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Topic 3: ED Providersí Views of and Preparation for Psychosocial Aspects of Pediatric Injury Care

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Why This Article is Relevant or Important:
This is the first large international survey to assess knowledge, confidence, and skills for psychosocial aspects of pediatric injury care among ED providers.

Brief Review
This online survey included 2648 ED staff from 87 countries. Results indicate that most ED staff saw psychosocial aspects of care for injured children as part of their job, and felt moderately confident in providing this care, but were interested in further training in this area. Some knowledge gaps were identified, e.g. in awareness that even very young children can be at risk for psychological sequelae of injury, or that children with a wide range of behavioral presentations may be experiencing emotional distress.

Title, Authors, Abstract
Alisic, E, Hoysted, C, Kassam-Adams, N, Landolt. M, Curtis, S, Kharbanda, A, Lyttle, M, Parri, N, Stanley, R, & Babl, F. (2016). Psychosocial care for injured children: Worldwide survey among hospital emergency staff. Journal of Pediatrics, 170: 227-233. doi: 10.1016/j.jpeds.2015.10.067 PMID: 26707581.

Abstract (from PubMed)

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.

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).

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.

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.