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

Eur J Psychotraumatol. 2018 May 8;9(1):1468703. doi: 10.1080/20008198.2018.1468703. eCollection 2018.

Abstract

Background: Provision of psychosocial care, in particular trauma-informed care, in the immediate aftermath of paediatric injury is a recommended strategy to minimize the risk of paediatric medical traumatic stress. Objective: To examine the knowledge of paediatric medical traumatic stress and perspectives on providing trauma-informed care among emergency staff working in low- and middle-income countries (LMICs). Method: Training status, knowledge of paediatric medical traumatic stress, attitudes towards incorporating psychosocial care and barriers experienced were assessed using an online self-report questionnaire. Respondents included 320 emergency staff from 58 LMICs. Data analyses included descriptive statistics, t-tests and multiple regression. Results: Participating emergency staff working in LMICs had a low level of knowledge of paediatric medical traumatic stress. Ninety-one percent of respondents had not received any training or education in paediatric medical traumatic stress, or trauma-informed care for injured children, while 94% of respondents indicated they wanted training in this area. Conclusions: There appears to be a need for training and education of emergency staff in LMICs regarding paediatric medical traumatic stress and trauma-informed care, in particular among staff working in comparatively lower income countries.

Introducción: Proveer atención psicosocial, en particular atención informada sobre el trauma, inmediatamente después de una lesión pediátrica es una estrategia recomendada para minimizar el riesgo de estrés traumático en medicina pediátrica. Objetivo: Examinar el conocimiento del estrés traumático en medicina pediátrica y las perspectivas para proporcionar atención informada sobre el trauma entre el personal de emergencias que trabaja en países de ingresos bajos y medios (PIBM).Método: Se evaluó el estado de capacitación, el conocimiento del estrés traumático en medicina pediátrica, las actitudes sobre la incorporación de la atención psicosocial y las barreras experimentadas mediante un cuestionario de autoinforme en línea. Los participantes fueron 320 individuos que pertenecían al personal de emergencia de 58 PIBM. Los análisis de datos incluyeron estadísticas descriptivas, pruebas t y regresión múltiple.Resultados: El personal de emergencia que trabajaba en PIBM tenía un nivel bajo de conocimiento del estrés traumático en medicina pediátrica. El noventa y uno por ciento de los encuestados no había recibido ningún entrenamiento o educación en el estrés traumático en medicina pediátrica, o en atención informada en trauma para niños con lesiones, mientras que el 94% de los encuestados indicó que quería capacitación en esta área.Conclusiones: Parece que es necesario capacitar y educar al personal de emergencia en PIBM en relación al estrés traumático en medicina pediátrica y sobre la atención informada en trauma, en particular entre el personal que trabaja en países de ingresos relativamente bajos.

背景:将儿科医疗创伤性应激风险降至最低的推荐策略是,在儿童伤害后立即提供社会心理护理,特别是创伤知情护理。目的:考察儿科医学创伤性应激的知识以及在低收入和中等收入国家(LMICs)工作的急诊人员中提供创伤护理的观点。方法:使用在线自我报告调查问卷评估培训状况、儿童医学创伤应激知识,对纳入社会心理护理的态度和经历的障碍。 受访者包括来自58个LMIC的320名急诊人员。数据分析包括描述性统计,t检验和多元回归。结果:在中低收入国家工作的紧急诊援人员对儿科医学创伤性压力知识水平偏低。 91%的受访者没有接受任何儿科医学创伤性应激的培训或教育,或受伤儿童的创伤性知识护理,而94%的受访者表示他们想要在这方面进行培训。结论:似乎有必要对中低收入国家的急诊医务人员进行培训和教育,特别是在收入相对较低的国家的工作人员,这些工作涉及儿童医疗创伤性应激和创伤护理。.

Keywords: Paediatric injury; child traumatic stress; psychological first aid; psychosocial care; traumatic stress; • Emergency staff in low- and middle-income countries (LMICs) showed knowledge gaps with regard to paediatric medical traumatic stress associated with childhood injury.• Knowledge of paediatric medical traumatic stress in injured children was associated with having had training in psychosocial care and working in a higher income country within LMICs.• Emergency staff in LMICs demonstrated a need and desire for education on paediatric medical traumatic stress in injured children and training in trauma-informed care, with the majority preferring training be delivered online..

Grant support

This work was supported by the Australian Government Research Training Program (RTP) Scholarship; National Health and Medical Research Council Australia Early Career Fellowship under Grant number 1090229; Centre of Research Excellence for Paediatric Emergency Medicine, National Health and Medical Research Council, Australia; Victorian Government’s Infrastructure Support Program, Melbourne, Australia; Royal Children’s Hospital Foundation, Melbourne, Australia; Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB), Emergency Medical Services for Children (EMSC) Network Development Demonstration Program under cooperative agreement number U03MC00008 and MCHB cooperative agreements U03MC00001, U03MC00003, U03MC00006, U03MC00007, U03MC22684 and U03MC22685. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the US Government; Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB), Emergency Medical Services for Children (EMSC) Network Development Demonstration Program [under cooperative agreement number U03MC00008 and MCHB cooperative agreements U03MC00001, U03MC00003, U03MC00006, U03MC00007, U03MC22684 and U03MC22685]; National Health and Medical Research Council Australia Early Career Fellowship [1090229].