multi-national randomized controlled trial found that erythropoietin (EPO), when compared to placebo, did not affect 6-month neurological outcome, but reduced illness severity-adjusted mortality in patients with traumatic brain injury (TBI), making the cost-effectiveness of EPO in TBI uncertain. The curren...
journal_title:Journal of neurotrauma
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1089/neu.2018.6229
更新日期:2019-09-01 00:00:00
abstract::Despite the shift in demographics of spinal cord injury (SCI) due to an aging population, relatively little has been reported regarding the effect of age on outcomes after SCI. This study examines the potential confounding effect of co-morbidities on the age-related differences in the hospital mortality following acut...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2008.0764
更新日期:2009-08-01 00:00:00
abstract::Patients with spinal cord injury (SCI) typically experience body weight loss, motor function deficits, and a general decline of physical fitness. Animal models with these characteristics can serve to study the detailed adaptive changes following SCI. In the present study, we report the use of an adult paraplegic mouse...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/0897715041651060
更新日期:2004-08-01 00:00:00
abstract::Spinal cord injury (SCI) frequently results in chronic neuropathic pain (CNP). However, the understanding of brain neural circuits in CNP modulation is unclear. The present study examined the changes of ventral tegmental area (VTA) putative GABAergic and dopaminergic neuronal activity with CNP attenuation in rats. SCI...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2017.5381
更新日期:2018-08-01 00:00:00
abstract::Mild traumatic brain injury (mTBI) has gained considerable notoriety during the past decade of conflict in Afghanistan and Iraq. However, the relationship between combat-related mTBI and residual mTBI symptoms, post-traumatic stress disorder (PTSD) symptoms, and neurocognitive deficits remains unclear. The purpose of ...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2012.2506
更新日期:2013-04-15 00:00:00
abstract::The purpose of this study was to define the relationships among clinical characteristics of chronic pain, injury characteristics, affective factors and autonomic dysreflexia (AD) in people with chronic cervical spinal cord injury (SCI). A survey containing questions concerning the presence of AD, demographic factors, ...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/089771504322778659
更新日期:2004-02-01 00:00:00