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Poster 79 Evaluating Access to Appropriate Concussion Care in Ontario
e38 2. Appearance, intimacy, and sexuality: Interpersonal relationships, personal safety, and risk of victimization. 3. Hormone imbalances: achieving and maintaining physical and mental health. Conclusions: The study explored the role of gender normative social expectations in successful community re-integration, illustrated the complex physical, social and environmental issues faced by women with ABI and identified limitations in current health care services. It highlighted the need for knowledgeable professionals, and individualized and functional supports for these women to help them lead a fulfilling life. Since there is limited gendered information and research, this study is an appropriate starting point and will form the basis for future full scale research. Disclosure: Halina Haag has nothing to disclose. Poster 77 WITHDRAWN
Traumatic Brain Injury (TBI) Diagnosis the 21 consented participants using an unstructured interview guide. Interviews were 20 to 60 minutes long, audio-recorded, and transcribed. Two investigators independently coded the transcripts based on the six identified themes. Based on initial coding, a seventh theme was identified: people. Two research assistants counted code frequency and coded across themes. Medical records were abstracted for injury-related information. Main Outcome Measures: Seven transition themes Results: The 21 transcripts had 585 coded segments, a mean of 29 per person. Themes addressed most frequently: “People” (373 coded segments), “Finding a balance between privacy and independence” (154), “Defining a new purpose in life” (113), and “Transitioning to more or less structure” (110). Themes addressed least frequently: “Experiencing faith, fulfillment & acceptance re disability” (78 coded segments), “Feeling invested in the process” (70), and “Practicing hobbies and interests” (60). Conclusions: Individuals being transitioned are not always engaged in the process (family members do most of the work); the most recent transition may be the latest of many; and co-morbidities complicate the transition process. Study limitations and implications of findings will be discussed. Key Words: Qualitative research; Chronic brain injury; Patient-centered care; Independent living Disclosure: Laura Lorenz has nothing to disclose.
Poster 79 Evaluating Access to Appropriate Concussion Care in Ontario Laura Langer (University Health Network - Toronto Rehab), Mark Theodore Bayley, Charissa Levy Objective: 1. To understand the frequency of adult and pediatric concussions treated by family practice physicians and pediatricians and their referrals to specialists through analysis of physician OHIP billing data set and Ambulatory Care databases 2. To complete the survey of all specialized concussion clinics to identify currently available services and areas where there are gaps in services
Poster 78 Transitional Life Experiences of Chronic Brain Injury Survivors: A Qualitative Study to Understand Their Perspectives Laura Lorenz (Brandeis University), Therese O’Neil-Pirozzi, Michelle Demore-Taber Objectives: To give voice to long-term acquired brain injury (ABI) survivor experiences moving to a fully-integrated, independent living model of housing with support services. Design: qualitative research design Setting: Three community-based supported living residences in eastern Massachusetts Participants: 21 residents who were at least two years-post acquired brain injury (17 male, 4 female; 28-68 years of age). Interventions: Investigators reviewed published stories about supportive living residents and identified six transition themes before interviewing
Design: A multi-modal design that incoprorated telephone and electronic surveys of clinics that treat concussions and analysis of physician billing and trauma registries to identify people with a diagnosis of concussion, where the concussions are diagnosed, how many required specialized treatment, how long between index case and being treated by a specialist and what types of specialists are treating those with concussions via the ICES database for 2008 - 2011. Setting: Concussion clinics in Ontario Participants: Health care providers that treat concussions Interventions: No intervention was used Main Outcome Measure(s): none listed Results: Over 200,000 residents of Ontario are diagnosed with a concussion per year and there was an incidence of greater than 1800 out of 100,000 residents; pediatric incidence was as high as 5,000 out of 100,000 for those under 5 years. Thirty to forty percent are referred to a specialist and adults have a wait time of 7 months and children have a 9 month wait to access these services. Clinic locations were not correlated with areas of high incidence. None of the clinics reported being able to provide the "ideal" concussion care and those treating pediatric concussions want more evidence based protocols that are specific to pediatrics. Conclusions: There are a limited number of specialized concussion clinics in Ontario that provide the full spectrum of care. These clinics are not typically located in areas of greater incidence. Younger people took longer to get to a specialist and had the highest levels of incidence and the clinics reported not being as confident treating pediatric concussions based upon guidelines and protocols that are currently available. Key Words: Concussion/mTBI, Access to Care, Pediatric Concussion, Adult Concussion Disclosure: Mark Bayley has nothing to disclose.
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Traumatic Brain Injury (TBI) Diagnosis the 21 consented participants using an unstructured interview guide. Interviews were 20 to 60 minutes long, audio-recorded, and transcribed. Two investigators independently coded the transcripts based on the six identified themes. Based on initial coding, a seventh theme was identified: people. Two research assistants counted code frequency and coded across themes. Medical records were abstracted for injury-related information. Main Outcome Measures: Seven transition themes Results: The 21 transcripts had 585 coded segments, a mean of 29 per person. Themes addressed most frequently: “People” (373 coded segments), “Finding a balance between privacy and independence” (154), “Defining a new purpose in life” (113), and “Transitioning to more or less structure” (110). Themes addressed least frequently: “Experiencing faith, fulfillment & acceptance re disability” (78 coded segments), “Feeling invested in the process” (70), and “Practicing hobbies and interests” (60). Conclusions: Individuals being transitioned are not always engaged in the process (family members do most of the work); the most recent transition may be the latest of many; and co-morbidities complicate the transition process. Study limitations and implications of findings will be discussed. Key Words: Qualitative research; Chronic brain injury; Patient-centered care; Independent living Disclosure: Laura Lorenz has nothing to disclose.
Poster 79 Evaluating Access to Appropriate Concussion Care in Ontario Laura Langer (University Health Network - Toronto Rehab), Mark Theodore Bayley, Charissa Levy Objective: 1. To understand the frequency of adult and pediatric concussions treated by family practice physicians and pediatricians and their referrals to specialists through analysis of physician OHIP billing data set and Ambulatory Care databases 2. To complete the survey of all specialized concussion clinics to identify currently available services and areas where there are gaps in services
Poster 78 Transitional Life Experiences of Chronic Brain Injury Survivors: A Qualitative Study to Understand Their Perspectives Laura Lorenz (Brandeis University), Therese O’Neil-Pirozzi, Michelle Demore-Taber Objectives: To give voice to long-term acquired brain injury (ABI) survivor experiences moving to a fully-integrated, independent living model of housing with support services. Design: qualitative research design Setting: Three community-based supported living residences in eastern Massachusetts Participants: 21 residents who were at least two years-post acquired brain injury (17 male, 4 female; 28-68 years of age). Interventions: Investigators reviewed published stories about supportive living residents and identified six transition themes before interviewing
Design: A multi-modal design that incoprorated telephone and electronic surveys of clinics that treat concussions and analysis of physician billing and trauma registries to identify people with a diagnosis of concussion, where the concussions are diagnosed, how many required specialized treatment, how long between index case and being treated by a specialist and what types of specialists are treating those with concussions via the ICES database for 2008 - 2011. Setting: Concussion clinics in Ontario Participants: Health care providers that treat concussions Interventions: No intervention was used Main Outcome Measure(s): none listed Results: Over 200,000 residents of Ontario are diagnosed with a concussion per year and there was an incidence of greater than 1800 out of 100,000 residents; pediatric incidence was as high as 5,000 out of 100,000 for those under 5 years. Thirty to forty percent are referred to a specialist and adults have a wait time of 7 months and children have a 9 month wait to access these services. Clinic locations were not correlated with areas of high incidence. None of the clinics reported being able to provide the "ideal" concussion care and those treating pediatric concussions want more evidence based protocols that are specific to pediatrics. Conclusions: There are a limited number of specialized concussion clinics in Ontario that provide the full spectrum of care. These clinics are not typically located in areas of greater incidence. Younger people took longer to get to a specialist and had the highest levels of incidence and the clinics reported not being as confident treating pediatric concussions based upon guidelines and protocols that are currently available. Key Words: Concussion/mTBI, Access to Care, Pediatric Concussion, Adult Concussion Disclosure: Mark Bayley has nothing to disclose.
www.archives-pmr.org