Afzal Nimrah, Lyttle Mark D, Alisic Eva, Trickey David, Hiller Rachel M, Halligan Sarah L
Department of Psychology University of Bath Bath UK.
Emergency Department Bristol Royal Hospital for Children Bristol UK.
JCPP Adv. 2022 Jul 21;2(3):e12091. doi: 10.1002/jcv2.12091. eCollection 2022 Sep.
It has been estimated that around 31% of children will experience a traumatic event during childhood, most commonly serious accidents that lead to hospitalisation. Around 15% of children who experience such events go onto develop post-traumatic stress disorder. Emergency department (ED) clinicians have a unique opportunity to intervene during the early peri-trauma period, which can involve incorporating a trauma-informed approach within their care. The available evidence indicates that clinicians internationally need further education and training to enhance their knowledge and confidence in providing trauma-informed psychosocial care. However, UK/Ireland specific knowledge is limited.
The current study analysed the UK and Irish subset of data ( = 434) that was collected as part of an international survey of ED clinicians. Questionnaires indexed clinician confidence in providing psychosocial care, and a range of potential barriers to providing that care. Hierarchical linear regression was used to identify predictors of clinician confidence.
Clinicians reported moderate levels of confidence in providing psychosocial care to injured children and families ( = 3.19, SD = 0.46). Regression analyses identified negative predictors of clinical confidence, including a lack of training, worrying about further upsetting children and parents, and low levels of perceived departmental performance in providing psychosocial care ( = 0.389).
The findings highlight the need for further training in psychosocial care for ED clinicians. Future research must identify nationally relevant pathways to implement training programmes for clinicians, in order to improve their skills in relation to paediatric traumatic stress and to reduce the perception of barriers identified in the present study.
据估计，约31%的儿童在童年时期会经历创伤性事件，最常见的是导致住院的严重事故。经历此类事件的儿童中约15%会患上创伤后应激障碍。急诊科（ED）临床医生有独特的机会在创伤发生后的早期阶段进行干预，这可能包括在其护理中采用创伤知情方法。现有证据表明，国际上的临床医生需要进一步的教育和培训，以增强他们在提供创伤知情心理社会护理方面的知识和信心。然而，英国/爱尔兰的具体知识有限。
本研究分析了作为对急诊科临床医生国际调查一部分收集的数据中的英国和爱尔兰子集（n = 434）。问卷对临床医生提供心理社会护理的信心以及提供该护理的一系列潜在障碍进行了索引。采用分层线性回归来确定临床医生信心的预测因素。
临床医生报告在为受伤儿童及其家庭提供心理社会护理方面有中等程度的信心（M = 3.19，标准差 = 0.46）。回归分析确定了临床信心的负面预测因素，包括缺乏培训、担心进一步使儿童和家长不安以及在提供心理社会护理方面对科室表现的感知水平较低（R² = 0.389）。
研究结果凸显了急诊科临床医生在心理社会护理方面进一步培训的必要性。未来的研究必须确定在全国范围内相关的途径，为临床医生实施培训计划，以提高他们在儿童创伤应激方面的技能，并减少本研究中确定的障碍感。
