Research Paper Example on Traumatic Brain Injuries: Types, Characteristics, & Challenges

Abstract

Background: Traumatic Brain Injuries often present nurses with different challenges depending on the severity of the case. The various types of TBI can be grouped as mild, moderate, and severe. The mild TBI often affects a patient’s physical functioning, emotional distress, and some levels of cognitive impairment. The characteristics of patients who are affected by traumatic brain injuries often vary with the severity of the particular injuries. Some of of the most important consequences of the mild TBI include mental and physical fatigue, impairment in concentration and attention, emotional distress as well as some somatic symptoms such as the sensitivity to sound, lights as well as headaches that may take some few weeks to resolve.

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Objectives: To determine the impact of the provision of education modules on patient satisfaction and the ability of family members to educate the traumatic brain injury patients on various therapy types.

Methods: Evidence-based Practice can be essential in changing and improving care in various healthcare settings. The home care patients and their families will be assessed pre and post the intervention on their satisfaction following the intervention. The assessment will also be done to post the intervention to assess the ability of the family members to educate their patients with traumatic brain injury. This will be done using the Self-Efficacy Questionnaire (SE). The data obtained from such scores would be entered into the SPSS tool for analysis.

Keywords: Traumatic Brain Injury, cognitive impairment, home-based care

Introduction

Traumatic Brain Injuries often present nurses with different challenges depending on the severity of the case. The various types of TBI can be grouped as mild, moderate, and severe. The mild TBI often affects a patient’s physical functioning, emotional distress, and some levels of cognitive impairment. A person suffering from moderate to severe TBI is likely to have psychomotor, verbal communication skills, cognitive function, attention, and problem-solving impairment (Oyesanya et al., 2018).

These impairment levels tend to limit a patient’s capacity to acquire new knowledge and skills, as well as the processing of information. According to Oyesanya et al. (2018), moderate to severe TBI can present immediate, chronic, and lasting impacts that significantly limits a patient’s ability to learn and socialize. On the other hand, the people who suffer from moderate to severe TBI are likely to live with the symptoms for the rest of their lives (Johnson et al., 2013). Even though there are lack ways of describing the human costs of the Traumatic brain injuries, some valid and complete estimates of costs associated with utilization cost are important in informing the allocation of the limited financial resources which are aimed at the prevention, identification of some best practices as well as addressing some of the future care needs (Oyesanya, 2019). However, there are several reasons why the estimation of the costs associated with a traumatic brain injury has always proven challenging (Peeters et al., 2015).

PICO question: In Nurses who care for TBI Patients, will an education module on the types of therapies patient receive to improve their ability to educate family members and improve patient and family satisfaction with nursing care.

Literature Review

Traumatic Brain Injury is one of the most significant socioeconomic problems across the world. It is one of the leading causes of disability and mortality among individuals in countries where it is more prevalent (Azman et al., 2020). Traumatic Brain Injury has significantly been linked to the ever-increasing use of motor vehicles, especially in high-income countries across the world (Azman et al., 2020). The WHO has postulated that traffic accidents would be one of the major causes of global injury and disease by 2020. In the persons aged 65 years and above, the damages to the brain account for more than 80000 visits to the emergency departments (Oyesanya et al., 2018).

Cognitive function was also assessed by using the Rancho Los Amigos Cognitive Functioning scale. Results of the study showed that regardless of the complexity in the cases of TBI, each patient experienced sleep disturbances and they can also occur soon following the injury, the severe cases of TBI also showed increased daytime sleepiness (Rabinowitz & Levin, 2014). The researchers of the study suggested that nurses could decrease the stimulation of TBI patients to allow for scheduled periods of rest by limiting visitors, making the patient's room dim and free of noise, and suppling high-protein food and encouraging short naps during the daytime when excessively tired. Without sleep, a patient can become moody, not want to participate in therapy sessions, increase stress in the patient, and ultimately cause other health problems if not treated.

Sleep is necessary for the patient to recover fully. The nurse needs to assess how a patient is sleeping by asking family members who might spend the night with the patient questions, assessing the patient for signs of sleepiness such as sleeping during the day versus at night, excessive yawning, or irritability in the patient can be a few signs of lack of sleep. Reasons for why the patient is experiencing a disturbance in sleep can be from medications, area in which the brain injury occurred that could have altered the sleeping cycle, stress, etc. Collaboration between nurses and physicians is the key to address this issue. Nurses need to make sure they are asking family members how the patient has been sleeping if they have not been able to observe themselves, they must make sure to ask other nurses caring for the TBI patients, and also relate any concern of medications to the physician so that the physician can alter it.

In a quantitative study by Lee et al., self-affirmation and the effect it has on exercise after a TBI injury was assessed (Rau et al., 2018). Twelve participants officially completed the study, and the participants were randomly assigned to an immediate intervention group or the waitlist control group, which included eight weeks of monitoring with an exercise intervention as well. For the control group that completed the questionnaire to assess their neuropsychological status and then participated in the exercise phase, the patients went to one-hour sessions twice per week and used positive affirmations during planned exercise movement (Helmick et al., 2012). Researchers found that the participants of the study had a positive experience with the therapy sessions and stated they felt like it provided them with a sense of community, safe environment and that they felt they had control over the skills they learned from other rehab programs because they were not judged or ridiculed. The therapy program the researchers used was called the IntenSanti program, and it took place at a rehabilitation hospital in New York. In a mixed-methods study by Helmick et al., 2012, researchers provided veterans, eighteen in total, who have had previous TBI injuries with vocational rehabilitation services that allowed therapists to assess veterans psychologically and then assist them in finding employment.

According to the Centers for Disease Control and Prevention, 2014, more than 2.5 million people within the United States sustain the Traumatic brain injuries each year with more than 500000 adolescents between ages 0-14 years (Oyesanya et al., 2016). It is essential to note from the report that more than 35000 adolescents have injuries that are range from moderate to severe. TBI results in verbal, psychomotor, as well as the impairment of cognitive functioning. Moderate-to-severe cases of the traumatic brain injury cause some chronic impairments that may occur throughout the lifetime of the survivors.

The characteristics of patients who are affected by traumatic brain injuries often vary with the severity of the particular injuries. Some of of the most important consequences of the mild TBI include mental and physical fatigue, impairment in concentration and attention, emotional distress as well as some somatic symptoms such as the sensitivity to sound, lights as well as headaches that may take some few weeks to resolve. Some of the cognitive impairments relate to problems such as loss of attention, memory as well as executive functioning. Such problems result in the reduction of the ability to learn new things as well as the reduced speed of information processing.

Prevalence of the Traumatic Brain Injury

Research indicates that alcohol and substance abuse can also be blamed for the increased cases of Traumatic Brain Injuries that have been reported across the world (Oyesanya et al., 2018). A traumatic brain injury significantly interrupts the normal functioning of the brain, thereby leading to a blot, bump, and a jolt of the head and subsequently, the declaration and the abrupt acceleration of the calvarium in the brain (Azman et al., 2020).

By the year 2010, the Centers for Disease Control and Prevention postulated that the Traumatic Brain Injury accounts for about 2.5 million cases within the emergency departments in the United States (Azman et al., 2020). Traumatic Brain Injury is one of the main causes of disability and death in the United States. For instance, research indicates that between 2006 and 2014, the number of patients admitted in the emergency departments as a result of the Traumatic Brain Injury had a 53% increase between 2006 and 2014 (Kochanek & Clark, 2016).

Most significantly, in the year 2014, an average of 154 people died each day from injuries, including the Traumatic Brain Injury in the United States. However, those who survive the effects of the TBI face challenges such as memory loss, personality changes, movement, and sensation challenges, among other impairments (Oyesanya et al., 2018). It has been recorded in various sources that the leading causes of the TBI are falls. Other proven causes of the TBI include being stuck against or on objects, motor vehicle crashes, and some intentional self-harm.

It is also important to note that despite the numerous cases of the Traumatic Brain Injuries, there is still a lack of the nurses' knowledge regarding the care for the patients affected by the condition (Azman et al., 2020). Again, there are inadequate policies, education materials, and protocols that necessitate care for the patients who suffer from the TBI. Based on a report by the National Center for Injury Prevention and Control, about 2% of the United States population is living with disabilities emanating from the traumatic brain inju...