Treatments for mild traumatic brain injury : fish oil supplementation and information provision in New Zealand health care services : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Wellington, New Zealand
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2020
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Massey University
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Abstract
Mild Traumatic Brain Injury (mTBI) has the highest incidence of all brain injuries and can lead to symptoms in the physical, cognitive and mood domains. Most symptoms abate within weeks to months, however some individuals experience ongoing symptoms leading to longer-term disruption of social and occupational functioning. Current mTBI management recommendations include providing early injury related education, and addressing symptoms in a multidisciplinary fashion as they arise. As with any injury, it is important to ensure treatments are effective in order to reduce the costs to both the health system and the individual. The studies presented in this thesis aimed to assess the effectiveness of fish oil – a novel treatment for mTBI symptoms, and the current practice for providing information to mTBI patients. Study One was a randomised placebo controlled trial of fish oil as an adjunct treatment for mTBI symptoms. This study was cancelled due to recruitment difficulties, nevertheless the literature review delineates the pre-clinical evidence of its potential to treat both cognitive and mood symptoms via various pathways. In addition, the outlined procedures and the researcher’s reflections highlight the unforeseen difficulties that will need to be addressed should a similar trial be conducted in future. Study Two surveyed New Zealand health practitioners on their current practice of information provision for mTBI patients. It aimed to assess whether practices have changed in the 16 years since similar research was published, and since the introduction of information sheets by the Accident Compensation Corporation (ACC). It also assessed the quality and accessibility of the information provided. The frequency of information provision after mTBI has improved since 2004, though the issues with variability and formatting of presented information remain similar. The majority of respondents provided information verbally and in writing, and had information available only in English and standard print formats, potentially disadvantaging those with visual impairment or whose first language is not English. Time constraints, patient concentration and distress, and a lack of appropriate resources were cited as barriers to providing information.
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Brain, Wounds and injuries, Treatment, Wounds and injuries, Patients, Rehabilitation, New Zealand, Fish oils, Therapeutic use