RESUMO
BACKGROUND: Nearly 2 million youth seek acute medical care following concussion in the U.S. each year. Current standard of care recommends rest for the first 48 h after a concussion. However, research suggests that prolonged rest may lengthen recovery time especially for patients with certain risk profiles. Research indicates that physical activity and behavioral management interventions (sleep, stress management) may enhance recovery. To date, there is limited empirical evidence to inform acute (<72 h) concussion recommendations for physical activity and behavioral management in adolescents. OBJECTIVE: To determine the effectiveness of physical activity and behavioral management for acute concussion in adolescents and young adults, and to evaluate the role of patient characteristics on treatment response. METHODS: This multicenter prospective randomized controlled trial will determine which combination of physical activity and behavioral management is most effective for patients 11-24 years old who present to the emergency department or concussion clinic within 72 h of injury. Participants are randomized into: 1) rest, 2) physical activity, 3) mobile health application (mHealth) behavioral management, or 4) physical activity and mHealth app conditions. Assessments at enrollment, 3-5 days, 14 days, 1 month, and 2 months include: concussion symptoms, balance, vestibular-ocular and cognitive assessments, quality of life, and recovery time. Somatic symptoms and other risk factors are evaluated at enrollment. Compliance with treatment and symptoms are assessed daily using actigraph and daily self-report. The primary study outcome is symptoms at 14 days. CONCLUSION: Prescribed physical activity and behavioral management may improve outcomes in youth following acute concussion.
Assuntos
Concussão Encefálica , Síndrome Pós-Concussão , Adulto Jovem , Humanos , Adolescente , Criança , Adulto , Síndrome Pós-Concussão/terapia , Síndrome Pós-Concussão/diagnóstico , Síndrome Pós-Concussão/etiologia , Estudos Prospectivos , Qualidade de Vida , Concussão Encefálica/terapia , Exercício FísicoRESUMO
Shared leadership involves a process as well as a structure. Two key principles apply to all forms of shared leadership: a commitment to true partnership and a decision-making structure that allows for balance of power. In this article, the author shares her personal experience of facilitating a shared leadership model for staff on a unit level and also an executive model of shared leadership. The executive model was implemented during a transition after a traditional nursing leadership position was vacated. Lessons learned in facilitating a staff shared leadership model and participating in an executive model are discussed and contrasted. Relationships, dialogue, partnership, and an understanding of boundaries are essential elements for successful implementation of shared leadership at any level.
Assuntos
Tomada de Decisões Gerenciais , Relações Interpessoais , Liderança , Enfermeiros Administradores/organização & administração , Enfermeiros Administradores/psicologia , Supervisão de Enfermagem/organização & administração , Humanos , Aprendizagem , Modelos de Enfermagem , Modelos OrganizacionaisRESUMO
A mentoring relationship can be a dynamic process for both participants, one filled with increased self-awareness, commitment, and mutual respect. The time spent with a mentor guides the transition of theory into practice while clearly expressing the humanistic and caring qualities of the nurse administrator.
