Pediatric Traumatic Brain Injury: Families and Healthcare Team Interaction Trajectories During Acute Hospitalization.

Journal Article (Journal Article)


To identify common or unique family-healthcare team interactions during acute hospitalization for pediatric patients with a traumatic brain injury (TBI) using a life course trajectory (LCT) theoretical approach.

Design and methods

A 3-year prospective observational study of 35 children, ages 5 days to 15 years who were admitted to an urban Level-1 trauma hospital for a TBI. We defined brain injury severity using the admission Glasgow Coma Scale score (mild 13-15, moderate 9-12, and severe 3-8). Using a life course trajectory theoretical approach, we extracted from the patient's electronic health record the first eight-days of hospitalization and plotted the number and type of daily family-healthcare team interactions to visualize patterns or phases.


A general trajectory for each severity group was determined. When individually compared, family trajectories were similar based on injury severity. Visual interpretations of family-healthcare interactions based on the brain injury severity yielded three phases. The interactions phases included: (1) information seeking, (2) watchful waiting and (3) decision making.


Using a LCT approach, phases identified based on injury severity and family interactions support the need for proper timing of tailored communication and support. The findings also support the development of future best care practices that facilitate family's needs, decrease caregiver burden to improve functional outcomes.

Full Text

Duke Authors

Cited Authors

  • Reuter-Rice, K; Doser, K; Eads, JK; Berndt, S

Published Date

  • May 2017

Published In

Volume / Issue

  • 34 /

Start / End Page

  • 84 - 89

PubMed ID

  • 28081932

Pubmed Central ID

  • PMC5444971

Electronic International Standard Serial Number (EISSN)

  • 1532-8449

International Standard Serial Number (ISSN)

  • 0882-5963

Digital Object Identifier (DOI)

  • 10.1016/j.pedn.2016.12.017


  • eng