Pediatric Providers' Self-Reported Knowledge, Practices, and Attitudes About Concussion

• Published in: Pediatrics (Evanston) 2012-12, Vol.130 (6), p.1120-1125
• Main Authors: ZONFRILLO, Mark R, MASTER, Christina L, GRADY, Matthew F, WINSTON, Flaura K, CALLAHAN, James M, ARBOGAST, Kristy B
• Format: Article
• Language: English
• Subjects: Adult and adolescent clinical studies; Attitude of Health Personnel; Attitude surveys; Biological and medical sciences; Brain; Brain Concussion - diagnosis; Brain Concussion - therapy; Brain Injury, Chronic - diagnosis; Brain Injury, Chronic - therapy; Care and treatment; Caregivers - education; Child; Clinical Competence; Clinical medicine; Concussion; Cooperative Behavior; Cross-Sectional Studies; Decision Support Techniques; Demographic aspects; Diagnosis; Emergency medical care; Emergency Medical Services; Evidence-Based Medicine; General aspects; Head injuries; Health Knowledge, Attitudes, Practice; Humans; Injuries of the nervous system and the skull. Diseases due to physical agents; Interdisciplinary Communication; Knowledge; Medical sciences; Organic mental disorders. Neuropsychology; Patient Care Team; Pediatricians; Pediatrics; Primary care; Primary Health Care; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Quality Assurance, Health Care; Referral and Consultation; Surveys; Traumas. Diseases due to physical agents
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2012-1431

To determine the self-reported practices and attitudes surrounding concussion diagnosis and management in a single, large pediatric care network. A cross-sectional survey was distributed to pediatric primary care and emergency medicine providers in a single, large pediatric care network. For all survey participants, practices and attitudes about concussion diagnosis and treatment were queried. There were 145 responses from 276 eligible providers, resulting in a 53% response rate, of which 91% (95% confidence interval [CI]: 86%-95%) had cared for at least 1 concussion patient in the previous 3 months. A Likert scale from 1 "not a barrier" to 5 "significant barrier" was used to assess providers' barriers to educating families about the diagnosis of concussion. Providers selected 4 or 5 on the scale for the following barriers and frequencies: inadequate training to educate 16% (95% CI: 11%-23%), inadequate time to educate 15% (95% CI: 12%-24%), and not my role to educate 1% (95% CI: 0.4%-5%). Ninety-six percent (95% CI: 91%-98%) of providers without a provider decision support tool (such as a clinical pathway or protocol) specific to concussion, and 100% (95% CI: 94%-100%) of providers without discharge instructions specific to concussion believed these resources would be helpful. Although pediatric primary care and emergency medicine providers regularly care for concussion patients, they may not have adequate training or infrastructure to systematically diagnose and manage these patients. Specific provider education, decision support tools, and patient information could help enhance and standardize concussion management.