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Advisory Committee Chair

Laura E Dreer

Advisory Committee Members

Olivio J Clay

James M Johnston

David C Schwebel

Document Type

Thesis

Date of Award

2018

Degree Name by School

Master of Arts (MA) College of Arts and Sciences

Abstract

When a child or adolescent sustains a concussion, several systems of care become involved (e.g., family, medical, school, sports/recreation). To effectively manage a concussion, all systems of care need to work together to maximize recovery for return-to-play (RTP) and return-to-learn (RTL). Thus, good communication and coordination of care is critical. The objectives of this study were to prospectively examine parent communication patterns (type, frequency, topic, and overall parent satisfaction with communication) with systems of care from the time of their child’s concussion up to 14 weeks past injury. Barriers to communication and parent satisfaction with overall concussion management by each system was evaluated. Seventy-four parent-child dyads were recruited from specialty sports medicine clinics and enrolled in the study within 14 days of injury. Parent participants were 87.9% female and 67.6% Caucasian, with a mean age of 43.6 (SD = 5.8). Child participants were 60.8% male and 67.6% Caucasian, with a mean age of 14.3 (SD = 2.1). The greatest percentage of parents communicated with medical personnel each week (range of 100% to 39.7% depending on the week). However, regarding the average number of times parents communicated with each system, school personnel were contacted the most frequently (averages each week ranged from 2.9 times up to 7.7 times). Face-to-face interactions were the most common method of communication with the sports and medical systems, while email was the most common method with the school system. The majority of parents reported high satisfaction ratings with communication and concussion management across all systems of care. Despite high satisfaction, parents indicated a range of communication barriers such as timeliness of responses and availability of appointments, among others. Poor communication was a top reason for dissatisfaction with concussion management across all systems. The highest ratings of satisfaction with concussion management were associated with the school’s compliance with physician recommendations and academic accommodations, sports personnel’s understanding and supportiveness, and general positive interactions with medical providers. These results have important implications for the development and modification of concussion management guidelines, clinical practice, and efforts to maximize outcomes related to concussion recovery, particularly for RTL.

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