BackgroundWhile talking about traumatic experiences is considered central to psychological recovery, little is known about how these conversations occur in daily life.ObjectiveWe investigated spontaneous injury talk among parents and children in the aftermath of a child’s hospitalisation due to physical trauma, and its relationship with children’s socioemotional functioning.MethodsIn a prospective naturalistic observation study, we audio-sampled the daily life of 71 families with the Electronically Activated Recorder after their child (3–16 years old) was discharged from hospital. We collected close to 20 000 snippets of audio information, which were double-coded for conversation characteristics, and measured children’s socioemotional functioning with the Strengths and Difficulties Questionnaire (SDQ) at 6 weeks and 3 months postinjury.FindingsThe children were involved in injury talk for, on average, 46 min/day, 9 min of which referred to emotions. Children had significantly more injury conversations with their mothers than with their fathers. The tone of injury conversations was significantly more positive than that of non-injury conversations. More direct injury talk was associated with fewer problems on the emotion subscale of the SDQ at 3 months. Other associations between aspects of injury talk and children’s socioemotional functioning were mostly non-significant, although they appeared to be stronger at 3 months than at 6 weeks.ConclusionsFamilies spontaneously talked about the injury and associated issues for about the same amount of time per day as a therapist might within a session (a ‘therapy hour’).Clinical implicationsMaking full use of naturally occurring injury talk may be a valuable direction for parent and family-focused postinjury interventions. However, the study design prevents causal inference, and further exploration is warranted.

Background While talking about traumatic experiences is considered central to psychological recovery, little is known about how these conversations occur in daily life. Objective We investigated spontaneous injury talk among parents and children in the aftermath of a child's hospitalisation due to physical trauma, and its relationship with children's socioemotional functioning. Methods In a prospective naturalistic observation study, we audio-sampled the daily life of 71 families with the Electronically Activated Recorder after their child (3-16 years old) was discharged from hospital. We collected close to 20 000 snippets of audio information, which were double-coded for conversation characteristics, and measured children's socioemotional functioning with the Strengths and Difficulties Questionnaire (SDQ) at 6 weeks and 3 months postinjury. Findings The children were involved in injury talk for, on average, 46 min/day, 9 min of which referred to emotions. Children had significantly more injury conversations with their mothers than with their fathers. The tone of injury conversations was significantly more positive than that of non-injury conversations. More direct injury talk was associated with fewer problems on the emotion subscale of the SDQ at 3 months. Other associations between aspects of injury talk and children's socioemotional functioning were mostly non-significant, although they appeared to be stronger at 3 months than at 6 weeks. Conclusions Families spontaneously talked about the injury and associated issues for about the same amount of time per day as a therapist might within a session (a 'therapy hour'). Clinical implications Making full use of naturally occurring injury talk may be a valuable direction for parent and family-focused postinjury interventions. However, the study design prevents causal inference, and further exploration is warranted. BaCkgrOundThe consequences of injuries in childhood can go beyond physical health. While most children recover well, a minority experience long-term distress, impairing functioning and development.1 In particular, children admitted to hospital after injury are at risk of mental health problems (eg, post-traumatic stress or depressive symptoms), academic underperformance and social difficulties.

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This study explores the importance of social networks and transport for people who had experienced a traumatic injury three years earlier. Many participants found travelling difficult because of pain, discomfort, fatigue and mobility impairments caused by their injuries which led them to be highly dependent on being a passenger in cars driven by others, or on public transport and taxis, to meet their travels needs. After injury, participants' needs to travel were often high because they had to attend regular medical and physiotherapy appointments. They also needed to be able to travel to reengage with social activities. For those who used public transport or taxis, new challenges were faced in terms of the preplanning, lack of accessibility and availability of these modes. Participants that lived in rural areas with infrequent public transport keenly felt their dependence on others for transport as did those who were wheelchair dependent where car based travel was the only option. Participants described their dependence on others for travel as feeling they were a burden. For some participants their social network could not help with travel. This meant that they either did not travel or had to absorb the costs of taxis. Practical support from the Transport Accident Commission compensation scheme in terms of taxi vouchers were useful and appreciated. However, the service provided by taxis was perceived as costly and, at times, described as unreliable and unsafe. There were many hidden costs related to supporting the travel needs of injured people. Participants who could not travel and reengage with social activities felt emotionally low, isolated and vulnerable. Service providers need to consider injured people's ability to access support for travel, the availability of accessible transport and help with travel costs in order to support their physical and psychological recovery.

Paediatric trauma can result in significant levels of on-going disability. The aim of this study was to explore the restrictions on activity participation that children experience following serious injury from the perspective of their caregivers. We performed a thematic analysis of transcripts of semi-structured in-depth interviews with the caregivers of 44 seriously injured children, conducted three-years after the injury, and purposively sampled from a population-based cohort study. Both temporary and on-going restrictions on school, sport, leisure and social activities were identified, some of which were imposed by caregivers, schools, or recommended by health providers. The perceived risk of further injury, physical restrictions, emotional state and fatigue levels were important influences on degrees of activity restriction. Children who were socially less engaged, especially those who were more severely injured, had difficulty making and retaining friends, and exhibited signs of depression or social withdrawal. The activities of pre-school children were strongly regulated by their caregivers, while school age children faced obstacles with participation in aspects such as study, sport, and peer and teacher relationships, affecting learning, school attendance and enjoyment. The findings highlight the need for primary prevention and reducing the impacts of serious injury throughout the continuum of care.