The emergency department social work intervention for mild traumatic brain injury (SWIFT-Acute): a pilot study.
OBJECTIVE
To determine acceptability and preliminary effectiveness of Emergency Department (ED) Social Work Intervention for Mild Traumatic Brain Injury (SWIFT-Acute) on alcohol use, community functioning, depression, anxiety, post-concussive symptoms, post-traumatic stress disorder and service use.


METHODS
This study enrolled 64 patients who received head CT after mild traumatic brain injury (mTBI) and were discharged <24 hours from a Level 1 trauma centre ED. The cohort study compared outcomes for SWIFT-Acute (n = 32) and Usual Care (n = 32) 3 months post-injury. SWIFT-Acute includes education about symptoms and decreasing alcohol use, coping strategies, reassurance and education about recovery process and follow-up guidelines and resources.


METHODS
Alcohol Use Disorders Identification Test (AUDIT), Community Integration Questionnaire (CIQ), Patient Health Questionnaire-4, Rivermead Post-concussion Symptoms Questionnaire, PTSD Checklist-Civilian, acceptability and service use surveys.


RESULTS
Paired t-test revealed SWIFT-Acute group maintained pre-injury community functioning; Usual Care significantly declined in functioning on the CIQ. Both groups reported 'hazardous' pre-injury drinking on AUDIT. Wilcoxon Signed Rank test showed the SWIFT-Acute group significantly reduced alcohol use; the Usual Care group did not. Both groups significantly increased medical service use. No statistically significant differences were found on other measures. Acceptability ratings were extremely high.


CONCLUSIONS
SWIFT-Acute was acceptable to patients. There is preliminary evidence of effectiveness for reducing alcohol use and preventing functional decline. Future randomized studies are needed.
School of Social Work, University of Washington , Seattle, WA , USA .
Megan
M
Moore
Amy
A
Winkelman
Sharon
S
Kwong
Steven P
SP
Segal
Geoffrey T
GT
Manley
Martha
M
Shumway
D000223:Adaptation, Psychological; D000328:Adult; D000437:Alcoholism / Q000175:diagnosis; D001924:Brain Concussion / Q000523:psychology* / Q000534:rehabilitation / Q000628:therapy*; D003863:Depression / Q000175:diagnosis; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D010351:Patient Discharge; D010353:Patient Education as Topic; D010865:Pilot Projects; D038223:Post-Concussion Syndrome / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D012017:Referral and Consultation; D018570:Risk Assessment; D012947:Social Work / Q000458:organization & administration; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis