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Updated: Apr 17, 2026
Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion
Published on: January 20, 2019
The headache electronic diary for children with concussion
Tracy Ann Pasek1, Lisa W Locasto, Joseph Reichard
1Author Affiliations: Clinical Nurse Specialist (Dr Pasek), Pain/Pediatric Intensive Care Unit, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center (UPMC); Assistant Professor of Nursing (Dr Locasto), Robert Morris University, Pittsburgh; Software Engineer Consultant (Mr Reichard) and Neuropsychologist (Dr Fazio Sumrok), UPMC Sports Medicine Concussion Program; Neuropsychologist, UPMC Sports Medicine Concussion Program, and Assistant Professor (Dr Johnson), Department of Orthopaedic Surgery, University of Pittsburgh; and Assistant Research Director, UPMC Sports Medicine Concussion Program, and Associate Professor (Dr Kontos), Department of Orthopaedic Surgery, University of Pittsburgh, Pennsylvania.
Purpose/Objectives:
The purposes of the study were to (1) develop a prospective, real time, age-appropriate, and appealing prototype of an electronic headache pain diary for children and (2) evaluate the clinical feasibility and utility of the diary for the assessment and documentation of concussion headache.
Design:
A mixed-methods design of qualitative interviews and a quantitative survey was used.
Setting:
The setting was a sports medicine concussion clinic.
Sample:
The sample included 2 independent groups of 30 children (females n = 36, males n = 24) each aged 12 to 17 years, with postconcussion headache and pediatric concussion expert clinicians (n = 5).
Methods:
During phase 1 of the study, subjects were interviewed individually about their headaches and their ideas for an electronic diary. A prototype was developed using these children's interview data. In phase 2 of the study, both children and clinicians piloted the prototype. Clinicians' survey data regarding the feasibility and utility of the diary were examined using thematic and descriptive analyses.
Results:
The phase 1 sample recommended a diary with calendar and clock functions, head views, menus (eg, pain descriptors), soft colors, a choice of pain assessment scales, and the ability to personalize it. All of the children thought that the new Headache Electronic Diary for Children With Concussion (HED-CC) would be helpful to track their headache and reported that other children with concussions would be likely to use it. Participants recommended improvement of the head views and clock function. In phase 2 of the study, all clinicians reported that the new HED-CC measure was feasible and useful for the assessment and documentation of headache.
Conclusions:
The new HED-CC provides for thorough assessment and documentation of postconcussion headache. Proactive, real-time measurement helps children remember the details of their headache pain and correlating events/circumstances. An appealing, age-appropriate measure increases the likelihood of children's symptom tracking and data accuracy. The HED-CC will improve clinicians' understanding of postconcussion headache and guide treatment. Additional testing with a larger sample is required to establish clinical application benefits and improve reliability/validity of the new measure.
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