Family Adversity and Resilience Measures in Pediatric Acute Care Settings

Abstract

Caregivers using pediatric acute care settings carry a high burden of ACEs and current adversities. Caregiver ACEs are associated with current child experiences of adversity. Caregivers socioeconomic status and education level may not be an accurate indicator of a family's risks or needs. Pediatric acute care settings offer opportunities to access, intervene, and prevent childhood adversity.

Nationwide efforts for trauma-informed care implementation and workforce development in healthcare and related fields: a systematic review

“…3,11,22,23,31,32 Mental health is associated with exposure to multiple ACEs, including learning and behavioral problems, somatic disorders, hallucinations, anxiety and obsessivecompulsive disorders, substance use disorders, depression and subsequent suicide attempts during adulthood as well as posttraumatic stress disorder, which may not always respond to traditional treatment. 2,5,[10][11][12][19][20][21]27,28,[33][34][35][36] Previous studies have explored how ACEs create an environment of traumatic toxic stress that can lead to prolonged activation of the stress response system, excess cortisol circulation, and disruption of the neuroendocrine and immune systems. When the stress response system remains on high alert, it can lead to remodeling of neurological pathways particularly in the hippocampus, amygdala, and prefrontal cortex.…”

“…[52][53][54][55] TIC organizations strive to improve multiple practice domains: education of providers to change practice, early identification of children experiencing adversity, treatment through evidence supported and resiliency-focused services, and collaboration within and across agencies that serve children and families in the broader community. 34,[56][57][58] The Substance Abuse and Mental Health Services Administration (SAMHSA) outlines six broad principles to implement TIC (Table I). 59 These principles include safety, organizational trustworthiness and transparency, peer support, organizational collaboration amongst its members, empowerment of clients, and culturally sensitive care.…”

Parental Adverse Childhood Experiences and Resilience on Coping After Discharge

“…7 The scale employs 6 items, each on a 5-point Likert scale; higher scores indicate higher resilience. 7,20 Example statements include "I tend to bounce back quickly after hard times" and "It does not take me long to recover from a stressful event." BRS responses are averaged yielding a final score ranging from 0 to 5; we treated this as a continuous variable.…”

Positive Psychology Intervention for Families of Hospitalized Children

“…This is in line with the idea that perceived social support -which may have been activated in the group intervention -can promote coping strategies and help adapt to stressful changes and moments (Schultze-Lutter et al, 2016). The strategy focused on the problem has the potential to be positive, because it can help mothers to focus on something evaluated as changeable and that, in some way, they can act to help resolve the issue (Hendriks et al, 2019;Lazarus & Folkman, 1984), reducing the feeling of powerlessness in the face of their children's illness (Muscara et al, 2015;O'Malley, Randell & Dowd, 2016). In addition, such results must be considered.…”