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Pediatricians' Knowledge, Attitudes, and Behaviors to Screening Children After Complicated Mild TBI: A Survey
Heather T Keenan1, Susan L Bratton, Rebecca R Dixon
1Department of Pediatrics, University of Utah, Salt Lake City.
Insights
Pediatricians surveyed feel ill-equipped to manage children with complicated mild traumatic brain injury (TBI) sequelae. They need better educational and referral support for optimal pediatric TBI care.
Area of Science:
- Pediatric neurology
- Neurotrauma
- Clinical practice research
Background:
- Mild traumatic brain injury (TBI) can lead to significant cognitive and behavioral sequelae in children.
- Pediatricians play a crucial role in the initial management and follow-up care of children with TBI.
- Understanding pediatricians' perspectives is vital for improving care pathways for complicated mild TBI.
Purpose of the Study:
- To assess pediatricians' knowledge, attitudes, and practices regarding the care of children with complicated mild TBI.
- To identify barriers pediatricians face in managing TBI sequelae and accessing specialist referrals.
- To inform the development of targeted educational and support resources for pediatricians.
Main Methods:
- A cross-sectional survey was administered to a random sample of 3500 pediatricians from the American Medical Association Master File.
- The survey assessed attitudes towards long-term TBI follow-up, knowledge of TBI sequelae, and current management practices.
- A total of 576 (16.5%) pediatricians completed the survey.
Main Results:
- Most surveyed pediatricians (51%) manage 1-2 children with complicated mild TBI annually.
- A majority of pediatricians do not believe they are the primary clinicians for managing cognitive (74%) or behavioral (54%) sequelae of complicated mild TBI.
- Pediatricians reported challenges in referring children for cognitive (56%) and behavioral (48%) specialty services, despite good knowledge of short-term TBI complications.
Conclusions:
- Pediatricians often feel they are not the primary care providers for children with complicated mild TBI, yet specialist access is limited.
- There is a clear need for enhanced educational resources and improved referral pathways to support pediatricians in managing TBI sequelae.
- Strengthening pediatrician capacity is essential for effective surveillance and care of children affected by complicated mild TBI.
Objective:
To understand pediatricians' attitudes, knowledge, and behaviors about the care of children with complicated mild traumatic brain injury (TBI).
Participants:
A total of 3500 pediatricians randomly selected from the American Medical Association Master File.
Design:
It was a cross-sectional survey.
Main Measures:
A survey developed to assess pediatricians' attitudes toward following children with complicated mild TBI for cognitive and behavioral sequelae; their knowledge of TBI sequelae; and their usual evaluation and management of children after TBI.
Results:
There were 576 (16.5%) completed responses. Most pediatricians (51%) see 1 or 2 patients with complicated mild TBI annually. Most do not think that pediatricians are the correct clinician group to be primarily responsible for following children with complicated mild TBI for cognitive (74%) or behavioral sequelae (54%). Pediatricians report difficulty referring children for cognitive (56%) and behavioral (48%) specialty services. Pediatricians have good knowledge of short-term complications of complicated mild TBI.
Conclusion:
Pediatricians do not think they are the clinicians that should primarily care for children after hospitalization for complicated mild TBI; however, other clinicians are frequently not accessible. Pediatricians need educational and referral support to provide surveillance for injury sequelae in this group of children.
