Parental Anxiety at Initial Acute Presentation Is Not Associated With Prolonged Symptoms Following Pediatric Concussion
Notice bibliographique
Résumé
OBJECTIVES: Anxiety modulates symptom perception in adults following concussion, prolonging the time to full recovery. The authors sought to determine whether parental anxiety was associated with persistent postconcussive symptoms (PCS) in their children following concussion. METHODS: A prospective observational cohort with 98 children aged 5 to 17 years following concussion participated from a tertiary pediatric emergency department (ED). The main exposure was parental anxiety at the time of acute presentation following pediatric concussion, measured using the self-administered, validated Spielberger State-Trait Anxiety Inventory-State Anxiety Scale (STAI-S). The primary outcome measured was presence of PCS in the child at 1 month, per the validated Post-Concussive Symptom Inventory (PCSI). Secondary outcome measures included parental anxiety score over time, school absenteeism, and return to sports. Data were collected during the initial ED visit and at 3-day, 7-day, 2-week, 1-month, and 3-month follow-ups. RESULTS: Of 98 children enrolled, 27% (95% confidence interval [CI] = 19% to 36%) developed PCS at 1 month. No significant associations were detected between parental anxiety at the index visits and the number of previous pediatric concussions (p = 0.73), sex (p = 0.61), loss of consciousness (p = 0.43), history of migraines (p = 0.31), or history of anxiety diagnosed in the patients (p = 0.09). A significant association was noted between patient diagnosis of attention deficit hyperactivity disorder (ADHD) and parental anxiety at the index visits (p = 0.001). Parental anxiety at acute presentation was not associated with children's prolonged symptoms at 1 month (p = 0.63). Parental anxiety remained elevated in parents whose children had prolonged symptoms compared to those parents whose children's symptoms resolved (median = 30, interquartile range [IQR] = 22 to 44; and median = 21, IQR = 20 to 25, respectively; p < 0.001). Initial parental anxiety presentation was not associated with school absenteeism (p = 0.23) or not returning to sport or gym class (p = 0.89). There were no significant effects involving ADHD alone (p = 0.44) or together with baseline parental anxiety (p = 0.36 for ADHD and p = 0.55 for anxiety) using logistic regression analysis to examine potential predictive effects of child's ADHD combined with parental anxiety at the index visit on persistent symptoms at 1 month. CONCLUSIONS: Parental anxiety at time of acute presentation does not appear to be associated with prolongation of postconcussive symptoms in their children. However, parents of persistently symptomatic children remain significantly more anxious than those whose children's symptoms have resolved. Future research should attempt to reduce the familial burden of concussion through expectation management strategies.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,008 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
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