Development and feasibility of an evidence-informed self-management education program in pediatric concussion rehabilitation.

BACKGROUND: Concussion is a considerable public health problem in youth. However, identifying, understanding and implementing best evidence informed recovery guidelines may be challenging for families given the vast amount of information available in the public domains (e.g. Internet). The objective of this study was to develop, implement and evaluate the feasibility of an evidence-informed self-management education program for concussion recovery in youth. METHODS: Synthesis of best evidence, principles of knowledge translation and exchange, and expert opinion were integrated within a self-management program framework to develop a comprehensive curriculum. The program was implemented and evaluated in a children's rehabilitation hospital within a universal health care system. A retrospective secondary analysis of anonymous data from a program evaluation survey was used to evaluate program feasibility, to identify features of importance to program participants and to assess changes in participants' knowledge. RESULTS: The program, "Concussion & You" includes a comprehensive, evidence informed, population specific curriculum that teaches participants practical strategies for management of return to school and play, sleep, nutrition, relaxation and energy conservation. A 'wheel of health' is used to facilitate participants' self-management action plan. Results from eighty-seven participant surveys indicate that the program is feasible and participant knowledge increased in all areas of the program with the highest changes reported in knowledge about sleep hygiene, rest and energy conservation. CONCLUSION: Findings indicate that "Concussion & You" is a feasible program that is acceptable to youth and their families, and fills a health system service gap.

Roles and Coping Strategies of Sons Caring for a Parent With Dementia.

OBJECTIVE: Little is known about sons' roles in caring for a parent with dementia. To ensure that interventions and practices appropriately match sons' needs, we investigated their experiences. METHOD: A qualitative descriptive approach was used; 20 sons of a parent with dementia participated in semistructured interviews. RESULTS: Participants reported varied paths to becoming a caregiver, primarily undertaking a care management role and managing by using their own occupational experiences and receiving support from other family members, peers, and private and public community services. They experienced negative consequences such as participation restriction and stress and positive consequences such as feelings of satisfaction. Strategies used to cope included boundary setting and practicing self-care. CONCLUSION: This study highlights the need to consider sons' role as care managers for their parent with dementia in community-based settings, as well as their need for education and intervention. Occupational therapy practitioners can use this information to inform their practices and support clients and their families.

A multi-modal approach to assessing recovery in youth athletes following concussion.

Concussion is one of the most commonly reported injuries amongst children and youth involved in sport participation. Following a concussion, youth can experience a range of short and long term neurobehavioral symptoms (somatic, cognitive and emotional/behavioral) that can have a significant impact on one's participation in daily activities and pursuits of interest (e.g., school, sports, work, family/social life, etc.). Despite this, there remains a paucity in clinically driven research aimed specifically at exploring concussion within the youth sport population, and more specifically, multi-modal approaches to measuring recovery. This article provides an overview of a novel and multi-modal approach to measuring recovery amongst youth athletes following concussion. The presented approach involves the use of both pre-injury/baseline testing and post-injury/follow-up testing to assess performance across a wide variety of domains (post-concussion symptoms, cognition, balance, strength, agility/motor skills and resting state heart rate variability). The goal of this research is to gain a more objective and accurate understanding of recovery following concussion in youth athletes (ages 10-18 years). Findings from this research can help to inform the development and use of improved approaches to concussion management and rehabilitation specific to the youth sport community.