Exploring the experiences of youth with persistent post-concussion symptoms and their families with an interprofessional team-based assessment

ABSTRACT

A proportion of youth who experience concussion develop persistent or prolonged post-concussion symptoms (PPCS). Owing to the complex clinical presentation of PPCS, an interprofessional approach to care is increasingly recommended. Despite increased research in this area, there remains a dearth of evidence from the perspective of the recipients of interprofessional concussion care. The objective of this qualitative descriptive study was to explore the experiences of youth with PPCS and their parents who participated in an interdisciplinary team-based assessment (ITA) at a children’s rehabilitation hospital in Ontario, Canada. Semi-structured interviews were conducted with fifteen individuals (eight youth [8–17 years] and seven parents). Results suggest that the ITA serves as a context for meaningful therapeutic interactions whereby youth, their parents, and the interprofessional team establish and build therapeutic relationships, engage in dialogue emphasizing collaboration, prioritize the young person rather than the injury, and co-create an individualized treatment plan. Results are discussed within the broader literature in the areas of client and family-centered care, interdisciplinary assessment, and concussion management.

KEYWORDS:

• Interprofessional care
• concussion
• pediatrics
• qualitative
• patient and family centered-care

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Acknowledgments

We would like to acknowledge all of the clients and families that participated in this research, as well as the members of the Persistent Concussion Clinic at Holland Bloorview Kids Rehabilitation Hospital, specifically: Nicholas Joachimides, Elaine Widgett, Kim Moody, Laurin Black, Dr. Janine Hay, Dr. Lily Riggs, Meghan Toswell, Tess Bardikoff, Dr. Peter Rumney, Dr. Alysha Ladha, Dr. Ryan Hung, Cyndy Bryson, Debra Moroz, Erin Kohlmetz, Christa MacDonald, and Charlotte Coy. We would like to acknowledge the efforts of the members of the NOvEL Lab Team (Bloorview Research Institute), specifically Dr. Sabrina Agnihotri and Christine Provvidenza. We would also like to thank Dr. Christine Till and Dr. Nick Reed for their collaboration.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/13561820.2022.2137482.

Additional information

Funding

This work was supported by the Centre for Leadership at Holland Bloorview Kids Rehabilitation Hospital.

Notes on contributors

Andrea Hickling

Andrea Hickling is an occupational therapist in the Persistent Concussion Clinic at Holland Bloorview Kids Rehabilitation Hospital (Toronto, Canada), and supports youth and their families in returning to meaningful activities after concussion. Andrea is a Research Manager in the NOvEL Lab (Neurorehab Outcomes via Education & Learning) at the Bloorview Research Institute. She holds a status-only appointment as a lecturer in the Department of Occupational Science and Occupational Therapy at the University of Toronto. Andrea has a passion for integrating research and clinical care, and is enthusiastic about implementing creative solutions in the healthcare setting.

Katie Mah

Katie Mah is a Postdoctoral Associate at Western University (London, Canada) supervised by Dr. Gail Teachman. She is a trainee with CRED (Childhood Rehabilitation Ethics Disability lab) at Western University , and the NOvEL Lab (Neurorehab Outcomes via Education & Learning) at Holland Bloorview Kids Rehabilitation Hospital (Toronto, Canada). Drawing on her background in nursing and occupational therapy, and her lived experience of concussion, Katie’s research aims to disrupt conventional ways of thinking and knowing about concussion and young people, while challenging clinicians and researchers to (re)imagine concussion education, care, and research. She is supported in this work by a Mitacs Elevate Postdoctoral Fellowship and project funding provided by VOICE: Views on Interdisciplinary Childhood Ethics at McGill University (Montreal, Canada).

Hiba Al-Hakeem

Hiba Al-Hakeem is a PhD student in Clinical Neuropsychology at the University of Windsor. She is also a trainee with the NOvEL Lab (Neurorehab Outcomes via Education & Learning Lab) at the Bloorview Research Institute. Her research is focused on interdisciplinary interventions that aim to support youth with persistent post-concussion symptoms and their families.

Shannon E. Scratch

Shannon Scratch is a clinician scientist at the Bloorview Research Institute, practicing clinical neuropsychologist at Holland Bloorview Kids Rehabilitation Hospital (Toronto, Canada), assistant professor in the Department of Paediatrics, and a member of the Rehabilitation Sciences Institute at the University of Toronto. She also holds the Holland Family Professorship in Acquired Brain Injury, which is an early career hospital-endowed research chair. She is the director of the NOvEL Lab (Neurorehab Outcomes via Education & Learning) Lab team who develop and test interventions for youth experiencing prolonged symptoms post-concussion or moderate-severe acquired brain injury, and their families.