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A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion
Published on: September 25, 2014
Physicians' Perspectives on Adolescent Return-to-Drive Post-Concussion: A Qualitative Study
Taylor Hartlaub1, Lindsay Sullivan, Vishaka Kalra
1Author Affiliations:Taylor Hartlaub, Department of Pediatrics, St. Rita's Medical Center, Lima, Ohio, USA (Dr Hartlaub); Division of Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, Ohio, USA (Dr Sullivan); Department of Psychological & Brain Sciences, Texas A&M University, College Station, Texas, USA (Ms Kalra); Center for Injury Research and Policy at the Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA (Ms Kalra); Division of Sports Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA (Dr Cuff); Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA (Dr Cuff); Institute for Social Science Research, The University of Alabama, Tuscaloosa, Alabama, USA (Dr Stavrinos); and Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA (Dr Stavrinos).
Objective:
To explore physicians' views and practices regarding driving following concussion, with a particular focus on return-to-drive recommendations for adolescents.
Setting:
Health care.
Participants:
A total of 11 participating physicians from various medical specialties, with 7 in Sports Medicine, 2 in Physical Medicine and Rehabilitation, 1 in Emergency Medicine, and 1 in Family Medicine.
Design:
Qualitative interview study using virtual, semi-structured interviews.
Main Measures:
Views and practices regarding return-to-drive protocols for adolescent patients following concussion.
Results:
Eleven interviews were conducted with 6 male and 5 female physicians. Two researchers independently coded the verbatim transcripts using systematic, open, and focused coding. Three major themes were identified regarding physicians' views and practices on return-to-drive following concussion: (1) evidence, (2) determinants, and (3) recommendations. Physicians expressed that the lack of clear evidence regarding the timing of safe return-to-drive contributed to their discomfort and infrequent discussions of the subject with their patients. The content and timing of return-to-drive discussions varied among physicians and were influenced by several factors, including the timing of initial and follow-up clinical visits, the physician's experience and comfort level, and the perceived receptivity and compliance of the adolescent with the recommendations. Physicians emphasized that return-to-drive guidelines should be tailored to each patient's unique recovery trajectory and needs, rather than following a one-size-fits-all approach.
Conclusion:
These findings underscore the urgent need for evidence-based clinical guidance, particularly for adolescent drivers as they face heightened risk for both concussion and motor vehicle collisions. Currently, the absence of standardized protocol leads to inconsistent practices among physicians and inadequate guidance for recovering adolescents.
