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Demetriou EA, Boulton KA, Bowden MR, Guastella AJ. Adjustment and homesickness in hospitalised children: A systematic review. Clin Psychol Rev 2024; 110:102431. [PMID: 38626645 DOI: 10.1016/j.cpr.2024.102431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 03/29/2024] [Accepted: 04/09/2024] [Indexed: 04/18/2024]
Abstract
Children can experience significant distress during hospitalisation, as a result of the treatment process and due to psychosocial factors impacting their adjustment to the hospital environment. Such factors can contribute to negative outcomes for the child. Despite this, limited research focus has been placed on understanding the psychosocial factors that contribute to a child's distress to inform support strategies that can improve the experience of hospitalisation across paediatric conditions. The objectives of this review were to synthesise the qualitative and quantitative literature on psychosocial factors associated with hospital adjustment and to identify risk and protective factors that influence the adjustment process. The literature search (1980 to February 2024: CINAHL / Embase / Medline / PsychINFO and Web of Science databases) identified thirty-four studies. Poor hospital adjustment, anxiety, depression and homesickness, were reported by the majority of hospitalised children. Several demographic and psychosocial factors were identified in the quantitative synthesis to contribute to poor adjustment. Child age, temperament, attachment style, past negative hospital experiences, homesickness and fear cognitions, were all associated with adjustment to the hospital environment. Homesickness was identified as a particularly understudied and important construct. Theoretical and methodological considerations are discussed, and recommendations made for future research that can further support inpatient children and their families.
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Affiliation(s)
- Eleni Andrea Demetriou
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 2050, Australia
| | - Kelsie Anne Boulton
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 2050, Australia
| | - Michael Russell Bowden
- Mental Health Branch, NSW Health; Sydney Children's Hospitals Network; Discipline of Psychiatry, Westmead Clinical School and The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Australia
| | - Adam John Guastella
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 2050, Australia.
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2
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Hayes LC, Shepard JA, SooHoo MM, Rouse CM, Papadakis JL. Preventing Pediatric Medical Traumatic Stress in a Pediatric Urology Outpatient Setting: Application of the Pediatric Psychosocial Preventative Health Model (PPPHM). J Pediatr Psychol 2024; 49:259-265. [PMID: 37738669 DOI: 10.1093/jpepsy/jsad064] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 08/30/2023] [Accepted: 09/10/2023] [Indexed: 09/24/2023] Open
Abstract
OBJECTIVE The objectives of this topical review are to (1) increase understanding of pediatric medical traumatic stress (PMTS) in pediatric urology populations through literature review, (2) identify a theoretical model to guide prevention of PMTS in this population, and (3) provide clinical care recommendations based on the model identified. Authors introduce a new term "uropsychology" to describe psychological practice that specializes in the treatment of urology patients. METHODS Pediatric uropsychologists from 5 pediatric medical care centers gathered to discuss their experience with treating PMTS in their settings and to review existing literature related to PMTS in pediatric urology, PMTS in other populations, and established models for prevention. Authors provide recommendations based on literature review for preventing PMTS in a pediatric urology population. RESULTS Gaps in the evidence base for preventing PMTS in this population are identified. Authors provide a series of clinical care recommendations, utilizing clinical experience, and the Pediatric Psychosocial Preventative Health Model (PPPHM) as a framework. CONCLUSIONS While there is limited research on PMTS in pediatric urology populations, urologic interventions can be perceived as invasive, painful, distressing, and traumatic. Application of the PPPHM can guide prevention and intervention efforts. Future research is needed to characterize PMTS in this population, evaluate the efficacy of trauma-informed prevention and intervention practices, and develop screening measures that accurately identify at-risk patients. Authors recommend intradisciplinary collaboration among uropsychologists, urology specialists, and patients and families to create formal standards of care, avenues for other future research, and equitable access to uropsychology care.
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Affiliation(s)
- Lillian C Hayes
- Department of Urology, Boston Children's Hospital, USA
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, USA
- Department of Psychiatry, Harvard Medical School, USA
| | - Jaclyn A Shepard
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, USA
| | | | | | - Jaclyn L Papadakis
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, USA
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Rich V, Plummer K, Padhy S, Barratt T, Tran J, Treadgold C, Robertson EG. Captains on call: A qualitative investigation of an intervention to support children with retinoblastoma undergoing regular eye examinations. Psychooncology 2024; 33:e6315. [PMID: 38423988 DOI: 10.1002/pon.6315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 02/05/2024] [Accepted: 02/19/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Retinoblastoma is a rare childhood ophthalmic cancer that requires frequent eye examinations under anaesthesia and painful or distressing procedures. This can cause significant anxiety for children and their families. OBJECTIVE We evaluated a Starlight Children's Foundation programme, 'Captains on Call', at the Queensland Children's Hospital, which aims to provide positive distraction and reduce stress, anxiety and pain during the perioperative journey for children in the retinoblastoma treatment pathway. This study examined the impact of the programme on the perioperative experience of the children and their families, using a qualitative design. METHODS This study was conducted in a paediatric operating suite at a tertiary-level children's hospital in Australia. We interviewed a parent from 20 families (from a cohort of 40 families, including 44 children), whose children received treatment or screening for retinoblastoma, focusing on the programme's impact on the child and family at various stages during the perioperative journey. We undertook a thematic analysis of transcribed interviews. RESULTS We identified two themes, each with two sub-themes: (1) the programme positively contributed to the overall treatment journey, by addressing different needs at different times, and helping to reframe a traumatic medical experience, and (2), the programme supported the whole family unit by empowering children through play, and adopting a family systems approach which recognised the impact of cancer treatment on the whole family. CONCLUSION This study highlights the value of the Captains on Call programme in supporting children with retinoblastoma and their families during perioperative visits. The Captains, particularly as non-medicalised professionals in a healthcare setting, built trust and rapport with the children through play over repeated episodes of care. The interprofessional collaborative approach with a reflective cycle of practice extended it beyond a programme providing simple distraction. Other retinoblastoma services may benefit from implementing a similar approach.
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Affiliation(s)
- Vanessa Rich
- Department of Anaesthesia, Children's Health Queensland, South Brisbane, Queensland, Australia
| | - Karin Plummer
- Department of Anaesthesia, Children's Health Queensland, South Brisbane, Queensland, Australia
- School of Nursing and Midwifery, Griffith University, Southport, Queensland, Australia
| | - Sofia Padhy
- Department of Anaesthesia, Children's Health Queensland, South Brisbane, Queensland, Australia
- Department of Anaesthesia, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Tamsin Barratt
- Department of Anaesthesia, Children's Health Queensland, South Brisbane, Queensland, Australia
| | - Johnson Tran
- Department of Anaesthesia, Children's Health Queensland, South Brisbane, Queensland, Australia
| | - Claire Treadgold
- Starlight Children's Foundation, New South Wales, New South Wales, Australia
| | - Eden G Robertson
- Starlight Children's Foundation, New South Wales, New South Wales, Australia
- Faculty of Medicine and Health, School of Clinical Medicine, UNSW Medicine & Health, UNSW Sydney, Sydney, New South Wales, Australia
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Boztepe H, Çınar Özbay S, Akçam A, Kanbay Y. The pediatric provider communication skills assessment scale. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2023; 36:307-315. [PMID: 37394543 DOI: 10.1111/jcap.12433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 06/12/2023] [Accepted: 06/20/2023] [Indexed: 07/04/2023]
Abstract
PROBLEM Building rapport and trust between healthcare professional and patient/parents would improve satisfaction of patient/parents. The purpose of this study was to develop "The Pediatric Provider Communication Skills Assessment Scale" in this study. METHODS A trial form, with linguistic and psychometric validation and consisting of 44 statements, was administered to a sample of 325 individuals. Data were collected between January 20 and October 22, 2021. The validity of the scale was concluded after examining its construct validity and internal validity. "Exploratory factor analysis" was used for determining construct validity, and "comparison of lower-upper groups" for internal validity. "Cronbach's α reliability coefficient" and "split half test consistency coefficient" were calculated for testing the reliability of the scale. FINDINGS The Pediatric Provider Communication Skills Assessment Scale that we developed consists of one dimension and 20 items, and the variance it can explain was calculated as 62.3%. The Cronbach α reliability coefficient of the scale was calculated as 0.90, indicating high reliability. CONCLUSIONS According to the findings, "The Pediatric Provider Communication Skills Assessment Scale" is a scale with features that can measure in a valid and reliable way, with high variance and a low number of items. The study aims to develop the "The Pediatric Provider Communication Skills Assessment Scale," and present it to the literature as a validated and reliable new objective measurement tool. This study will enable us to understand more about the complex communication processes involved in pediatric care and how these may influence care delivery.
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Affiliation(s)
- Handan Boztepe
- Department of Nursing, Faculty of Health Sciences, Atilim University, Ankara, Turkey
| | - Sevil Çınar Özbay
- Emergency Aid and Disaster Management, Faculty of Health Sciences, Artvin Coruh University, Artvin, Turkey
| | - Aysun Akçam
- Department of Turkish Language Teaching, Faculty of Education, Necmettin Erbakan University, Konya, Turkey
| | - Yalçın Kanbay
- Department of Nursing, Faculty of Health Sciences, Artvin Coruh University, Artvin, Turkey
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5
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Cuneo AA, Sifflet C, Bardach N, Ly N, von Scheven E, Perito ER. Pediatric Medical Traumatic Stress and Trauma-Informed Care in Pediatric Chronic Illness: A Healthcare Provider Survey. J Pediatr 2023; 261:113580. [PMID: 37353148 DOI: 10.1016/j.jpeds.2023.113580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 06/06/2023] [Accepted: 06/16/2023] [Indexed: 06/25/2023]
Abstract
OBJECTIVE To inform approaches to pediatric medical traumatic stress (PMTS) by exploring providers' (1) perception of the impact of PMTS on the medical care of patients with pediatric-onset chronic illnesses, (2) self-reported competencies and practices of PMTS prevention, treatment, and counseling, and (3) perception of the barriers influencing the adoption of these practices. STUDY DESIGN A convenience sample of multidisciplinary healthcare providers was recruited through a multimodal recruitment strategy to participate in an electronic survey adapted from the Trauma-Informed Care Provider Survey. RESULTS Among participants (n = 304), 99% agreed that PMTS impacts patient health. Participants report altering medical care plans due to PMTS, including deferring or stopping treatments (n = 98 [32%]) and changing medication regimens (n = 88 [29%]). Sixty-eight percent (n = 208) report negative impact of PMTS on patient implementation of medical care plans, including medication nonadherence (n = 153 [50%]) and missed appointments (n = 119 [39%]). Although participants agreed it is their job to decrease patient stress (n = 292 [96%]) and perform PMTS assessments (n = 268 [88%]), few practiced PMTS-focused trauma informed care. Systems-level barriers to practice included insufficient training, absent clinical workflows, and lack of access to mental health experts. CONCLUSIONS Our findings have helped inform a conceptual framework for understanding the relationship between PMTS and health outcomes. Systems-level opportunities to optimize PMTS-focused trauma-informed care include (1) dissemination of provider training, (2) integrated workflows for PMTS mitigation, and (3) enhanced accessibility to mental health providers. Further work is required to determine if these interventions can improve health outcomes in patients with pediatric-onset chronic illnesses.
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Affiliation(s)
- Addison A Cuneo
- Department of Pediatrics, University of California San Francisco, San Francisco, CA.
| | - Christopher Sifflet
- School of Public Health, University of California, Berkeley, Berkeley, CA; School of Medicine, University of California, San Francisco, San Francisco, CA
| | - Naomi Bardach
- Department of Pediatrics, University of California San Francisco, San Francisco, CA
| | - Ngoc Ly
- Department of Pediatrics, University of California San Francisco, San Francisco, CA
| | - Emily von Scheven
- Department of Pediatrics, University of California San Francisco, San Francisco, CA
| | - Emily R Perito
- Department of Pediatrics, University of California San Francisco, San Francisco, CA
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Sharp R, Muncaster M, Baring CL, Manos J, Kleidon TM, Ullman AJ. The parent, child and young person experience of difficult venous access and recommendations for clinical practice: A qualitative descriptive study. J Clin Nurs 2023; 32:6690-6705. [PMID: 37204006 DOI: 10.1111/jocn.16759] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 04/02/2023] [Accepted: 05/03/2023] [Indexed: 05/20/2023]
Abstract
AIMS AND OBJECTIVES Explore the parent and child/young person experience of difficult venous access and identify ideas and preferences for changes to clinical practice. BACKGROUND Peripheral intravenous catheter insertion is one of the most common invasive procedures in hospitalised paediatric patients. Multiple insertion attempts in paediatric patients are common and associated with pain and distress. Little research has explored the parent and child/young person experience of difficult venous access nor sought to identify their suggestions to improve clinical practice. DESIGN Qualitative description. METHODS A purposive sampling approach was used to identify children and young people with experience of difficult venous access and their parents. Semi-structured interviews were conducted, with sample size based on data saturation. Transcripts were analysed using thematic analysis. RESULTS There were 12 participants, seven parents and five children/young people (five parent/child dyads and two individual parents). Analysis of the data revealed three main themes: (1) Distress-before, during and after (2) Families navigating the system: the challenging journey from general clinician to specialist and (3) Difficult venous access impacts both treatment and life outside the hospital A pre-determined theme, (4) Recommendations for good clinical practice is also described. CONCLUSIONS Multiple attempts to insert a peripheral intravenous catheter are a source of substantial distress for children/young people, leading to treatment avoidance. Effective interpersonal skills, providing choice and avoiding frightening language are important to minimise distress. Clinicians without specialist training should assess each child's venous access experience and consider immediate referral to a specialist if they have a history of difficult venous access. Cultural change is required so clinicians and healthcare services recognise that repeated cannulation may be a source of psychological distress for children/young people.
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Affiliation(s)
- Rebecca Sharp
- Clinical & Health Sciences, University of South Australia, Adelaide, South Australia, Australia
- Rosemary Bryant AO Research Centre, University of South Australia, Adelaide, South Australia, Australia
| | - Michele Muncaster
- South Australian Medical Imaging, Adelaide, South Australia, Australia
- Womens' and Children's Hospital Network, Adelaide, South Australia, Australia
| | - Catherine L Baring
- Clinical & Health Sciences, University of South Australia, Adelaide, South Australia, Australia
- South Australian Medical Imaging, Adelaide, South Australia, Australia
- Womens' and Children's Hospital Network, Adelaide, South Australia, Australia
| | - Jacinta Manos
- South Australian Medical Imaging, Adelaide, South Australia, Australia
- Womens' and Children's Hospital Network, Adelaide, South Australia, Australia
| | - Tricia M Kleidon
- Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia
| | - Amanda J Ullman
- Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia
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Dewan T, Birnie K, Drury J, Jordan I, Miller M, Neville A, Noel M, Randhawa A, Zadunayski A, Zwicker J. Experiences of medical traumatic stress in parents of children with medical complexity. Child Care Health Dev 2023; 49:292-303. [PMID: 35947493 PMCID: PMC10087969 DOI: 10.1111/cch.13042] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 05/25/2022] [Accepted: 08/07/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Parents of children with medical complexity (CMC) experience high levels of stress and adverse mental health outcomes. Pediatric medical traumatic stress (PMTS) could be an important contributor that has not yet been explored. PMTS describes parents' reactions to their child's illness and medical treatment and can lead to post-traumatic stress symptoms. This is the first study to describe the experiences and impact of PMTS among parents of CMC. METHODS We conducted semi-structured interviews with 22 parents of CMC. Reflexive thematic analysis was used to generate themes that described the experiences of PMTS and potential contributing factors in the healthcare setting. Themes were validated by study participants. RESULTS Parents experienced a spectrum of events and circumstances that impacted PMTS. These corresponded to three major themes: (a) the distinctive context of being the parent of a CMC, (b) interactions with healthcare providers that can hurt or heal and (c) system factors that set the stage for trauma. The consequences of repeated PMTS were a common point of emphasis among all the themes. Parents identified numerous changes that could mitigate PMTS such as acknowledgement of trauma and provision of proactive mental health support. CONCLUSIONS Our study highlights the issue of PMTS among parents of CMC and presents opportunities to mitigate their traumatic experiences. Supporting the integration of trauma-informed care practices, increasing awareness of PMTS and advocating for parental mental health services could better support parents and families.
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Affiliation(s)
- Tammie Dewan
- Department of Pediatrics, University of Calgary, Calgary, Canada.,Alberta Children's Hospital Research Institute, Calgary, Canada
| | - Katie Birnie
- Department of Anesthesia and Pain Medicine, University of Calgary, Calgary, Canada
| | | | | | - Megan Miller
- Rotary Flames Children's Hospice and Palliative Care Service, Calgary, Canada
| | | | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Alam Randhawa
- Department of Pediatrics, University of Calgary, Calgary, Canada
| | - Anna Zadunayski
- Department of Pediatrics, University of Calgary, Calgary, Canada
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Davis KA, Dietrich MS, Gilmer MJ, Fuchs DC, Akard TF. Postoperative opioid administration and post-traumatic stress symptoms in preschool children after cardiac surgery. J Pediatr Nurs 2023; 68:44-51. [PMID: 36333168 DOI: 10.1016/j.pedn.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 10/05/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE The purpose of this study was to explore relationships between postoperative opioid administration and posttraumatic stress symptoms (PTSS) in preschool-aged children surviving cardiac surgery. DESIGN AND METHODS This was a cross-sectional, descriptive study using survey administration and medical chart review. Primary caregivers of children aged three to six years who underwent cardiac surgery at our institution between 2018 and 2020 were invited to participate. Opioid administration was calculated according to morphine milligram equivalents and indexed to the child's body weight. Caregivers completed the Young Child Posttraumatic Stress Disorder Checklist to explore child PTSS. We used correlational methods to assess the strength and direction of relationships between postoperative opioid administration and child PTSS. RESULTS We did not find a statistically significant relationship between total postoperative opioid administration and child PTSS. When analyzing individual opioid agents, morphine did show a significant inverse relationship to YCPC scores (rs = -.57, p = .017) in children with single ventricle physiology. CONCLUSIONS Total postoperative opioid administration was not statistically significantly related to child PTSS in our sample. Differing patterns of association were noted among children with single- versus bi-ventricular physiology. Postoperative morphine administration was favorably associated with PTSS in children with single-ventricle physiology. PRACTICE IMPLICATIONS Nurses caring for preschool children who undergo cardiac surgery should anticipate the potential development of PTSS in their patients. Studies using larger sample sizes and longitudinal design are needed to replicate the significant relationship between morphine administration and PTSS in preschoolers with single-ventricle physiology.
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Affiliation(s)
- Kelly A Davis
- Vanderbilt University School of Nursing, Vanderbilt University, 461 21st Avenue South, Nashville, TN 37240, USA; Division of Pediatric Critical Care, Vanderbilt University Medical Center, 2200 Children's Way, Nashville, TN 37232, USA.
| | - Mary S Dietrich
- Vanderbilt University School of Nursing, Vanderbilt University, 461 21st Avenue South, Nashville, TN 37240, USA; Department of Biostatistics, Vanderbilt University Medical Center, 1211 Medical Center Drive Nashville, TN 37232, USA
| | - Mary Jo Gilmer
- Vanderbilt University School of Nursing, Vanderbilt University, 461 21st Avenue South, Nashville, TN 37240, USA
| | - D Catherine Fuchs
- Department of Child and Adolescent Psychiatry, Vanderbilt University Medical Center, 2200 Children's Way, Nashville, TN 37232, USA
| | - Terrah Foster Akard
- Vanderbilt University School of Nursing, Vanderbilt University, 461 21st Avenue South, Nashville, TN 37240, USA
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Demers LA, Wright NM, Kopstick AJ, Niehaus CE, Hall TA, Williams CN, Riley AR. Is Pediatric Intensive Care Trauma-Informed? A Review of Principles and Evidence. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101575. [PMID: 36291511 PMCID: PMC9600460 DOI: 10.3390/children9101575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/03/2022] [Accepted: 10/10/2022] [Indexed: 11/23/2022]
Abstract
Pediatric critical illness and injury, along with the experience of recovering from critical illness are among the most potentially traumatic experiences for children and their families. Additionally, children often come to the Pediatric Intensive Care Unit (PICU) with pre-existing trauma that may sensitize them to PICU-related distress. Trauma-informed care (TIC) in the PICU, while under-examined, has the potential to enhance quality of care, mitigate trauma-related symptoms, encourage positive coping, and provide anticipatory guidance for the recovery process. This narrative review paper first describes the need for TIC in the PICU and then introduces the principles of TIC as outlined by the American Academy of Pediatrics: awareness, readiness, detection and assessment, management, and integration. Current clinical practices within PICU settings are reviewed according to each TIC principle. Discussion about opportunities for further development of TIC programs to improve patient care and advance knowledge is also included.
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Affiliation(s)
- Lauren A. Demers
- Pediatric Critical Care and Neurotrauma Recovery Program, Oregon Health & Science University, Portland, OR 97239, USA
- Division of Pediatric Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
| | - Naomi M. Wright
- Division of Pediatric Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Psychology, University of Denver, Denver, CO 80208, USA
| | - Avi J. Kopstick
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Texas Tech University Health Science Center El Paso, El Paso, TX 97705, USA
| | - Claire E. Niehaus
- Division of Psychology and Psychiatry, University of Louisville School of Medicine, Louisville, KY 40202, USA
| | - Trevor A. Hall
- Pediatric Critical Care and Neurotrauma Recovery Program, Oregon Health & Science University, Portland, OR 97239, USA
- Division of Pediatric Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
- Correspondence: ; Tel.: +1-503-418-2134
| | - Cydni N. Williams
- Pediatric Critical Care and Neurotrauma Recovery Program, Oregon Health & Science University, Portland, OR 97239, USA
- Division of Pediatric Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
- Division of Pediatric Critical Care, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
| | - Andrew R. Riley
- Division of Pediatric Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
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10
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Huebschmann NA, Cook NE, Murphy S, Iverson GL. Cognitive and Psychological Outcomes Following Pediatric Cardiac Arrest. Front Pediatr 2022; 10:780251. [PMID: 35223692 PMCID: PMC8865388 DOI: 10.3389/fped.2022.780251] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 01/06/2022] [Indexed: 11/13/2022] Open
Abstract
Cardiac arrest is a rare event in children and adolescents. Those who survive may experience a range of outcomes, from good functional recovery to severe and permanent disability. Many children experience long-term cognitive impairment, including deficits in attention, language, memory, and executive functioning. Deficits in adaptive behavior, such as motor functioning, communication, and daily living skills, have also been reported. These children have a wide range of neurological outcomes, with some experiencing specific deficits such as aphasia, apraxia, and sensorimotor deficits. Some children may experience emotional and psychological difficulties, although many do not, and more research is needed in this area. The burden of pediatric cardiac arrest on the child's family and caregivers can be substantial. This narrative review summarizes current research regarding the cognitive and psychological outcomes following pediatric cardiac arrest, identifies areas for future research, and discusses the needs of these children for rehabilitation services and academic accommodations.
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Affiliation(s)
- Nathan A Huebschmann
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, United States.,Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States.,New York University Grossman School of Medicine, New York, NY, United States
| | - Nathan E Cook
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, United States.,Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States
| | - Sarah Murphy
- Division of Pediatric Critical Care, MassGeneral Hospital for Children, Boston, MA, United States.,Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Grant L Iverson
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, United States.,Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States.,Spaulding Research Institute, Charlestown, MA, United States
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11
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Latif F, Albreiki M. Management of Common Psychiatric Illnesses on Pediatric Medical Floors. Psychiatr Ann 2021. [DOI: 10.3928/00485713-20210920-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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12
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Santacrose DE, Kia-Keating M, Lucio D. A systematic review of socioecological factors, community violence exposure, and disparities for Latinx youth. J Trauma Stress 2021; 34:1027-1044. [PMID: 34647363 DOI: 10.1002/jts.22733] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 01/02/2023]
Abstract
Community violence exposure poses a public health risk exacerbated by immigration-related stressors and environmental factors, including systemic racism and interpersonal discrimination, socioeconomic disparities, and anti-immigrant laws and policies, that disproportionately impact Latinx-immigrant and systematically minoritized youth. Using the ecological-transactional model of community violence as a conceptual framework, this systematic review was conducted to examine research on exposure to community violence, risk and protective factors, and associated health and mental health sequelae among Latinx youth. The initial search generated 2,152 articles, 291 of which were reviewed for detailed evaluation; ultimately, 59 articles were included. Mexican-origin youth and adolescent samples were the most represented in research studies. Across several studies, Latinx youth reported high rates of violence exposure and poor health or mental health outcomes. The findings revealed important gaps in socioecological factors, with a dearth of evidence establishing macrosystem factors or culturally salient and immigrant-related factors. Notable risk and protective factors at various ecological levels were identified and discussed as key opportunities for future research and points of intervention or prevention efforts for Latinx-immigrant and systematically minoritized youth.
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Affiliation(s)
- Diana E Santacrose
- Department of Psychology, Loyola Marymount University, Los Angeles, California, USA
| | - Maryam Kia-Keating
- Department of Counseling, Clinical and School Psychology, University of California, Santa Barbara, Santa Barbara, California, USA
| | - Daniella Lucio
- Department of Psychology, Loyola Marymount University, Los Angeles, California, USA
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Bichard E, Wray J, Aitken LM. Discharged from paediatric intensive care: A mixed methods study of teenager's anxiety levels and experiences after paediatric intensive care unit discharge. Nurs Crit Care 2021; 27:429-439. [PMID: 34405487 DOI: 10.1111/nicc.12703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 07/16/2021] [Accepted: 08/04/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Teenagers represent a small proportion of patients on paediatric intensive care units (PICU) in the United Kingdom. During a time when their development is rapidly changing, an admission to PICU causes additional disruption. The impact of critical illness on psychological health after discharge has not been widely reported within this population. AIM AND OBJECTIVES To measure anxiety that teenagers report 48-96 hours and 4 weeks after discharge from PICU. To explore teenagers' experiences of being admitted onto PICU. DESIGN Two-phase mixed methods, explanatory sequential design. METHODS This single-site study was conducted between February and July 2018. An NHS Ethics committee approved the study. Teenagers were screened if they were aged 13-18 years old and had an elective or emergency admission to PICU for longer than 24 hours. Hospital Anxiety and Depression Scale, Anxiety subscale (HADS-A) was administered on paper and completed with the researcher present. Semi-structured interviews were conducted in-person and over the telephone, audio-recorded and transcribed verbatim. Data were analysed using inductive thematic analysis. RESULTS Nine of eighteen participants (50%) obtained scores indicating levels of anxiety which were mild (n = 3; 17%), moderate (n = 2; 11%), or severe (n = 4; 22%) 48-96 hours after PICU discharge. Four weeks later, all participants scored below the clinically significant cut-off level for the HADS-A-1 Teenagers described their experiences on PICU within three themes: Memories of treatments, side effects, and the PICU environment Losing a sense of self Feeling cared for CONCLUSIONS: Measured levels of anxiety had resolved in this small sample, 4 weeks after PICU discharge. This finding was not consistent with qualitative data that indicated that many experiences shared by participants were anxiety provoking. RELEVANCE TO CLINICAL PRACTICE Support for teenagers after PICU discharge should be available to meet individual needs; screening teenagers to identify support needs would be beneficial.
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Affiliation(s)
- Elizabeth Bichard
- London South Bank University, London, UK.,Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Jo Wray
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,NIHR GOSH BRC, London, UK
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Herrenkohl TI, Mersky JP, Topitzes J. Applied and Translational Research on Trauma-Responsive Programs and Policy: Introduction to a Special Issue of the American Journal of Community Psychology. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 64:281-285. [PMID: 31593311 DOI: 10.1002/ajcp.12402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The special issue highlights work across systems that include child welfare, education, juvenile justice and health, as well as agencies serving adults who are at-risk for high levels of childhood and adult trauma exposure. While articles appearing in the special issue are not divided equally across these systems, they cover important and overlapping concepts within each. Some articles span more than a single system or domain of research, whereas others fit primarily within single area or domain. Articles provide new insights from research on practices, programs, and policies that help to transform systems so they are increasingly more responsive to the needs of vulnerable populations.
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Affiliation(s)
- Todd I Herrenkohl
- School of Social Work, University of Michigan, Ann Arbor, Michigan, MI, USA
| | - Joshua P Mersky
- Helen Bader School of Social Welfare, University of Wisconsin- Milwaukee, Milwaukee, WI, USA
| | - James Topitzes
- Helen Bader School of Social Welfare, University of Wisconsin- Milwaukee, Milwaukee, WI, USA
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