Stancin T, Taylor H G, Thompson G H, Wade S, Drotar D, Yeates K O
School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
J Trauma. 1998 Dec;45(6):1031-8. doi: 10.1097/00005373-199812000-00010.
The acute psychosocial effects of orthopedic injuries on children and their families are poorly understood. Previous studies have relied on retrospective reports or failed to take into account accompanying brain injuries. The purpose of the present study was to examine prospectively the psychosocial impact of pediatric orthopedic traumatic fractures with and without accompanying brain injuries.
Participants were 108 children 6 to 12 years old with orthopedic injuries requiring hospitalization: group 1 (n=80) had fractures only, group 2 (n=28) also had moderate or severe brain injuries. Using standardized measures and parent interviews, we obtained preinjury estimates of family functioning and child behavior problems and postinjury measures of parental distress, family stresses, and child behavior.
Parents reported significant clinical distress (35% in group 1, 57% in group 2), family burdens (group 2 > group 1), and child behavioral changes (41% in group 1, 89% in group 2). Multiple regression analyses indicated that preinjury family status and brain injuries predicted postinjury parental and family distress.
Pediatric orthopedic injuries have greater social effects on children with accompanying brain injuries and poorer preinjury family functioning.
骨科损伤对儿童及其家庭造成的急性心理社会影响鲜为人知。以往的研究依赖回顾性报告，或未考虑到伴随的脑损伤。本研究的目的是前瞻性地研究伴有和不伴有脑损伤的小儿骨科创伤性骨折的心理社会影响。
研究对象为108名6至12岁因骨科损伤需住院治疗的儿童：第1组（n = 80）仅有骨折，第2组（n = 28）还伴有中度或重度脑损伤。我们通过标准化测量和对家长的访谈，获取了伤前家庭功能和儿童行为问题的评估数据，以及伤后家长痛苦程度、家庭压力和儿童行为的测量数据。
家长报告了显著的临床痛苦（第1组为35%，第2组为57%）、家庭负担（第2组>第1组）和儿童行为变化（第1组为41%，第2组为89%）。多元回归分析表明，伤前家庭状况和脑损伤可预测伤后家长及家庭的痛苦程度。
小儿骨科损伤对伴有脑损伤且伤前家庭功能较差的儿童具有更大的社会影响。
