Trauma-informed and family-centered paediatric resuscitation: Defining domains and practices.

2023

100374

06/2023

2666-5204

AIM: For paediatric patients and families, resuscitation can be an extremely stressful experience with significant medical and psychological consequences. Psychological sequelae may be reduced when healthcare teams apply patient- and family-centered care and trauma-informed care, yet there are few specific instructions for effective family-centered or trauma-informed behaviours that are observable and teachable. We aimed to develop a framework and tools to address this gap.

METHODS: We reviewed relevant policy statements, guidelines, and research to define core domains of family-centered and trauma-informed care, and identified observable evidence-based practices in each domain. We refined this list of practices via review of provider/team behaviours in simulated paediatric resuscitation scenarios, then developed and piloted an observational checklist.

RESULTS: Six domains were identified: (1) Sharing information with patient and family; (2) Promoting family involvement in care and decisions; (3) Addressing family needs and distress; (4) Addressing child distress; (5) Promoting effective emotional support for child; (6) Practicing developmental and cultural competence. A 71-item observational checklist assessing these domains was feasible for use during video review of paediatric resuscitation.

CONCLUSION: This framework can guide future research and provide tools for training and implementation efforts to improve patient outcomes through patient- and family-centered and trauma-informed care.

10.1016/j.resplu.2023.100374

Resusc Plus

37007186

COVID-19 Exposure and Family Impact Scales for Adolescents and Young Adults.

2022

2022 Apr 23

1465-735X

<p><strong>OBJECTIVE: </strong>To understand the impact of the coronavirus disease 2019 (COVID-19) pandemic on adolescents and young adults (AYAs), we adapted the COVID-19 Exposure and Family Impact Scales (CEFIS; Kazak et al., 2021) for AYAs. Here, we report on the development, structure, and psychometric properties of the CEFIS-AYA.</p>

<p><strong>METHODS: </strong>The CEFIS-AYA was developed by a multidisciplinary, multi-institutional team using a rapid iterative process. Data from 3,912 AYAs from 21 programs at 16 institutions across the United States were collected from May 2020 to April 2021. We examined the underlying structure of the CEFIS-AYA using principal component analysis (PCA), calculated internal consistencies, and explored differences in scores by gender and age.</p>

<p><strong>RESULTS: </strong>Participants reported exposure to a range of COVID-19-related events (M = 9.08 events, of 28). On the bidirectional 4-point Impact scale, mean item scores were mostly above the midpoint, indicating a slightly negative impact. Kuder-Richardson 20/Cronbach's Alpha was good for Exposure (α = .76) and excellent for Impact (α = .93). PCA identified seven factors for Exposure (Severe COVID-19, Loss of Income, Limited Access to Essentials, COVID-19 Exposure, Disruptions to Activities, Disruptions to Living Conditions, and Designation as an Essential Worker) and five for Impact (Self and Family Relationships, Physical Well-Being, Emotional Well-Being, Social Well-Being, and Distress). Gender and age differences in CEFIS-AYA scores were identified.</p>

<p><strong>DISCUSSION: </strong>Initial reliability data are strong and support use of the CEFIS-AYA for measuring the effect of the COVID-19 pandemic on AYAs in research and clinical care.</p>

10.1093/jpepsy/jsac036

J Pediatr Psychol

35459946

Implementing Family Presence During Pediatric Resuscitations in the Emergency Department: Family-Centered Care and Trauma-Informed Care Best Practices.

2021

689-692

2021 Sep

1527-2966

10.1016/j.jen.2021.07.003

J Emerg Nurs

34530971

A Survivor-Derived Approach to Addressing Trafficking in the Pediatric ED.

2020

2020 Dec 17

1098-4275

<p><strong>OBJECTIVES: </strong>Our objective was to elicit the perspectives of survivors of child trafficking on addressing trafficking in the pediatric emergency department (ED) and, secondarily, to provide a survivor-derived framework to help pediatric emergency medicine (PEM) providers discuss trafficking with their patients.</p>

<p><strong>METHODS: </strong>We conducted in-depth, semistructured interviews with young adults who experienced trafficking as children and/or as adolescents. In the interviews, we employed a novel video-elicitation method designed by the research team to elicit detailed participant feedback and recommendations on the pediatric ED through an interactive, immersive discussion with the interviewer. A grounded theory approach was employed.</p>

<p><strong>RESULTS: </strong>Seventeen interviews were conducted revealing the following themes, which we present in an integrated framework for PEM providers: (1) fear is a significant barrier; (2) participants do want PEM providers to ask about trafficking, and it is not harmful to do so; (3) PEM providers should address fear through emphasizing confidentiality and privacy and encouraging agency; (4) PEM providers should approach the patient in a direct, sensitive, and nonjudgmental manner; and (5) changes to the ED environment may facilitate the conversation. Suggested wordings and tips from survivors were compiled.</p>

<p><strong>CONCLUSIONS: </strong>Trafficking survivors feel that the pediatric ED can be a place where they can be asked about trafficking, and that when done in private, it is not harmful or retraumatizing. Fear is a major barrier to disclosure in the pediatric ED setting, and PEM providers can mitigate this by emphasizing privacy and confidentiality and increasing agency by providing choices. PEM providers should be direct, sensitive, and nonjudgmental in their approach to discussing trafficking.</p>

10.1542/peds.2020-0772

Pediatrics

33334922

Acceptability and feasibility of family use of The Cellie Cancer Coping Kit.

2012

3315-24

2012 Dec

1433-7339

<p><strong>PURPOSE: </strong>This study aims to examine the acceptability and feasibility of child and parent use of The Cellie Cancer Coping Kit (Cellie Kit). The Cellie kit is designed to promote coping and decrease distress in children undergoing pediatric cancer treatment. It includes a plush toy, coping cards, and book for caregivers.</p>

<p><strong>METHODS: </strong>In study 1, 15 children (ages 6-12) undergoing cancer treatment and their parents reviewed the Cellie Kit materials and provided feedback on its acceptability and perceived feasibility of use. In study 2, 15 additional children (ages 6-12) and their parents participated in a pilot intervention of the Cellie Kit and completed follow-up interviews and a satisfaction measure.</p>

<p><strong>RESULTS: </strong>In study 1, all parents reported that they could understand the book and enact its coping tips and that the Cellie Kit was relevant to their families' cancer experience. Children explained they would use the Cellie Kit for emotional expression, fun, and comfort. The Cellie Kit was revised after study 1 to integrate additional material suggested by families. In study 2, all families completing follow-up assessments reported utilizing the Cellie Kit. A majority (86 % of children and 100 % of parents) indicated that they would recommend the Cellie Kit to others, and most (64 % of children and 93 % of parents) reported learning new information and/or skills from the Cellie Kit.</p>

<p><strong>CONCLUSIONS: </strong>The Cellie Kit is an engaging, helpful, and easy-to-use coping tool for families facing pediatric cancer treatment. Future research should examine the efficacy of brief interventions using the Cellie Kit to promote adjustment to pediatric cancer.</p>

10.1007/s00520-012-1475-y

Support Care Cancer

22572922