A Longitudinal Study of Post - Concussion Syndrome in Patients with Mild Head Injury การศึกษาติดตามอาการภายหลังสมองได้รับการกระทบกระเทือนใน ผู้ป่วยบาดเจ็บที่ศีรษะระดับเล็กน้อย

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นิภาวรรณ สามารถกิจ

Abstract

This descriptive research aimed to explore and compare the occurrence of post-concussion symptoms of patients with mild head injury at 24 hours, 1 month, 2 month, 3 month and 6 month after the injury. Fifty-nine patients were consecutively recruited by the inclusion criteria at a Trauma ward of Chonburi Hospital during June 2016 to June 2017. Research instruments included the Personal Information questionnaire, and the Rivermead Post-Concussion Symptoms Questionnaire (RPQ). Data were analyzed by using descriptive statistics, and Repeated Measures ANOVA.


          The results showed that at 24 hours, the 1st month, 2nd month, 3th month and 6th month after head injury, the samples reported having all post-concussion symptoms. At 24 hours, most of them reported having physical symptoms more often than cognitive symptoms and behavioral symptoms. However, at the 1st, 2nd, 3th, and 6th month after head injury, the samples reported decreasing physical symptoms while increasing cognitive symptoms and behavioral symptoms. The mean scores of the severity of physical symptoms at 24 hours and the 1st month were significantly different (p < .05, p < .01), from those in the 2nd month, 3th month and 6th month post injury. The mean scores of the severity of cognitive symptoms at 24 hours was significantly different (p < .01, p < .05), from those in the 1st month and 2nd month post injury. However, the mean score of the severity of behavioral symptoms was not significantly different at all the time of the study.


The findings recommend that, nurses and health care providers should be aware that the patients post mild head injury may have post-concussion symptoms including physical symptoms, cognitive symptoms and behavioral symptoms. Symptoms assessment should be continuously performed in order to early manage any symptoms occurred and to provide appropriate care, for decreasing symptom severity and prevention persistent post-concussion symptoms, which is disable that can affect the long-term performance and quality of life among this population.

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Section
Research Articles; บทความวิจัย

References

1. Willer, B., Leddy, J.J. Management of Concussion and Post - Concussion Syndrome. Current Treatment Options in Neurology 2006; 8: 415-26.
2. Roe C, Sveen U, Alvsaker K, Bautz-Holter E. Post-concussion symptoms after mild traumatic brain injury: Influence of demographic factors and injury severity in a 1-year cohort study. Disability and Rehabilitation, 2009; 31(15), 1235-1243.
3. Hall Ryan CW, Hall Richard CW, Chapman MJ. Definition, diagnosis and forensic implications of postconcussional syndrome. Psychosomatics 2005; 46(3): 195-202.
4. Centers of Disease Control and Prevention [CDC]. Injury Prevention & Control: Traumatic Brain Injury. [database on Internet]. 2014 [Cited 2016 May 16]. Available from http://www.cdc.gov/concussion/index.html
5. Carr J. Postconcussion syndrome: a review. Trauma 2007; 9(1): 21-27.
6. Lundin A, de Boussard C, Edman G, Borg J. Symptoms and disability until 3months after mild TBI. Brain Injury 2006; 20(8): 799-806.
7. Premsai, T. Follow up study of patients’ adaptation after mild head injury. [Thesis]. Bangkok: Mahidol University; 2003.
8. Sigurdardottir S., Andelic N, Roe C, Jerstad T, Schanke AK. Post-concussion symptoms after brain injury at 3 and 12 months’ post-injury: A prospective study. Brain Injury, 2009; 23(6), 489-497.
9. Stalnacke BM, Bjornstig U, Karlsson K, Sojka P. One-year Follow-up of mild traumatic brain injury: Post-Concussion symptoms, Disabilities and Life Satisfaction in Relation to serum levels of S-100B and Neurone-Specific Enolase in acute phase. J Rehabil Med, 2005; 37, 300-305.
10. Savola O, Hillbom M. Early predictors of post-concussion syndroms in patients with mild head injury. European jounal of Neurology, 2003; 10(2), 175-181.
11. Stalnacke BM, Elgh E, Sojka P. One-year Follow-up of mild traumatic brain injury: Cognitive, Disability and Life Satisfaction of patients seeking consultation. J Rehabil Med, 2007; 39, 405-411.
12. Hawley C, Ward AB, Magnay A, Mychalkiw W. Return to school after brain injury. Archives of Disease in Childhood 2004; 89(2): 136-42.
13. Chong CS. Management strategies for post-concussion syndrome after mild head injury: A systematic review. Hong Kong Journal of Occupational Therapy. 2008; 18(2): 59-67.
14. Pataraporn K, Waraporn C, Chanokporn J. Healthy of Traumatic Brain Injury Patients in Thailand: A Systematic Review. Journal of Nursing Science Chulalongkorn University 2010; 22 Suppl 1: S1-21. (in Thai).
15. Lenz ER, Pugh LC, Milligan RA, Audrey G, Frederic S. The middle-range theory of unpleasant symptom: an update. Advance in Nursing Science. 1997; 19(3): 14-27.
16. Stevens JP. Applied multivariate statistics for the social sciences. USA: Lawrence Erlbaum Associates. 2002.
17. Bazarian JJ, Blyth B, Cimpello L. Bench to bedside: Evidence for brain injury after concussion-looking beyond the computed tomography scan. Academic Emergency Medicine. 2006; 13, 199-214.