Nível de conhecimento e de equívocos sobre concussão cerebral em adultos brasileiros

De Araújo, Amanda Vitória Lacerda; Areza-Fegyveres, Renata; Guariglia, Carla Cristina; Ianof, Jéssica Natuline; Baratho, Regina Maria; Demario, José Luiz Carlos; Watanabe, Rafael Gustavo Sato; Anghinah, Renato

doi:10.1590/0004-282X-ANP-2019-0436

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Article • Arq. Neuro-Psiquiatr. 79 (6) • Jun 2021 • https://doi.org/10.1590/0004-282X-ANP-2019-0436 copiar

Nível de conhecimento e de equívocos sobre concussão cerebral em adultos brasileiros

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO

Introdução:

A concussão cerebral (CC) é considerada prioridade em saúde pública devido à sua alta incidência e taxa de morbidade. Há necessidade de identificação rápida, diagnóstico acurado e manejo correto após essas lesões, com objetivo de reduzir problemas de curto e longo prazo. O conhecimento apropriado da população, atletas e de clínicos é primordial para que isto seja alcançado.

Objetivos:

Avaliar o nível de conhecimento autorrelatado sobre CC, descrever lacunas/equívocos e identificar variáveis correlacionadas com este nível.

Métodos:

Foi realizada uma pesquisa descritiva transversal. O Questionário de Conhecimento sobre Concussão Cerebral (QCCC) criado foi amplamente distribuído. Pontuações totais e parciais em domínios e porcentagens de respostas corretas e incorretas foram calculadas para obter o nível de conhecimento sobre CC.

Resultados:

A amostra foi formada por 1.247 brasileiros adultos (41,7±11,8 anos). Pontuações parciais do QCCC revelaram baixo nível de conhecimento, principalmente em questões sobre recuperação e manejo. Observou-se correlações moderadas entre a pontuação no QCCC e a profissão dos participantes (p=0,312, P=0,00) ou conhecimento prévio sobre CC (p=0,489, P=0,00). A regressão linear múltipla mostrou que a idade, profissão e prática de esportes podem ser preditoras do conhecimento sobre CC.

Conclusão:

Esse primeiro estudo a analisar o nível de conhecimento sobre CC em uma amostra de adultos brasileiros sugere baixo conhecimento e equívocos sobre esta condição. Assim, informações úteis e significantes foram fornecidas para o desenvolvimento de programas de educação em saúde sobre CC para o público, com objetivo de melhorar a identificação rápida e o manejo correto de concussões.

Palavras-chave:
Concussão Encefálica; Concussão Cerebral; Atenção à Saúde; Questionários

Demographic characteristics		Frequency (%)
Sex (n=1,247)
	Female	1048 (84)
	Male	199 (16)
Age in years (n=1,247)
	<20	9 (0.7)
	20–29	165 (13.2)
	30–39	435 (34.9)
	40–49	313 (25)
	50–59	210 (16.8)
	60–69	103 (8.3)
	>70	12 (1)
Education level (n=1,247)
	Elementary school	6 (4.8)
	High school graduate	121 (9.8)
	Bachelor's degree or higher	1120 (89.8)
Profession
	Fields of healthcare or sports	284 (23)
	Other areas	963 (77)
Type of sports (n=1,214)
	Contact sports	61 (5)
	Non-contact sports	704 (58)
	None	449 (37)
Level of sports practice (n=1,239)
	Professional	21 (1.8)
	Semi-professional	49 (4)
	Recreational	703 (56.7)
	None	466 (37.6)
Sports frequency
	None	449 (36)
	Once every 15 days	78 (6.3)
	Once or twice a week	288 (23.1)
	Three or four times a week	313 (25.1)
	Five or six times a week	69 (5.5)
	Daily	50 (4)

Questions and alternatives		Frequency (%)
Have you heard of concussion? (n=1,247)
	Yes	701 (56)
	No	546 (44)
What is your source of knowledge about concussion? (n=1,014)
	Healthcare professional	268 (38)
	Television, newspaper or magazine	272 (39)
	Internet	189 (27)
	Coach or team coach	25 (4)
	Congress, conference or scientific meeting	51 (7)
	Others	209 (30)
Have you ever had concussion or do you live with someone who has had concussion? (n=1,365^* * Question with multiple possible answers. )
	I have never had concussion	635 (51)
	Yes, I have already had concussion	62 (5)
	Yes, I have a family member or friend who had concussion	126 (10)
	I do not know or am not sure what concussion is	542 (44)
	Not available	7 (1)

BCKQ (n=700) Statements (correct answer)		Frequency (%)
BCKQ (n=700) Statements (correct answer)		True	False	NA
Domain of identification and causes of brain concussion
	1. Brain concussion can cause brain damage even if the person has not fainted (T)	580 (82)	120 (18)	0
	2. A person needs to have passed out to be diagnosed with brain concussion (F)	154 (23)	544 (77)	2
	3. The only way to tell whether someone has suffered brain damage from concussion is by mean of cranial tomography or magnetic resonance imaging (F)	608 (87)*	91 (13)	1
	4. Brain concussion can only occur if there is a direct hit to the head (F)	233 (34)	465 (66)	2
	5. An impact on the body that causes rapid acceleration and deceleration of the head can cause brain damage even if there is no direct blow to the head (T)	528 (75)	172 (25)	0
	6. It is easy to tell whether a person has brain damage from concussion from the way the person looks or behaves (F)	391 (56)*	309 (44)	0
Domain of functional and neurological consequences of brain concussion
	7. Brain concussion is harmless and never results in long-term problems or brain damage (F)	196 (28)	504 (72)	0
	8. A little brain damage does not matter, as people only use a small part of their brains anyway (F)	92 (13)	607 (87)	1
	9. Most people who suffer brain concussion do not realize the effect of concussion on their behavior and reasoning (T)	310 (45)	388 (55)*	2
	10. A person may die if a second brain concussion occurs before recovery from a previous one (T)	223 (41)	473 (69)*	4
	11. Brain concussion can make a person feel depressed, hopeless and sad (T)	278 (40)	422 (60)*	0
	12. Emotional problems after brain concussion are usually not related to brain damage (F)	453 (65)*	245 (35)	2
	13. A person who has suffered brain concussion may have trouble recalling facts before the concussion (T)	547 (78)	151 (22)	2
	14. Multiple concussions over the course of life can give rise to brain problems (T)	518 (74)	180 (26)	2
	15. A person who has suffered brain concussion may have trouble learning new things (T)	330 (48)	368 (52)*	2
Domain of recovery and management of brain concussion
	16. Sometimes a second blow to the head can help a person remember things that were forgotten (F)	273 (40)	425 (60)	2
	17. Once a recovering person feels normal, the recovery process is complete (F)	197 (29)	501 (71)	2
	18. Complete recovery from brain concussion is not possible, no matter how badly the person wants to recover (F)	362 (52)*	337 (48)	1
	19. How quickly a person recovers from brain concussion depends mainly on how hard they work on recovery (F)	374 (54)*	324 (46)	2
	20. It is recommended to rest and remain inactive during recovery from brain concussion (F)	521 (76)*	178 (24)	1
	21. After 10 days the symptoms of brain concussion are usually completely gone (T)	65 (8)	634 (91)*	1
	22. A person who has not recovered from brain concussion is less able to withstand a second blow to the head (T)	297 (42)	402 (58)*	1
	23. The most appropriate way to evaluate the progress of recovery after brain concussion is by asking the person who was concussed how they feel (T)	101 (14)	596 (86)*	3
	24. Most people wake up quickly and undamaged after being knocked unconscious by a blow to the head (T)	165 (24)	531 (76)*	4
Domain of sports-related brain concussion
	25. In sports, brain concussion rarely happens (F)	70 (10)	628 (90)	2
	26. Athletes who have had one brain concussion are more susceptible to having another (T)	178 (26)	517 (74)*	5
	27. Athletes who practice contact sports are at greater risk of brain concussion (T)	560 (80)	137 (20)	3
	28. A soccer player who has suffered brain concussion may continue to play as long as they feels good (F)	385 (55)*	313 (45)	2
	29. A soccer player who has suffered brain concussion during a workout can return to the next ball practice as long as they feel good (F)	401 (57)*	295 (43)	4
	30. A soccer player who felt dizzy after suffering brain concussion and returned to dizziness when training should continue training until the dizziness improves (F)	173 (25)	523 (75)	4

Variables		Estimate	SE	p-value
Age (years)		-0.15	0.03	<0.001^* * p<0.05.
Sex (female)		1.20	0.93	0.195
Profession
	Healthcare (reference category)	1.00	-	-
	Sports-related	-7.03	2.37	0.003^* * p<0.05.
	Not related to healthcare or sports	-7.32	0.84	<0.001^* * p<0.05.
Degree of schooling
	Elementary school (reference category)	1.00	-	-
	High school graduate	6.19	6.95	0.373
	Bachelor's degree or higher	6.59	6.85	0.336
	Sport practice (yes)	1.82	0.78	0.021^* * p<0.05.
Sports frequency
	None (reference category)	1.00	-	-
	Once every 15 days	-1.58	1.55	0.309
	Once or twice a week	-1.84	0.97	0.058
	Three or four times a week	-1.70	0.98	0.084
	Five or six times a week	-1.00	1.68	0.551
	Daily	-4.01	1.92	0.037^* * p<0.05.

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[1] Correspondence: Amanda Vitória Lacerda de Araújo; E-mail: amandavla@usp.br.