Trauma-informed care for children in the ambulance: international survey among pre-hospital providers

Abstract

Background: Pre-hospital providers, such as paramedics and emergency medical technicians, are in a position to provide key emotional support to injured children and their families. Objective: Our goal was to examine (a) pre-hospital providers’ knowledge of traumatic stress in children, attitudes towards psychosocial aspects of care, and confidence in providing psychosocial care, (b) variations in knowledge, attitudes, and confidence according to demographic and professional characteristics, and (c) training preferences of pre-hospital providers regarding psychosocial care to support paediatric patients and their families. Method: We conducted a cross-sectional, online survey among an international sample of 812 pre-hospital providers from high-income countries. The questionnaire was adapted from a measure for a similar study among Emergency Department staff, and involved 62 items in 7 main categories (e.g. personal and work characteristics, knowledge of paediatric traumatic stress, and confidence regarding 18 elements of psychosocial care). The main analyses comprised descriptive statistics and multiple regression analyses. Results: On average, respondents answered 2.7 (SD = 1.59) out of seven knowledge questions correctly. Respondents with higher knowledge scores were more often female, parent of a child under 17, and reported that at least 10% of their patients were children. A majority of participants (83.5%) saw all 18 aspects of psychosocial care as part of their job. Providers felt moderately confident (M = 3.2, SD = 0.45) regarding their skills in psychosocial care, which was predicted by gender (female), having more experience, having a larger proportion of child patients, and having received training in psychosocial care in the past five years. Most respondents (89.7%) wanted to gain more knowledge and skills regarding psychosocial care for injured children. In terms of training format, they preferred an interactive website or a one-off group training. Conclusions: There appears to be both a need and an opportunity for education initiatives regarding paediatric traumatic stress in the pre-hospital context.

Perceived support at work after critical incidents and its relation to psychological distress: a survey among prehospital providers

“…The questionnaire consisted of a recently developed measure regarding provision of psychosocial care to children (see Alisic et al (2017) for details),14 validated measures on distress and perceived support and some purposely generated items regarding practitioners’ own psychosocial support. All items were pilot tested with providers, ambulance management staff and topic experts.…”

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

“…The same studies that report healthcare provider gaps in confidence and knowledge regarding addressing trauma in their patients also report a keen desire among providers for training in trauma sensitive methods to address clients' psychological distress effectively and confidently. 141,142 Barriers to asking about trauma may include the providers' discomfort with their own trauma history and the need for self-protection to avoid secondary trauma, compassion fatigue, and burn out. 138,139,143,144 Because one of the strengths of TIC is its focus on self-care and awareness of a provider's own needs, compassion satisfaction, and peer support, it may mitigate secondary traumatization and contribute to the providers' resilience.…”

Trauma Providers' Knowledge, Views, and Practice of Trauma-Informed Care

“…Trauma-informed pediatric health care, including the care of traumatically injured children, has begun to be better defined and described (Kassam-Adams, et al, 2015; Marsac, et al 2016; Weiss, et al, 2017; Alisic, 2016; Alisic, 2017). However, infusion of TIC for the treatment of adult patients admitted to hospital trauma centers has not been explored.…”