Attending Follow-up Appointments After Pediatric Traumatic Brain Injury: Caregiver-Perceived Barriers and Facilitators

Abstract

Objective: 

To examine barriers and facilitators for follow-up care of children with traumatic brain injury (TBI).

Setting: 

Urban children's hospital.

Participants: 

Caregivers of children (aged 2-18 years) discharged from an inpatient unit with a TBI diagnosis in 2014-2015.

Design: 

Survey of caregivers.

Main Measures: 

Caregiver-reported barriers and facilitators to follow-up appointment attendance.

Results: 

The sample included 159 caregivers who completed the survey. The top 3 barriers were “no need” (38.5%), “schedule conflicts” (14.1%), and “lack of resources” (10.3%). The top 5 identified facilitators were “good hospital experience” (68.6%), “need” (37.8%), “sufficient resources” (35.8%), “well-coordinated appointments” (31.1%), and “provision of counseling and support” (27.6%). Caregivers with higher income were more likely to report “no need” as a barrier; females were less likely to do so. Nonwhite caregivers and those without private insurance were more likely to report “lack of resources” as a barrier. Females were more likely to report “good hospital experience” and “provision of counseling and support” as a facilitator. Nonwhite caregivers were more likely to report “need” but less likely to report “sufficient resources” as facilitators.

Conclusions: 

Care coordination, assistance with resources, and improvements in communication and the hospital experience are ways that adherence might be enhanced.