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Symptoms Associated With Mild Traumatic Brain Injury/Concussion: The Role of Bother

Bergman, Karen; Given, Barbara; Fabiano, Robert; Schutte, Debra; von Eye, Alexander; Davidson, Scott

Journal of Neuroscience Nursing: June 2013 - Volume 45 - Issue 3 - p 124–132
doi: 10.1097/JNN.0b013e31828a418b

ABSTRACT Traumatic brain injury (TBI) affects 1.4 million Americans annually, and mild TBI (MTBI) accounts for approximately 75% of those injured. For those with mild injury who seek treatment in an emergency department, there is inconsistency in the management and follow-up recommendations. Approximately, 38% of patients treated in the emergency department for MTBI are discharged with no recommendations for follow-up. In addition, there are an unknown number of persons with MTBI who do not seek healthcare after their injury. Persons with MTBI are, for the most part, managing their concussion symptoms on their own. The purpose of this study was to describe the symptom experience for persons with mild TBI and identify whether there was an association between being bothered by symptoms and self-management of symptoms. The sample for this study included 30 persons with MTBI and a 30-person comparison group. Results indicate that persons within 3 months of their MTBI report an average of 19 symptoms, whereas the comparison group reported six symptoms, and that the most frequently reported symptoms are not always the symptoms rated as most severe or most bothersome. Persons with MTBI reported their most common symptoms to be headache (n = 25, 83%), feeling tired (n = 24, 80%), difficulty thinking and being irritable (each n = 22, 73%), dizziness, trouble remembering, and being forgetful (each n = 21, 70%). There is a significant relationship between overall reports of being bothered by symptoms and the use of symptom management strategies (F = 8.322, p = .008). Persons are more likely to use symptom management strategies when they are bothered by the symptoms. Nurses can assist with symptom self-management by providing simple symptom management strategies to assist with the symptom management process. Early symptom management for the MTBI population may improve the outcomes such as return to work and role functions, for this population.

Questions or comments about this article may be directed to Karen Bergman, PhD RN CNRN, at She is an Assistant Professor at Western Michigan University and a Neuroscience Coordinator at Bronson Methodist Hospital, Kalamazoo, MI.

Barbara Given, PhD RN FAAN, is a University Distinguished Professor at Michigan State University, East Lansing, MI.

Robert Fabiano, PhD, is a Psychologist at PAR Rehabilitation, Lansing, MI.

Debra Schutte, PhD RN, is an Associate Professor at Michigan State University, East Lansing, MI.

Alexander von Eye, PhD, is a Professor at Michigan State University, East Lansing, MI.

Scott Davidson, MD, is a Trauma Surgeon at Bronson Hospital, Kalamazoo, MI.

The authors declare no conflicts of interest.

© 2013 American Association of Neuroscience Nurses