Background: Traumatic brain injury (TBI) affects 1.4 million Americans annually and mild TBI (MTBI) accounts for approximately 75 % of those injured. For those with mild injury that seek treatment in an emergency department, there is inconsistency in the management and follow up recommendations. Approximately 38% of patients treated in the ED for MTBI are discharged with no recommendations for follow up. In addition, there are an unknown number of persons with MTBI that do not seek healthcare following their injury. Persons with MTBI are for the most part managing their concussion symptoms on their own. It is unknown what persons with MTBI do to manage their symptoms, or how well those strategies work at relieving symptoms. Purpose: The purpose of this study was to describe the symptom experience for persons with mild TBI in terms of presence of symptoms and bothersome nature of symptoms and identify what persons do to manage those symptoms. This study will also describe how well persons report their symptom management strategy as being effective. A better understanding of these concepts by healthcare workers may improve the discharge process of what information is given to persons with MTBI and whether follow up appointments are necessary for this population. Methods: This study of 30 persons with MTBI and a 30 person comparison group describes the symptoms that were present following MTBI and compared those symptoms to the non-brain injured group. In addition, the symptom-self management for MTBI questionnaire was used to explore what symptom self-management strategies were used as well as how effective persons rated those strategies to be. Results: Results of this study indicate that persons within three months of their MTBI report an average of 19 symptoms while the comparison group reported 6 symptoms, and that the most frequently reported symptoms are not always the symptoms rated as most severe or most bothersome. Persons with MTBI reported their most common symptoms to be headache (n=25, 83%), feeling tired (n= 24, 80%), difficulty thinking and irritable (each n=22, 73%), dizziness, trouble remembering, and forgetful (each 21, 70%). Persons with MTBI use symptom management strategies such as activities/thoughts, complimentary therapies, and exercise to manage their symptoms. There is a significant relationship between overall reports of being bothered by symptoms and the use of symptom management strategies (F=8.322, p=.008) and there were no significant relationships among the covariates of age (F=.398, p=.534), gender (F=.030, p=.864), education (F=.539, p=.745), or group (F=.095, p=.761). There was a significant relationship between strategies used and effectiveness of symptom relief (F=34.63, p=.000) and gender (F=4.77, p=.04). Significance: Symptoms after MTBI are common and persons use strategies such as activities/thoughts, medications, exercise, and complimentary therapies to manage their symptoms. Persons are more likely to use symptom management strategies when they are bothered by the symptoms, and they report their symptom management strategies to be effective at symptom relief. Nurses can assist with symptom self-management for persons with MTBI by educating about the symptoms that can result from the injury, and by providing simple symptom management strategies, through the use of a symptom management toolkit, to assist with the symptom management process. Currently, a symptom management toolkit does not exist for the MTBI related symptoms, and results of this study can be used to develop the toolkit, with future research to validate the tool followed by intervention studies to verify the usefulness of the symptom management toolkit. Early symptom management for the MTBI population may improve the outcomes such as return to work and role functions, for this population.
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