Doctor of Philosophy
Suzanne Ameringer, PhD, RN, FAAN
Background: Adolescents experience a variety of symptoms following a concussion that affect their everyday life. Initial management consists of physical and cognitive rest followed by a gradual return to activities while monitoring symptoms. Managing concussion symptoms in adolescents is a challenge due to their lifestyle and developmental needs but it is the key to improving adolescents’ lives. Symptom self-management is the prevention and control of symptoms and has been shown to improve health outcomes but has not been studied in adolescents with concussion symptoms. Using the Individual and Family Self-Management Theory (IFSMT), the purpose of this study was to describe symptom self-management in adolescents following a concussion.
Methods: A descriptive, cross-sectional correlational design was used in this study. Adolescents aged 13-17, who reported a concussion within the past six months and had at least one symptom, were recruited. Adolescents completed a battery of self-report measures that assessed context and process factors, and proximal and distal outcomes. Context factors included perceptions related to the concussion, concern for school, anxiety, and depressive symptoms. Process factors were concussion knowledge, self-efficacy for managing symptoms, and social support. Proximal outcomes were self-management strategies and perceived effectiveness of the strategies, while distal outcomes were concussion symptoms and severity, school attendance, and physical activity.
Results: Fifty-eight adolescents participated in the study. More than half of the sample were female (59%) and the majority of concussions were sports-related (59%). Both self-efficacy and social support were positively correlated to the perceived effectiveness of strategies and negatively correlated to concussion symptoms and severity. Sex differences were found in concussion symptoms and severity. Regression analysis was used to examine the context and process factors as predictors of perceived effectiveness of self-management strategies and concussion symptom severity. Twenty-nine percent of the variance in perceived effectiveness was explained by their perception of concussion, concern for school, and social support. Fifty-five percent of the variance in symptom severity was explained by perceived recovery, sex, depressive symptoms, and self-efficacy.
Conclusions: This study increased our understanding of symptom self-management in adolescents following a concussion. Using the IFSMT, our findings suggest several context and process factors that are important to the effectiveness of self-management strategies and concussion symptom severity. Adolescents are managing multiple symptoms following a concussion and using a variety of self-management strategies. Understanding symptom self-management can help nurses support adolescents in their recovery from concussion by improving their symptoms.
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Available for download on Monday, May 04, 2026