Attitude of patients, healthcare professionals, and noninjured lay persons towards online video instructions on mild traumatic brain injury: a cross-sectional study
Hoek et al. International Journal of Emergency Medicine
Attitude of patients, healthcare professionals, and noninjured lay persons towards online video instructions on mild traumatic brain injury: a cross-sectional study
Amber E. Hoek 0
Maaike van den Hamer 0
Carianne K. Deelstra 0
Ed F. van Beeck 2
Diederik W. J. Dippel 1
Juanita A. Haagsma 0 2
Pleunie P. M. Rood 0
0 Department of Emergency Medicine, Erasmus University Medical Center , P.O. Box 2040, 3000 CA Rotterdam , The Netherlands
1 Department of Neurology, Erasmus University Medical Center , P.O. Box 2040, 3000 CA Rotterdam , The Netherlands
2 Department of Public Health, Erasmus University Medical Center , P.O. Box 2040, 3000 CA Rotterdam , The Netherlands
Background: The objective of this study was to determine the attitude of patients, healthcare professionals, and noninjured lay persons towards adding a video with discharge instructions to patient care for patients with mild traumatic brain injury (MTBI). A survey was conducted at the emergency department (ED). Participants consisted of MTBI patients (n = 50), healthcare professionals (n = 50), and noninjured lay persons (n = 50). The participants viewed a video with discharge instructions on MTBI and filled out a questionnaire that measured their attitude towards the use of a video as part of discharge instructions. Findings: Nearly all healthcare professionals (94%) and 70% of the noninjured lay persons considered the video to be a valuable addition to oral discharge instructions. For 84% of patients, verbal information from the doctor is of importance. And, 50% of patients would like to receive additional video discharge instructions. Conclusions: The majority of noninjured lay persons and healthcare professionals and half of the MTBI patients consider a video with discharge instructions to be a valuable addition to patient care. Video discharge instructions are a relative low-cost measure that could enhance patient care at the ED, provided that this does not compromise the personal contact between patient and healthcare professional.
Mild traumatic brain injury; Emergency department; Discharge instructions; Video
Introduction
Mild traumatic brain injury (MTBI), or concussion,
often leads to persistent symptoms. These symptoms,
such as headaches, mild cognitive problems, and
dizziness, may last for weeks or even months after
the concussion [
1–3
].
Evidence suggests that providing patients with
discharge instructions containing adequate educational
information on MTBI can help reduce or even prevent
post-concussion symptoms, particularly early after the
injury [
4
]. Patients remember discharge instructions better
when they receive written instructions additional to oral
information only [
5
]. However, a prerequisite for the
effectiveness of written discharge instruction is a sufficient
literacy level of the recipient. For some treatments in the
emergency department (ED) video discharge instructions
have shown to improve comprehension and recall of key
points [
6, 7
]. However, for patients with brain concussion,
potentially suffering from headache and cognitive
problems, this is unknown.
An important step in finding the most effective way of
providing patient information on MTBI is to assess the
feasibility and acceptability of an online video with
discharge instructions.
The objective of this study was to determine the attitude
of patients, healthcare professionals, and noninjured lay
persons towards adding a video with discharge
instructions to patient care for patients with MTBI.
Methods
A survey study was conducted at the ED of a tertiary
center in Rotterdam, the Netherlands, between November
2014 and July 2015. The aim was to include 50 MTBI
patients, 50 healthcare professionals, and 50 noninjured
lay persons. The study subjects consisted of a convenience
sample of MTBI patients, healthcare professionals, and
noninjured lay persons. The noninjured lay persons were
recruited from a social network by contacting them
personally or by email. Snowball sampling was used for
the recruitment strategy, i.e., participants were asked to
recruit future participants among their contacts. The
selection criterion was that the noninjured lay persons
were not engaged in any medical profession. The
healthcare professionals consisted of nurses and doctors.
Selection criteria for the healthcare professionals were that they
had to be entrusted with the care for MTBI patients and
were not involved in the study. Healthcare professionals
were recruited during their shift at the ED or the
neurology department. The selection criteria for MTBI
patients were treatment at the ED, aged 18 years and
older, a Glasgow Coma Scale (GCS; a neurological scale
ranging from 3 to 15 that is based on eye, motor, and
verbal responses of the patient) greater than 13 at first
contact, and post-traumatic loss of consciousness of less
than 30 min (indicated in the history of the patients).
MTBI patients were exclu (...truncated)