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伤害的影响:儿童创伤后儿童和家庭的经历。

The impact of injury: The experiences of children and families after a child's traumatic injury.

机构信息

Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.

Department of Trauma and Orthopaedics, Royal Manchester Children's Hospital, Manchester Foundation Trust, Manchester, UK.

出版信息

Clin Rehabil. 2021 Apr;35(4):614-625. doi: 10.1177/0269215520975127. Epub 2020 Dec 7.

Abstract

OBJECTIVE

To explore the experiences of children and families after a child's traumatic injury (Injury Severity Score >8).

DESIGN

Qualitative interview study.

SETTING

Two children's major trauma centres in England.

PARTICIPANTS

32 participants: 13 children with traumatic injuries, their parents/guardians ( = 14) and five parents whose injured child did not participate.

METHODS

Semi-structured interviews exploring the emotional, social, practical and physical impacts of children's injuries, analysed by thematic analysis.

RESULTS

Interviews were conducted a median of 8.5 months (IQR 9.3) post-injury. Injuries affected the head, chest, abdomen, spine, limbs or multiple body parts. Injured children struggled with changes to their appearance, physical activity restrictions and late onset physical symptoms, which developed after hospital discharge when activity levels increased. Social participation was affected by activity restrictions, concerns about their appearance and interruptions to friendships. Psychological impacts, particularly post-traumatic stress type symptoms often affected both children and parents. Parents' responsibilities suddenly increased, which affected family relationships and roles, their ability to work and carry out daily tasks. Rapid hospital discharge was wanted, but participants often felt vulnerable on return home. They valued continued contact with a healthcare professional and practical supports from family and friends, which enabled resumption of their usual lives.

CONCLUSIONS

Injured children experience changes to their appearance, friendships, physical activity levels and develop new physical and mental health symptoms after hospital discharge. Such challenges can be addressed by the provision of advice about potential symptoms, alternative activities during recovery, strategies to build resilience and how to access services after hospital discharge.

摘要

目的

探索儿童创伤后(损伤严重度评分>8)儿童及其家庭的经历。

设计

定性访谈研究。

地点

英国的两个儿童主要创伤中心。

参与者

32 名参与者:13 名创伤儿童及其父母/监护人(=14 名)和 5 名受伤儿童未参加的父母。

方法

采用半结构式访谈,探讨儿童受伤后情绪、社会、实际和身体方面的影响,采用主题分析进行分析。

结果

访谈在受伤后中位数 8.5 个月(IQR 9.3)进行。受伤部位涉及头部、胸部、腹部、脊柱、四肢或多个身体部位。受伤儿童因外貌变化、活动受限和住院后活动水平增加时出现的迟发性身体症状而挣扎。社交活动受到活动限制、对外貌的担忧以及友谊中断的影响。心理影响,特别是创伤后应激类型的症状,经常影响儿童和父母。父母的责任突然增加,影响了家庭关系和角色、他们的工作能力和日常任务的完成。他们希望快速出院,但参与者回家后常常感到脆弱。他们重视与医疗保健专业人员的持续联系以及来自家人和朋友的实际支持,这使他们能够恢复正常生活。

结论

受伤儿童在出院后会经历外貌、友谊、身体活动水平的变化,并出现新的身心健康症状。通过提供有关潜在症状的建议、康复期间的替代活动、建立韧性的策略以及出院后如何获得服务,可以解决这些挑战。

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