Pediatricians' Knowledge, Attitudes, and Behaviors to Screening Children After Complicated Mild TBI: A Survey.
Heather T Keenan, Susan L Bratton, Rebecca R Dixon
PMID 28489701WHAT IT FOUND
Pediatricians recognized early symptoms after a child's complicated mild TBI but were less aware of later emotional, social, learning, and growth problems.
Referral to neuropsychology or behavioral medicine was often blocked by wait times, availability, and insurance.
Key findings
01General pediatricians infrequently encountered children after an overnight or longer TBI hospital stay, and 43% reported no formal training in caring for children with TBI.
02Pediatricians recognized common early symptoms after complicated mild TBI, but 35.1% were unsure whether attention problems might result from the injury, and approximately 40 to 50% did not agree that emotional lability, depression, and social problems could occur at 15 months.
03For learning problems, 50.2% preferred referral to neuropsychology, but 56% were not able to refer to their preferred subspecialist; wait times, provider unavailability, and insurance were common barriers.
STILL TO COME
How it was doneWhat they found
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What it does not show
The response rate was low, with 576 completed surveys from 3,500 mailed, so the results may not represent all general pediatricians. If pediatricians interested in TBI were more likely to respond, the survey may overestimate pediatricians' knowledge. Respondents were more likely to be suburban, private practice pediatricians with a lower percent of publicly insured patients than a comparison survey, so they may have had more resources than other pediatricians. Pediatricians reported their own practice patterns, so responses may not match actual practice. The survey reports self-reported attitudes, knowledge, and behaviors, not patient outcomes or treatment effects.
Declared interests
The supplied metadata lists Research Support, N.I.H., Extramural. No author conflict-of-interest declaration is included in the supplied text.
The easy way to misread this
Do not conclude that all pediatricians lack long-term TBI knowledge. Only 16.5% of mailed surveys were completed, and respondents may have been more interested in TBI than nonrespondents.