ABSTRACT
OBJECTIVE: To examine the accuracy of knowledge about mild traumatic brain injury (TBI) of veterans and their friends/family members. SETTING: VA Medical Center. PARTICIPANTS: One hundred veterans and 50 of their friends/family members. DESIGN: Cross-sectional survey. MAIN MEASURES: A 60-item questionnaire was created by drawing both from the Neurobehavioral Symptom Inventory and from a brain injury knowledge survey developed for use with the general public. RESULTS: Both groups were equally able to identify true mild TBI items, but both also endorsed numerous items not typical of a mild injury. Self-reported prior TBI and receipt of TBI education were unrelated to the level of knowledge. For both groups, knowing another individual with TBI was unrelated to other aspects of mild TBI knowledge. Only 1 in 5 veterans endorsed receiving brain injury education while in the military. CONCLUSION: Results of this study may assist in the development of targeted TBI educational interventions for veterans and their friends/family members within the Veterans Affairs system. Ultimately, increased knowledge about mild TBI improves the likelihood that veterans receive care congruent with their needs and may potentially improve outcomes for those with mild TBI.
Subject(s)
Brain Injuries/diagnosis , Brain Injuries/psychology , Caregivers/psychology , Friends/psychology , Judgment , Surveys and Questionnaires , Veterans/psychology , Adult , Aged , Attitude to Health , Caregivers/education , Cross-Sectional Studies , Culture , Data Collection , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Middle Aged , Neuropsychological Tests , Patient Education as Topic , United States , Veterans/educationABSTRACT
BACKGROUND/OBJECTIVE: We conducted a randomized, double-blind comparison of twice daily bladder irrigation using 1 of 3 different solutions in community-residing persons with neurogenic bladder who used indwelling catheters to evaluate efficacy in treatment of bacteriuria. METHODS: Eighty-nine persons with bacteriuria were randomized to irrigate their bladders twice daily for 8 weeks with 30 mL of (a) sterile saline, (b) acetic acid, or (c) neomycin-polymyxin solution. Urinalysis, cultures, and antimicrobial susceptibility tests were performed at baseline and weeks 2, 4, and 8 to determine the extent to which each of the solutions affected numbers and types of bacteria, urinary pH, urinary leukocytes, and generation of antimicrobial-resistant organisms. RESULTS: Bladder irrigation was well tolerated with the exception of 3 participants who had bladder spasms. None of the 3 irrigants had a detectable effect on the degree of bacteriuria or pyuria in 52 persons who completed the study protocol. A significant increase in urinary pH occurred in all 3 groups. No significant development of resistance to oral antimicrobials beyond what was observed at baseline was detected. CONCLUSIONS: Bladder irrigation was generally well tolerated for 8 weeks. No advantages were detected for neomycin-polymyxin or acetic acid over saline in terms of reducing the urinary bacterial load and inflammation. We cannot recommend bladder irrigation as a means of treatment for bacteriuria in persons with neurogenic bladder.
