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. 2017 Dec;98(12):2548-2552.
doi: 10.1016/j.apmr.2017.06.007. Epub 2017 Jul 5.

Perception of Barriers to the Diagnosis and Receipt of Treatment for Neuropsychiatric Disturbances After Traumatic Brain Injury

Jennifer S Albrecht  1 , Lyndsay M O'Hara  2 , Kara A Moser  2 , C Daniel Mullins  3 , Vani Rao  4
Affiliations

Perception of Barriers to the Diagnosis and Receipt of Treatment for Neuropsychiatric Disturbances After Traumatic Brain Injury

Jennifer S Albrecht et al. Arch Phys Med Rehabil. 2017 Dec.

Abstract

Objective: To explore perceptions of barriers and facilitators to the diagnosis and receipt of treatment for neuropsychiatric disturbances (NPDs) after traumatic brain injury (TBI).

Design: Qualitative study using semistructured interviews and focus groups.

Setting: A clinic specializing in the treatment of TBI NPDs, an urban trauma center, and a large urban academic hospital.

Participants: A sample (N=33) of health care providers (n=10) who treat individuals with TBI, persons with TBI (n=18), and caregivers (n=5).

Interventions: Not applicable.

Main outcome measures: Topic guides for the interviews and focus groups were guided by previous literature, clinical experience, and the goals of the project and focused on the 3 most common TBI NPDs: depression, anxiety, and posttraumatic stress disorder. The interviews and focus groups were audio-recorded and transcribed verbatim. We performed a conventional content analysis on the transcripts and grouped concepts into overall themes, incorporating feedback from stakeholders.

Results: Patient education, insurance, provider type, time since TBI, caregiver support, and recognition or screening for TBI NPDs were the most frequently mentioned barriers or facilitators to the diagnosis and treatment of TBI NPDs by both interview and focus group participants. We grouped these and other frequently mentioned concepts into 3 broad themes: education, access, and support. Each of these themes is explored in depth and supported with direct quotations.

Conclusions: This study explored patient, caregiver, and health care provider and identified barriers and facilitators to the diagnosis and receipt of treatment for TBI NPDs. Barriers included poor provider education on TBI NPDs and limited access to care due to lack of insurance, transportation, and income. Facilitators included patient education on TBI NPDs and strong caregiver support. Future studies should develop and pilot interventions aimed at quality of care that address the identified barriers and facilitators.

Keywords: Brain injury; Mental disorders; Rehabilitation.

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Factors Contributing to Diagnosis and Treatment of Psychiatric Disturbances following TBI
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References

    1. National Hospital Discharge Survey (NHDS), 2010; National Hospital Ambulatory Medical Care Survey (NHAMCS), 2010; National Vital Statistics System (NVSS), 2010. All data sources are maintained by the CDC National Center for Health Statistics
    1. Faul M, Xu L, Wald MM, Coronado VG. Traumatic brain injury in the United States: emergency department visits, hospitalizations, and deaths Atlanta (GA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2010.
    1. Rosenthal M, Christensen BK, Ross TP. Depression Following Traumatic Brain Injury. Arch Phys Med Rehabil. 1998;79: 90–103 - PubMed
    1. Rapoport MJ, Kiss A, Feinstein A. The Impact of Depression on Outcome Following Mild-to-Moderate Traumatic Brain Injury in Older Adults. Journal of Affective Disorders. 2006. 92:273–276 - PubMed
    1. Dikmen SS, Bombardier CH, Machamer JE, Fann JR, Temkin NR. Natural History of Depression in Traumatic Brain Injury. Arch Phys Med Rehabil. 2004. 85: 1457–1464 - PubMed

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