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This study used a quasi-experimental research design with pretest-posttest and control groups aimed at evaluating the effects of a continuing care program on the perceived self-efficacy of caregivers and post-concussion syndrome in persons with mild traumatic brain injury (mild TBI). The study was undertaken at a university hospital in Pathum Thani, Thailand from May 2017 to January 2018. A total of 72 mild TBI patients and their caregivers that met the inclusion criteria was studied. The experimental group participated in the continuing care program, designed based on self-efficacy theory and the concept of continuing care, whereas the control group received usual care by the nursing staff. The instruments used were a demographic questionnaire, the self-efficacy scale for mild TBI patient care, the Rivermead Post-Concussion Symptom Questionnaire, a continuing care program, a video regarding the caregiver’s experience in caring for mild TBI, and a handbook for mild TBI patients. Data were analyzed using descriptive statistics, independent sample t-test, and repeated measures ANOVA. The findings showed that the experimental group had a significantly greater mean score on the self-efficacy scale for caring for patients at weeks 1 and 4 after being discharged from the hospital, and greater than the control group (p<.001). The experimental group decreased its mean score for post-concussion syndrome at weeks 1, 4, and 6 after being discharged from the hospital and the score was less than that of the control group (p<.05). These results demonstrated that a continuing care program can increase the perceived self-efficacy of caregivers and decrease the post-concussion syndrome in persons with mild TBI. Healthcare teams can apply this program to prepare caregivers and persons with mild TBI, after being discharged from the hospital, for the prevention of the post-concussion syndrome and complications especially during the first 4 week.
บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการตีพิมพ์ในรามาธิบดีพยาบาลสาร ถือเป็นลิขสิทธิ์ของวารสาร หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่หรือเพื่อกระทำการใด ใด จะต้องได้รับอนุญาตเป็นลายลักษณ์อักษรจากรามาธิบดีพยาบาลสารก่อนเท่านั้น
2. National Center for Injury Prevention and Control (US). Report to congress on mild traumatic brain injury in the United States: steps to prevent a serious public health problem. Centers for Disease Control and Prevention; 2003.
3. Bureau of Epidemiology, Department of Disease Control Ministry of Public Health. Epidemiological study on road traffic injury with focus motorcycle injuries and policy recommendations; 2014. [cited 2016 May 14]. Available from: https://220.127.116.11/nphss/home.php (in Thai)
4. National Center for Injury Prevention and Control (US). Report to congress on mild traumatic brain injury in the United States: steps to prevent a serious public health problem. Centers for Disease Control and Prevention; 2006.
5. Imhof HG, Lenzlinger PM. Management of traumatic brain injury. European Journal of Trauma. 2005;31(4):331-43.
6. Kliangda R. Experiences of headache, management strategies and health-related quality of life in patients with mild traumatic brain injury [thesis]. Bangkok: Mahidol University; 2009. (in Thai)
7. Buranavanich W, Pearkao P. Quality of life and symptoms among adults after mild traumatic brain injury in Maharat Nakhonratchasima Hospital. Journal of Nurses Association of Thailand, North-Eastern Division. 2012;30(2):82-8. (in Thai)
8. Eisenberg MA, Meehan WP, Mannix R. Duration and course of post-concussive symptoms. Pediatrics. 2014;133(6):999-1006.
9. Sterr A, Herron KA, Hayward C, Montaldi D. Are mild head injuries as mild as we think? Neurobehavioral concomitants of chronic post-concussion syndrome. BMC Neurol. 2006;6:7. doi: 10.1186/1471-2377-6-7
10. Scholten AC, Haagsma JA, Andriessen TM, Vos PE, Steyerberg EW, Van Beeck EF, et al. Health-related quality of life after mild, moderate and severe traumatic brain injury: patterns and predictors of suboptimal functioning during the first year after injury. Injury. 2015;46(4):616-24.
11. Yang CC, Tu YK, Hua MS, Huang SJ. The association between the postconcussion symptoms and clinical outcomes for patients with mild traumatic brain injury. J Trauma Acute Care Surg. 2007;62(3):657-63.
12. King, N. S. Post-concussion syndrome: clarity amid the controversy?. Br J Psychiatry. 2003:183(4), 276-78.
13. Carroll L, Cassidy JD, Peloso P, Borg J, Von Holst H, Holm L, et al. Prognosis for mild traumatic brain injury: results of the WHO collaborating centre task force on mild traumatic brain injury. J Rehabil Med. 2004;36(0):84-105.
14. Ponsford J, Willmott C, Rothwell A, Cameron P, Kelly AM, Nelms R, et al. Factors influencing outcome following mild traumatic brain injury in adults. J Int Neuropsychol Soc. 2000 Jul;6(5):568-79.
15. Rose SC, Fischer AN, Heyer GL. How long is too long? The lack of consensus regarding the post-concussion syndrome diagnosis. Brain Injury. 2015;29(7-8):798-803.
16. Laborey M, Masson F, Ribéreau-Gayon R, Zongo D, Salmi LR, Lagarde E. Specificity of postconcussion symptoms at 3 months after mild traumatic brain injury: results from a comparative cohort study. J Head Trauma Rehabil. 2014;29(1):E28-36.
17. Binder LM, Rohling ML, Larrabee GJ. A review of mild head trauma. Part I: Meta-analytic review of neuropsychological studies. J Clin Exp Neuropsychol. 1997;19(3):421-31.
18. Heng KW, Tham KY, How KY, Foo JS, Lau YH, Li AY. Recall of discharge advice given to patients with minor head injury presenting to a Singapore emergency department. 2007;48(12):1107-10.
19. Bazarian J, Hartman M, Delahunta E. Review of subject minor head injury: predicting follow-up after discharge from the emergency department. Brain Injury. 2000;14(3):285-94.
20. Bergman K, Bay E. Mild traumatic brain injury/concussion: a review for ED nurses. J Emerg Nurs. 2010 May 1;36(3):221-30.
21. Komet O, Sangchan H, Hirunchunha S. Relationships of perceived susceptibility and perceived severity to intracranial hemorrhage monitoring in persons with mild traumatic brain injury and their caregivers. Thai Journal of Nursing Council [Internet]. 2012 [cited 17 Jul 2014];25(2):54. Available from: https://www.tci-thaijo.org/index.php/TJONC/article/view/2609. (in Thai)
22. Thailand Nursing and Midwifery Council. Standard of nursing and midwifery service organization. 2014. [10 May 2018]. Available from: https://tnmc.or.th/images/userfiles/files/M001(1).pdf (in Thai)
23. Coleman EA, Parry C, Chalmers SA, Chugh A, Mahoney E. The central role of performance measurement in improving the quality of transitional care. Home Health Care Serv Q. 2007;26(4):93-104
24. Bandura A. Self-efficacy: The exercise of control. Macmillan; 1997.
25. Sawing P, Phuenpathom N, Weerathat K. Clinical practice guidelines for traumatic brain injury. Bangkok: Thanaplace; 2013. (in Thai)
26. Whittaker R, Kemp S, House A. Illness perceptions and outcome in mild head injury: a longitudinal study. J Neurol Neurosurg Psychiatry. 2007;78(6):644-6.
27. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007,39(2):91- 175.
28. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3.0.10 [Internet]. 2008 (cited 2016 Feb 5). Available from: https://www.brothersoft.com/gpower-405573.html
29. Srisompotch S, Unhasuta K, Kasemkitwattana S, Asadornvised Usawadee. Effect of individual teaching on capability for daily activities and complications in patients with mild head injury [thesis]. Nakhon Pathom: Mahidol University; 2005. (in Thai)
30. Premsai T, Sirapo-Ngam Y, Putwatana P. Follow up study of patients’ adaptation after mild head injury [thesis]. Nakhon Pathom: Mahidol University. Bangkok; 2005. (in Thai)
31. Firmawati E, Songwathana P, Kitrungrote L. Effect of Self-Efficacy Enhancing Education Program on Family Caregivers’ Competencies in Caring for Patients with mild Traumatic Brain Injury in Yogyakarta, Indonesia. Nurse Media Journal of Nursing. 2014;4(2):767-83.
32. Caron CD, Griffith J, Arcand M. Decision making at the end of life in dementia: how family caregivers perceive their interactions with health care providers in long-term-care settings. J Appl Gerontol T. 2005;24(3):231-47.
33. McCarthy DM, Engel KG, Buckley BA, Forth VE, Schmidt MJ, Adams JG, et al. Emergency department discharge instructions: lessons learned through developing new patient education materials. Emerg Med Int. 2012;2012. 306859. doi: 10.1155/2012/306859
34. Poramaporn N. Effect of educational program for caregivers on caring of patient with minor head injury [Thesis]. Chiangmai: Chiangmai University; 2005. (in Thai)
35. Chaiwongnakkapun C, Jinawin S, Yottavee W. Impact of supportive-educative nursing system on stress and caring abilities in neuro patients caregivers.The Southern College Network Journal of Nursing and Public Health. 2017;4(3):203-17. (in Thai)
36. Lundin A, de Boussard C, Edman G, Borg J. Symptoms and disability until 3 months after mild TBI. Brain Injury. 2006;20(8):799-806.
37. Nelson LD, Furger RE, Ranson J, Tarima S, Hammeke TA, Randolph C, et al. Acute clinical predictors of symptom recovery in emergency department patients with uncomplicated mild traumatic brain injury or non-traumatic brain injuries. J Neurotrauma. 2018;35(2):249-59.
38. Makkhunthod W, Masingboon K, Kunsongkeit W. Effects of a discharge preparedness program for mild traumatic brain injury patients and caregivers on post concussion symptoms and re-hospitalization [Thesis]. Burapha University; 2012. (in Thai)