Attending Follow-up Appointments After Pediatric Traumatic Brain Injury: Caregiver-Perceived Barriers and Facilitators

J Head Trauma Rehabil. 2019 Mar/Apr;34(2):E21-E34. doi: 10.1097/HTR.0000000000000433.

Abstract

Objective: To examine barriers and facilitators for follow-up care of children with traumatic brain injury (TBI).

Setting: Urban children's hospital.

Participants: Caregivers of children (aged 2-18 years) discharged from an inpatient unit with a TBI diagnosis in 2014-2015.

Design: Survey of caregivers.

Main measures: Caregiver-reported barriers and facilitators to follow-up appointment attendance.

Results: The sample included 159 caregivers who completed the survey. The top 3 barriers were "no need" (38.5%), "schedule conflicts" (14.1%), and "lack of resources" (10.3%). The top 5 identified facilitators were "good hospital experience" (68.6%), "need" (37.8%), "sufficient resources" (35.8%), "well-coordinated appointments" (31.1%), and "provision of counseling and support" (27.6%). Caregivers with higher income were more likely to report "no need" as a barrier; females were less likely to do so. Nonwhite caregivers and those without private insurance were more likely to report "lack of resources" as a barrier. Females were more likely to report "good hospital experience" and "provision of counseling and support" as a facilitator. Nonwhite caregivers were more likely to report "need" but less likely to report "sufficient resources" as facilitators.

Conclusions: Care coordination, assistance with resources, and improvements in communication and the hospital experience are ways that adherence might be enhanced.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Brain Injuries, Traumatic / epidemiology*
  • Caregivers*
  • Child
  • Child, Preschool
  • Continuity of Patient Care*
  • Female
  • Hospitals, Pediatric
  • Hospitals, Urban
  • Humans
  • Income
  • Insurance Coverage
  • Male
  • Office Visits*
  • Parents*
  • Race Factors
  • Sex Factors
  • Surveys and Questionnaires