DOI: 10.3886/icpsr38039
title: Barriers and Facilitators to the Receipt of Treatment for Psychiatric Disturbances following Traumatic Brain Injury, United States, 2015-2016
title: Archival Version

description: The objective of the study was to explore perceptions of barriers and
facilitators to diagnosis and receipt of treatment for neuropsychiatric
disturbances (NPD) following traumatic brain injury (TBI) from the viewpoint of the healthcare provider, patient, and caregiver. The data comprise deidentified transcripts of ten semi-structured interviews conducted with healthcare providers who treat individuals with TBI and four focus groups conducted among individuals aged 18 years and older with TBI who had been diagnosed with an NPD (primarily anxiety and depression). Participants in the semi-structured interviews included three neuropsychiatrists, a psychiatric nurse
practitioner, two psychotherapists, a neurologist, an emergency department
physician, an occupational therapist and a speech pathologist. Interviews were conducted by phone and lasted 40-50 minutes. The four focus groups comprised 23 individuals, of whom five were caregivers. Time since TBI ranged from 18 months to 15 years and levels of TBI severity ranged from mild to severe.
description: The purpose of the study was to explore perceptions of barriers and facilitators to diagnosis and receipt of treatment for neuropsychiatric disturbances (NPD) following traumatic brain injury (TBI) from multiple viewpoints: healthcare providers, patients, and caregivers.
description: For healthcare providers, a single researcher conducted individual interviews with participants by phone between November 2015 and February 2016. Interviews lasted between 40-50 minutes, and participants were compensated $100.
For individuals with TBI and their caregivers, research team members moderated four focus groups between March 2016 and August 2016. Focus groups lasted about 90 minutes each. 23 individuals, including five caregivers, participated and were compensated $50.
Guides for individual interviews and focus groups were created based on existing literature and clinical expertise. All interviews were audio-recorded and transcribed verbatim. The study team performed a content analysis on four of the interview transcripts to create an initial coding scheme that would be revised through iterative rounds of coding. NVivo 11 was used to perform the coding. Stakeholders (individuals with TBI, caregiver, neuropsychiatrist, state-level advocate) were solicited for feedback about major analytic themes.
description: Focus group interview questions covered diagnosis and treatment of depression, anxiety, or PTSD following TBI. Participants were asked about their awareness of any psychiatric disturbances, if they believed it was related to their injury, actions they took to resolve their issues, barriers and facilitators to seeking/receiving treatment, interactions with healthcare providers, and types of treatments received.
Individual interview questions covered provider contact with patients and recognizing, diagnosing, and treating psychiatric disturbances after TBI. Participants were asked about typical timelines for seeing patients following TBI, challenges in the diagnosis and treatment processes, screening, referral processes, and perceptions of barriers and facilitators to patients receiving a diagnosis and treatment.
description: Healthcare providers known to study investigators were recruited by phone and email. Focus group participants were recruited using flyers posted at clinics and by healthcare providers known to study investigators. Recruitment settings included a clinic specializing in treating psychiatric disorders after brain injury, an emergency department at a large academic hospital, and a state designated primary adult resource trauma center, all located within the United States.
Individuals with TBI were predominantly men (83%), and caregivers were predominantly women (60%). TBI severity ranged from mild to severe.
description: Datasets: 
DS0: Study-Level Files
DS1: Patient and Caregiver Focus Group Data
DS2: Healthcare Provider Interview Data
description: Adults with traumatic brain injury and neuropsychiatric disturbances, caregivers, and healthcare providers.
description: face-to-face interview; telephone interviewThis study is part of the Washington University in St. Louis (WUSTL) Qualitative Data Sharing (QDS) project.ICPSR has zipped the 14 interview transcripts into two qualitative data packages, separated into focus group data and individual interview data. These packages are available for restricted download. Please refer to the ICPSR README documents for more information.