Physician recommended school accommodations and student outcomes following a mild traumatic brain injury among youth with persistent post-concussive symptoms.
Physician recommended school accommodations and student outcomes following a mild traumatic brain injury among youth with persistent post-concussive symptoms.
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DOI：
10.3233/nre-210324
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发表时间：
2022
影响因子：
2
通讯作者：
Vavilala, Monica S.
中科院分区：
文献类型：
--
作者：
Takagi-Stewart, Julian;Johnson, Ashleigh M.;Smith, Mallory B.;Wang, Jin;Marcynyszyn, Lyscha A.;Zatzick, Douglas F.;McCarty, Carolyn A.;Rivara, Frederick P.;Vavilala, Monica S.
脑震荡后重返学习（RTL）指导方针包括学校住宿的实施。然而，医生对学校住宿的建议及其影响知之甚少，特别是在经历持续性脑震荡后症状（PPCS）的青少年中。我们研究了医生推荐的学校住宿与经历PPCS的青少年学生成绩之间的关系。使用了来自随机比较有效性试验的数据。通过图表摘要收集医生建议的学校住宿（伤后≤90天）。平均绩点取自学校记录。通过调查（基线、研究进入后3个月和12个月）收集学校问题、脑震荡症状、健康相关生活质量（HRQOL）、焦虑症状和抑郁症状的报告。在200名参与者中（法师= 14.7，62%为女性），86%的人得到了推荐的学校住宿。 推荐的学校住宿数量与3个月（aRR 1.18，95% CI：1.12-1.24）和12个月（aRR 1.11，95% CI：1.05-1.18）时的学校问题数量呈正相关。推荐的学校住宿与GPA，HRQOL，焦虑症状或抑郁症状之间没有显着关联。医生建议为脑震荡后遇到更多学校问题的学生提供更多的学校住宿。通过促进医生，学生和学校之间的伙伴关系，医生提出的RTL建议的适当实施可能需要实现以学生为中心的RTL。
Post-concussion return-to-learn (RTL) guidelines include implementation of school accommodations. Yet, little is known about physician recommendations for school accommodations and their impact, particularly among youth experiencing persistent post-concussive symptoms (PPCS). We examined the association between physician recommended school accommodations and student outcomes among youth experiencing PPCS. Data from a randomized comparative effectiveness trial was used. Physician recommended school accommodations (≤90 days post-injury) were collected via chart abstraction. Grade point average was extracted from school records. Reports of problems at school, concussion symptoms, health-related quality of life (HRQOL), anxiety symptoms, and depressive symptoms were collected by survey (at baseline, three months, and 12 months post study entry). Of 200 participants (Mage = 14.7, 62% female), 86% were recommended school accommodations. Number of recommended school accommodations was positively associated with number of school problems at three months (aRR 1.18, 95% CI:1.12–1.24) and 12 months (aRR 1.11, 95% CI:1.05–1.18). No significant associations were found between recommended school accommodations and GPA, HRQOL, anxiety symptoms, or depressive symptoms. Physicians recommend more school accommodations for students experiencing more school problems post-concussion. Appropriate implementation of RTL recommendations made by physicians by fostering partnerships among physicians, students, and schools may be needed to achieve student-centered RTL.