Main Article Content
OBJECTIVES: The objective of this study is to evaluate the effects of implementing clinical nursing practice guidelines in mild traumatic brain injury patients at Bangkok Pattaya Hospital. (CNPG)
MATERIALS AND METHODS: In this quasi-experimental study there was one group design. Participants were 40 mild traumatic brain injury patients who fulfilled the inclusion criteria. Patients were treated according to clinical nursing practice guidelines. Data were collected using a set of questionnaires, including demographic information, the Rivermead post-concussion symptoms questionnaire, the Rivermead head injury follow up questionnaire and satisfaction questionnaire. Data were analyzed using descriptive statistics and Wilcoxon signed-rank test.
RESULTS: Patients with mild traumatic brain injury and post-concussion symptoms have been affected with an impact on daily life ranging from mild to moderate. The symptoms were improved within 2, 4 and 6 weeks after the onset, respectively. The functional performance was significantly increased (p < 0. 05) within 2, 4 and 6 weeks after traumatic brain injury. The satisfaction of patients with nursing care was at a high level.
CONCLUSION: The CNPG can improve patient outcomes by minimizing complications and enhancing the functional performance of mild traumatic brain injury patients.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
2. College of Neurosurgeons of Thailand, The Royal College of Surgeons of Thailand, Department of Medical Services, Ministry of Public Health, Institute of Neurology, Department of Medical Services, Royal Thai Army Medical Department, Royal Thai Air Force Medical Department, et al. Clinical practice guidelines for traumatic brain injury. 1st ed. Bangkok: Thanappress Publishing; 2013 [in Thai]
3. McQuillan KA, Thurman PA, editors. Trauma nursing. 4th ed. United Stated of America: Tom Wilhelm Publishing; 2009
4. Kristman VL, Borg J, Godbolt AK, et al. Methodological issues and research recommendations for prognosis after mild traumatic brain injury: results of the international collaboration on mild traumatic brain injury prognosis. Arch Rehabil Res Clin Transl 2014;95(3 Suppl):S265-77.
5. Ruff RM, Iverson GL, Barth JT, et al. Recommendations for diagnosing a mild traumatic brain injury: a National Academy of Neuropsychology education paper. Arch Clin Neuropsychol 2009;24(1):3-10.
6. Artha R, Pimphate C, Anong S. Severe injuries related to motorcycle accident in Thailand, 2012. Weekly epidemiological surve i l lance report, Thai land 2013;44(31):481-84. [in Thai]
7. Nakornchai P. Minor head injury In Nakornchai P editor. Head injury. 2nd ed. Bangkok: OS Printing House; 1998:29-35. [in Thai]
8. Holm L, Cassidy JD, Carroll LJ, Borg J. Summary of the WHO Collaborating Centre for Neurotrauma Task Force on Mild Traumatic Brain Injury. J Rehabil Med 2005;37(3):137-41.
9. Chong CS. Management strategies for post-concussion syndrome after mild head injury: A systematic review. Hong Kong J Occupat Therapy 2008;18(2): 59-67.
10. Hall Ryan CW, Hall Richard CW, Chapman MJ. Definition, diagnosis and forensic implication of postconcussional syndrome. Psychosomatic 2005;46(3): 195-202.
11. Yang CC, Tu YK, Hua MS, et al. The association between the postconcussion symptoms and clinical outcomes for patients with mild traumatic brain injury. J Trauma 2007;62(3):657-63
12. Kennedy JE, Lumpkin RJ, Grissom JR. A survey of mild traumatic brain injury treatment in the emergency room and primary care medical clinics. Mil Med 2006;171(6):516-21.
13. Lundin A, de Boussard C, Edman G, et al. Symptoms and disability until 3 months after mild TBI. Brain Inj 2006;20(8):799-806.
14. Haboubi NH, Long J, Koshy M, et al. Short-term sequelae of minor head injury (6 years’ experience of minor head injury clinic). Disabil Rehabil 2001;23(14):635-8.
15. Wimol M. Effects of a discharge preparedness program for mild traumatic brain injury patients and caregivers on post-concussion symptoms and re-hospitalization. [thesis]. Chonburi: Burapha University, 2012. [in Thai]
16. Thanaporn P. A follow-up study of adaptation of the patients after receiving a mild head injury. [thesis]. Bangkok: Mahidol University, 2003.
17. Elgmark AE, Emanuelson I, Björklund R, et al. Mild traumatic brain injuries: the impact of early intervention on late sequelae. A randomized controlled trial. Acta Neurochir (Wien) 2007;149(2):151-9.
18. King NS, Crawford S, Wenden FJ, et al. The Rivermead Post Concussion Symptoms Questionnaire: a measure of symptoms commonly experienced after head injury and its reliability. J Neurol 1995;242(9):587-92.
19. Crawford S, Wenden FJ, Wade DT. The Rivermead head injury follow up questionnaire: a study of a new rating scale and other measures to evaluate outcome after head injury. J Neurol Neurosurg Psychiatry 1996; 60(5): 510–14.
20. Kanokphon W. Development and evaluation of clinical nursing practice guideline for pain management in elderly trauma patients. [thesis]. Songkla: Prince of Songkla University, 2014. [in Thai]
21. Wasana S. Protective behaviors against accident in shuttlemotorcycle riding in district of Mueang, Nakhonpathom province. [thesis] Bangkok: Silpakorn University, 2005. [in Thai]
22. Piyawat K. Study of patterns and duration of road accidents. A case study of Phitsanulok municipality. [thesis]. Phitsanulok: Naresuan University, 2015. [in Thai]
23. Laorm S, Jareeyavat K, Kranokpron N. A study of fall prevention guidelines in older adults living in Mitraphappatana community. J Royal Thai Army Nurs 2014;15(1): 122-29. [in Thai]
24. Intira T, Kesarin U, Prangthip C, et al. The relationships between post-concussion syndrome and functional status in patients with mild traumatic brain injury. Thai J Nurs Council 2010; 25(2): 39-53. [in Thai]
25. Duangkamol D. Relationship between post-concussion symptoms and functional performance in patients with mild traumatic brain injury. [thesis]. Chonburi: Burapha University, 2015. [in Thai]
26. De Kruijk JR, Leffers P, Menheere PPCA, et al. Prediction of post-traumatic complaints after mild traumatic brain injury: early symptoms and biochemical markers. J Neurol Neurosurg Psychiatry 2002 Dec; 73(6): 727–32.
27. Browndyke JN. Mild head injury and posttraumatic headache. 2002. (Accessed July 20, 2017, at http://bianj.org/Websites/ bianj/images/Mildheadinjury andposttraumaticheadache.pdf).
28. Gupta G. Intracranial pressure monitoring. 2015 (Accessed July 22, 2017, at http://emedicine.medscape.com/ article/1829950-overview#a1.).
29. Romrudee K. Headache, symptom management, and quality of life of patients with mild traumatic brain injury. [thesis]. Bangkok : Mahidol University, 2009. [in Thai]
30. Reneker JC, Cheruvu VK, Yang J, et al. Physical examination of dizziness in athletes after a concussion: a descriptive study. 2018;34:8-13.
31. Chamelian L, Feinstein A. Outcome after mild to moderate traumatic brain injury: the role of dizziness. Arch Phys Med Rehabil 2004;85(10):1662-6
32. Writghtson P, Gronwall D. Mild head injury: a guide to management. New York: Oxford University, Press. 1999.
33. Paramaporn N. Effect of educational program for caregivers on caring of patient with minor head injury. [thesis]. Chiang Mai: Chiang Mai University, 2005. [in Thai]
34. Mittenberg W, Canyock EM, Condit D, et al. Treatment of post-concussion syndrome following mild head injury. J Clin Exp Neuropsychol 2001;23(6):829-36.
35. Ponsford J, Willmott C, Rothwell A, et al. Impact of early intervention on outcome following mild head injury in adults. J Neurol Neurosurg Psychiatry 2002;73(3):330-2.