Attitudes and Perceptions of Concussion in Nonathlete Adolescents: School-Based Team Perspectives

PURPOSE: The purpose of this research is to understand the effects of current attitudes and perceptions surrounding non-athlete adolescents who experience a concussion(s). There is a clear gap in the knowledge base regarding perceptions of a concussion diagnosis from members of a primary care team, specifically in non-athlete adolescents. Healthcare professionals are unsure of their role in post-concussion management (Welch Bacon, 2017). Furthermore, evidence has also shown that the etiology of the concussion injury can lead to clinician bias (Graves & Klein, 2017). Therefore, this research study explored perceptions of members of a school-based team on the concussion diagnosis in non-athlete adolescents.

DESIGN: A Mixed-methods approach was utilized in this inquiry. Specifically, an explanatory sequential design was utilized, where quantitative data is first collected and analyzed, which in turn informed the qualitative data collection and analysis. To be involved with this research project participants met the inclusion criteria of being employed by a Maine school system, a person who interfaces with students between the ages of 10-18 years old in school-based activities (teachers, nurses, support staff, etc). Similarly, individuals could not participate in this research project if they are school-based team members working solely with adolescents who acquired a concussion from participating in sports. Snowball sampling was used to recruit participants as well as E-Surveys sent via email and social media.

METHOD: Researchers electronically sent surveys to our sample population of school-based teams located in Maine. Surveys included questions on individuals attitudes, perceptions and experiences working with non-athlete adolescents with concussions. The researchers collected quantitative data using a Likert scale on the providers perceptions and attitudes on non-athlete adolescents with concussions. Participants were asked to provide contact information for follow-up interviews, which were conducted and recorded via Zoom. Interviews were semi-structured, and included prompts that expanded on the quantitative data collected in the survey. Researchers then analyzed the deidentified Zoom recording transcripts and utilized line by line coding to delineate overarching themes in the interviews. Once coding and thematic analysis of the qualitative data was completed, the quantitative and qualitative results were analyzed together to provide insight into the research question.

RESULTS: Overall, participants agreed that a concussion impacts both physical and mental well being in adolescents. Participants reported high levels of confidence regarding concussion management, yet only 58% of participants reported formal training about concussion in adolescents. Additionally, participants endorsed complete rest as the best intervention following concussion, which is not supported in the current literature. Participants also reported limited cross-professional communication related to non-athlete adolescents compared to athletes, and a high reliance on nursing and athletic training staff for concussion management.

CONCLUSION AND IMPACT STATEMENT: Initial findings indicate that there is a need for increased concussion training in schools, which school-based occupational therapy practitioners can be instrumental in providing holistic and collaborative education. By providing more comprehensive and occupation-centered education, school-based teams may better understand and support adolescent non-athletes as they engage in their primary occupation of education. This training should include signs and symptoms of concussions, current treatment options, and how concussions can impact occupational participation and engagement in adolescents.

References

Graves, J. M., & Klein, T. A. (2017). The impact of patient characteristics on nurse practitioners’ assessment and management of adolescent concussion. Journal of the American Association of Nurse Practitioners, 29(3), 136–148. https://doi-org.une.idm.oclc.org/10.1002/2327-6924.12431

Welch Bacon, C. E., Erickson, C. D., Kay, M. C., Weber, M. L., & Valovich McLeod, T. C. (2017). School nurses’ perceptions and experiences with an interprofessional concussion management team in the secondary school setting. Journal of Interprofessional Care, 31(6), 725-733. https://doi.org/10.1080/13561820.2017.1345873