Is injury-related parental stress in the acute phase following early childhood concussion associated with symptoms and recovery?

Objective: To examine the association between injury-related parental-stress during the acute phase following early-childhood concussion on post-concussion-symptoms (PCS) severity and recovery. Methods: Thirty-eight children aged 0.1–5.7 years (median 1.3) following concussion, within 72-h post-injury, were included. Injury-related parental-stress was screened using three questions from the Revised-Illness-Perception questionnaire, regarding the child’s 1) well-being, 2) injury-outcomes, and 3) recovery. PCS were assessed using the Post-Concussion-Symptoms-Inventory-Parent form (PCSI-P). Since not all symptoms were suitable for all ages, individualized percentage scores for both the PCSI-P number-of-symptoms (number-PCSI-P) and PCSI-P symptom-severity (severity-PCSI-P) were calculated. Parents completed the stress questionnaire and PCSI-P in the emergency-department (T0), and two-weeks post-injury (T1). The PCSI-P was also completed 1-month post-injury (T2). Results: Parental-stress did not change significantly between T0 and T1. However, the number and severity of PCSI-P significantly decreased over this period (p < 0.001). A significant moderate positive correlation was found between T0 and T1 parental-stress and T0 number-PCSI-P (r_s = 0.39;p = 0.015 and r_s = 0.49;p = 0.002, respectively) and severity-PCSI-P (r_s = 0.42;p = 0.008 and r_s = 0.58;p < 0.001, respectively). At T2, 26 children were fully recovered; they presented lower T0 PCSI-P scores (p < 0.049), but showed no difference in parental-stress scores. Conclusion: Higher injury-related parental-stress following early childhood concussion is associated with PCS in the first 72-h post-injury, but not with symptom recovery.