Sinopidis Xenophon, Kallianezos Panagiotis, Petropoulos Constantinos, Gkentzi Despoina, Kostopoulou Eirini, Fouzas Sotirios, Dassios Theodore, Vervenioti Aggeliki, Karatza Ageliki, Roupakias Stylianos, Panagidis Antonios, Blevrakis Evangelos, Jelastopulu Eleni
Department of Pediatric Surgery, School of Medicine, University of Patras, 26504 Patras, Greece.
Department of Pediatric Surgery, Pediatric Hospital of Patras, 26331 Patras, Greece.
Children (Basel). 2023 Jun 27;10(7):1115. doi: 10.3390/children10071115.
Head trauma is one of the most common pediatric emergencies. While the psychological effects of severe head injuries are well studied, the psychological consequences of mild head injuries often go overlooked. Head injuries with a Glasgow Coma Scale score of 13-15, with symptoms such as headache, vomiting, brief loss of consciousness, transient amnesia, and absence of focal neurological signs, are defined as mild. The aim of this study is to evaluate the stress of children with mild head injuries and their parents' relevant perception during the early post-traumatic period.
This is a prospective cross-sectional study on a cohort of children with mild head injuries and their parents. Two questionnaires were implemented, the Child Trauma Screening Questionnaire (CTSQ) which was compiled by the children, and the Children's Revised Impact of Event Scale (CRIES-13), compiled by their parents. Both questionnaires are widely used and reliable. The first presents an excellent predictive ability in children with a risk of post-traumatic stress disorder, while the second is a weighted self-completed detecting instrument for the measurement of post-traumatic stress in children and adolescents, with a detailed evaluation of their reactions to the traumatic incident. The participants responded one week and one month after the traumatic event.
A total of 175 children aged 6-14 years and 174 parents participated in the study. Stress was diagnosed in 33.7% of children after one week, and in 9.9% after one month. Parental responses suggesting stress presence in their children were 19.0% and 3.9%, respectively. These outcomes showed that mild head injuries are not so innocent. They are often underestimated by their parents and may generate a psychological burden to the children during the early post-traumatic period.
Mild head injuries may affect the emotional welfare of children. Healthcare providers should understand the importance of the psychological effect of this overlooked type of injury. They should be trained in the psychological effect of trauma and be aware of this probability, promptly notify the parents accordingly, and provide psychological assistance beyond medical treatment. Follow-up and support are needed to avoid the possibility of future post-traumatic stress disorder. More extensive research is needed as the outcomes of this study regarded a limited population in numbers, age, and survey period. Furthermore, many children with mild head injuries do not ever visit the emergency department and stay at home unrecorded. Community-based research on the topic should therefore be considered.
头部创伤是最常见的儿科急症之一。虽然严重头部损伤的心理影响已得到充分研究，但轻度头部损伤的心理后果往往被忽视。格拉斯哥昏迷量表评分为13 - 15分，伴有头痛、呕吐、短暂意识丧失、短暂失忆且无局灶性神经体征等症状的头部损伤被定义为轻度。本研究的目的是评估轻度头部损伤儿童及其父母在创伤后早期的压力及相关认知。
这是一项针对轻度头部损伤儿童及其父母队列的前瞻性横断面研究。实施了两份问卷，一份是由儿童填写的儿童创伤筛查问卷（CTSQ），另一份是由其父母填写的儿童事件影响量表修订版（CRIES - 13）。两份问卷都被广泛使用且可靠。前者在有创伤后应激障碍风险的儿童中具有出色的预测能力，而后者是一种加权自填式检测工具，用于测量儿童和青少年的创伤后应激，详细评估他们对创伤事件的反应。参与者在创伤事件发生后一周和一个月进行回答。
共有175名6 - 14岁儿童和174名父母参与了该研究。一周后33.7%的儿童被诊断出有压力，一个月后为9.9%。父母认为孩子有压力的比例分别为19.0%和3.9%。这些结果表明轻度头部损伤并非无害。它们常常被父母低估，并且在创伤后早期可能给孩子带来心理负担。
轻度头部损伤可能会影响儿童情感健康。医疗服务提供者应了解这种被忽视的损伤类型心理影响的重要性。他们应接受创伤心理影响方面的培训并意识到这种可能性，及时通知父母，并在医疗之外提供心理援助。需要进行随访和支持以避免未来发生创伤后应激障碍的可能性。由于本研究的结果涉及的人群在数量、年龄和调查周期方面有限，因此需要更广泛的研究。此外，许多轻度头部损伤儿童从未去过急诊科，未被记录在家中。因此应考虑基于社区的该主题研究。
