title: Psychosocial care for seriously injured children and their families: a qualitative study among emergency department nurses and physicians.
abstract: BACKGROUND
  Approximately one in five children who sustain a serious injury develops persistent stress symptoms. Emergency Department nurses and physicians have a pivotal role in psychosocial care for seriously injured children. However, little is known about staff's views on this role.
  
  
  OBJECTIVE
  Our aim was to investigate Emergency Department staff's views on psychosocial care for seriously injured children.
  
  
  METHODS
  We conducted semi-structured interviews with 20 nurses and physicians working in an Australian Paediatric Emergency Department. We used purposive sampling to obtain a variety of views. The interviews were transcribed verbatim and major themes were derived in line with the summative analysis method. We also mapped participants' strategies for child and family support on the eight principles of Psychological First Aid (PFA).
  
  
  RESULTS
  Five overarching themes emerged: (1) staff find psychosocial issues important but focus on physical care; (2) staff are aware of individual differences but have contrasting views on vulnerability; (3) parents have a central role; (4) staff use a variety of psychosocial strategies to support children, based on instinct and experience but not training; and (5) staff have individually different wishes regarding staff- and self-care. Staff elaborated most on strategies related to the PFA elements 'contact and engagement', 'stabilization', 'connection with social supports' and least on 'informing about coping'.
  
  
  CONCLUSIONS
  The strong notion of individual differences in views suggests a need for training in psychosocial care for injured children and their families. In addition, further research on paediatric traumatic stress and psychosocial care in the ED will help to overcome the current paucity of the literature. Finally, a system of peer support may accommodate wishes regarding staff care.
authors.affiliation: Monash Injury Research Institute, Monash University, Melbourne, Australia; Murdoch Childrens Research Institute, Melbourne, Australia. Electronic address: eva.alisic@monash.edu.
authors.forename: Eva
authors.initials: E
authors.lastname: Alisic
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Australia; Psychology Department, The University of Melbourne, Melbourne, Australia; Psychology Service, The Royal Children's Hospital, Melbourne, Australia.
authors.forename: Rowena
authors.initials: R
authors.lastname: Conroy
authors.affiliation: Emergency Department, The Royal Children's Hospital, Melbourne, Australia.
authors.forename: Joanne
authors.initials: J
authors.lastname: Magyar
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Australia; Psychology Service, The Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia.
authors.forename: Franz E
authors.initials: FE
authors.lastname: Babl
authors.affiliation: Australian Centre for Posttraumatic Mental Health, Melbourne, Australia; Department of Psychiatry, The University of Melbourne, Melbourne, Australia.
authors.forename: Meaghan L
authors.initials: ML
authors.lastname: O'Donnell
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001291:Attitude of Health Personnel; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D009726:Nurses / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D010820:Physicians / Q000523:psychology*; D011368:Professional-Family Relations; D036301:Qualitative Research; D012720:Severity of Illness Index; D012944:Social Support; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000523:psychology* / Q000628:therapy
keywords: Child; Debriefing; Emergency; Family; Nurses; Physicians; Professional practice; Psychological First Aid; Traumatic stress disorders; Wounds and injuries