The Effect of Social Determinants of Health on Clinical Recovery Following Concussion: A Systematic Review.

IF 1.3 4区 医学 Q3 REHABILITATION
Tamerah N Hunt, Kylie Roberts, Erica M Taylor, Carolina P Quintana, Melissa K Kossman
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引用次数: 0

Abstract

Context: Concussion evaluations include a multifaceted approach; however, individual differences can influence test score interpretations and validity. Social determinants of health (SDoH) differentially affect disease risk and outcomes based upon social and environmental characteristics. Efforts to better define, diagnose, manage, and treat concussion have increased, but minimal efforts have focused on examining SDoH that may affect concussion recovery.

Objective: This review examined previous research that examined the effect of SDoH on concussion recovery of athletes.

Evidence acquisition: CINAHL, MEDLINE, PsycInfo, and SPORTDiscus databases were used to search the terms "concussion" AND "recovery," "youth, adolescent, teen and/or adult," and "social determinants of health" and variations of these terms. The evidence level for each study was evaluated using the 2011 Oxford Center for Evidence-Based Medicine Guide.

Evidence synthesis: Seven thousand nine hundred and twenty-one articles were identified and screened for inclusion. Five studies met the inclusion criteria and were included in this systematic review. Using the Downs and Black Quality Index, the studies included in this review were deemed high quality.

Conclusion: Though limited literature exists, there is preliminary evidence to suggest that SDoH (specifically, economic stability, education access and quality, and social and community context) may have an impact on the clinical recovery from concussion. The dimensions evaluated varied between studies and the results were inconsistent. No single factor consistently affected clinical recovery; however, private insurance and race appear to have an association with the speed of recovery. Unfortunately, the potential intersection of these variables and other preinjury factors limits the ability to make clear recommendations. While most of the studies in this review are retrospective in nature, future efforts should focus on training clinicians to prospectively evaluate the effect of SDoH on concussion recovery and injury outcomes. Funding and registration for this systematic review were not obtained nor required.

健康的社会决定因素对脑震荡后临床康复的影响:系统回顾
背景:脑震荡评估包括多方面的方法;然而,个体差异会影响测试分数的解释和有效性。健康的社会决定因素(SDoH)会根据社会和环境特征对疾病风险和结果产生不同的影响。为更好地定义、诊断、管理和治疗脑震荡所做的努力不断增加,但对可能影响脑震荡恢复的 SDoH 的研究却很少:本综述考察了以往有关 SDoH 对运动员脑震荡恢复影响的研究:证据获取:使用 CINAHL、MEDLINE、PsycInfo 和 SPORTDiscus 数据库搜索术语 "脑震荡"、"恢复"、"青少年、少年和/或成人"、"健康的社会决定因素 "以及这些术语的变体。采用 2011 牛津循证医学中心指南对每项研究的证据等级进行评估:共鉴定并筛选出 7921 篇文章供纳入研究。五项研究符合纳入标准,被纳入本系统综述。根据唐斯和布莱克质量指数(Downs and Black Quality Index),纳入本综述的研究被认为是高质量的:尽管文献资料有限,但有初步证据表明,SDoH(特别是经济稳定性、教育机会和教育质量以及社会和社区环境)可能会对脑震荡的临床康复产生影响。不同研究评估的维度各不相同,结果也不一致。没有任何一个因素会持续影响临床康复;不过,私人保险和种族似乎与康复速度有关。遗憾的是,这些变量与其他受伤前因素的潜在交叉限制了提出明确建议的能力。虽然本综述中的大多数研究都是回顾性的,但今后的工作应侧重于培训临床医生,以前瞻性地评估 SDoH 对脑震荡恢复和损伤结果的影响。本系统综述未获得资金支持,也未要求注册。
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来源期刊
Journal of Sport Rehabilitation
Journal of Sport Rehabilitation 医学-康复医学
CiteScore
3.20
自引率
5.90%
发文量
143
审稿时长
>12 weeks
期刊介绍: The Journal of Sport Rehabilitation (JSR) is your source for the latest peer-reviewed research in the field of sport rehabilitation. All members of the sports-medicine team will benefit from the wealth of important information in each issue. JSR is completely devoted to the rehabilitation of sport and exercise injuries, regardless of the age, gender, sport ability, level of fitness, or health status of the participant. JSR publishes peer-reviewed original research, systematic reviews/meta-analyses, critically appraised topics (CATs), case studies/series, and technical reports that directly affect the management and rehabilitation of injuries incurred during sport-related activities, irrespective of the individual’s age, gender, sport ability, level of fitness, or health status. The journal is intended to provide an international, multidisciplinary forum to serve the needs of all members of the sports medicine team, including athletic trainers/therapists, sport physical therapists/physiotherapists, sports medicine physicians, and other health care and medical professionals.
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