Psychosocial Care for Injured Children: Worldwide Survey among Hospital Emergency Department Staff

Abstract

OBJECTIVE:\ud To examine emergency department (ED) staff's knowledge of traumatic stress in children, attitudes toward providing psychosocial care, and confidence in doing so, and also to examine differences in these outcomes according to demographic, professional, and organizational characteristics, and training preferences.\ud STUDY DESIGN:\ud We conducted an online survey among staff in ED and equivalent hospital departments, based on the Psychological First Aid and Distress-Emotional Support-Family protocols. Main analyses involved descriptive statistics and multiple regressions. Respondents were 2648 ED staff from 87 countries (62.2% physicians and 37.8% nurses; mean years of experience in emergency care was 9.5 years with an SD of 7.5 years; 25.2% worked in a low- or middle-income country).\ud RESULTS:\ud Of the respondents, 1.2% correctly answered all 7 knowledge questions, with 24.7% providing at least 4 correct answers. Almost all respondents (90.1%) saw all 18 identified aspects of psychosocial care as part of their job. Knowledge and confidence scores were associated with respondent characteristics (eg, years of experience, low/middle vs high-income country), although these explained no more than 11%-18% of the variance. Almost all respondents (93.1%) wished to receive training, predominantly through an interactive website or one-off group training. A small minority (11.1%) had previously received training.\ud CONCLUSIONS:\ud More education of ED staff regarding child traumatic stress and psychosocial care appears needed and would be welcomed. Universal education packages that are readily available can be modified for use in the ED

Knowledge and training in paediatric medical traumatic stress and trauma-informed care among emergency medical professionals in low- and middle-income countries

“…Consistent with observations from past research, greater knowledge was associated with higher country income (Alisic et al, 2016; Chandran et al, 2010; Fodor et al, 2014; Schnyder et al, 2016). LMIC emergency staff had somewhat greater gaps in knowledge than their high-income country counterparts and in particular were less likely to identify that toddlers can be at risk of developing paediatric medical traumatic stress and recognize behaviours that indicate risk (Alisic et al, 2016; Hoysted et al, 2017). Conversely, LMIC emergency staff demonstrated greater awareness of the impact of pain on the risk of developing paediatric medical traumatic stress (Alisic et al, 2016; Hoysted et al, 2017).…”

“…LMIC emergency staff had somewhat greater gaps in knowledge than their high-income country counterparts and in particular were less likely to identify that toddlers can be at risk of developing paediatric medical traumatic stress and recognize behaviours that indicate risk (Alisic et al, 2016; Hoysted et al, 2017). Conversely, LMIC emergency staff demonstrated greater awareness of the impact of pain on the risk of developing paediatric medical traumatic stress (Alisic et al, 2016; Hoysted et al, 2017). In the current analysis, LMIC emergency staff demonstrated a moderate level of knowledge of some risk factors for the development of paediatric medical traumatic stress.…”

“…The study design and data collection procedures have been previously described (Alisic et al, 2016). The Human Research Ethics Committee of the Royal Children’s Hospital Melbourne granted ethics approval for this study (HREC 33,085).…”

“…We utilized four subscales (training experiences and preferences, knowledge of paediatric medical traumatic stress, barriers to implementing psychosocial care, attitude towards psychosocial care) of the Psychosocial Care Survey (described in Alisic et al, 2016) to assess: (1) the training status and preferences of emergency staff in LMICs; (2) emergency staff’s knowledge of paediatric medical traumatic stress; (3) perceived barriers to providing psychosocial care; and (4) emergency staff’s attitudes to providing psychosocial care. The measure was available in 12 language versions (English, French, Italian, Arabic, Spanish, Russian, Japanese, Cantonese, Mandarin, Hindi, Malay, Dutch).…”

“…However, research has consistently demonstrated that emergency staff are lacking knowledge of psychological difficulties, such as paediatric medical traumatic stress and skills in promoting psychological recovery utilizing a trauma informed care approach (Banh, Saxe, Mangione, & Horton, 2008; Hoysted et al, 2017; Kassam-Adams et al, 2015; Ziegler, Greenwald, DeGuzman, & Simon, 2005). Further, research has found a greater need for training in LMICs (Alisic et al, 2016) potentially explained by the lack of available resources, including professional training and education, in many LMICs (Chandran et al, 2010; Hsia, Thind, Zakariah, Hicks, & Mock, 2015; Obermeyer et al, 2015). Therefore, the development of targeted training programmes is required to address these limitations in emergency staff knowledge in these economic regions.…”