title: Systematic Review: A Reevaluation and Update of the Integrative (Trajectory) Model of Pediatric Medical Traumatic Stress.
abstract: OBJECTIVE
  The objective of this systematic review is to reevaluate and update the Integrative Model of Pediatric Medical Traumatic Stress (PMTS; Kazak et al., 2006), which provides a conceptual framework for traumatic stress responses across pediatric illnesses and injuries.
  
  
  METHODS
  Using established systematic review guidelines, we searched PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and PubMed (producing 216 PMTS papers published since 2005), extracted findings for review, and organized and interpreted findings within the Integrative Model framework.
  
  
  RESULTS
  Recent PMTS research has included additional pediatric populations, used advanced longitudinal modeling techniques, clarified relations between parent and child PMTS, and considered effects of PMTS on health outcomes. Results support and extend the model's five assumptions, and suggest a sixth assumption related to health outcomes and PMTS.
  
  
  CONCLUSIONS
  Based on new evidence, the renamed Integrative Trajectory Model includes phases corresponding with medical events, adds family-centered trajectories, reaffirms a competency-based framework, and suggests updated assessment and intervention implications.
authors: Center for Healthcare Delivery Science, Nemours Children's Health System, Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University.
authors: Julia
authors: J
authors: Price
authors: Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, and Division of Emergency Medicine, The Children's Hospital of Philadelphia.
authors: Nancy
authors: N
authors: Kassam-Adams
authors: Center for Healthcare Delivery Science, Nemours Children's Health System, Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University.
authors: Melissa A
authors: MA
authors: Alderfer
authors: Center for Healthcare Delivery Science, Nemours Children's Health System.
authors: Jennifer
authors: J
authors: Christofferson
authors: Center for Healthcare Delivery Science, Nemours Children's Health System, Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, anne.kazak@nemours.org.
authors: Anne E
authors: AE
authors: Kazak
mesh_terms: D002648:Child; D004194:Disease / Q000523:psychology*; D006801:Humans; D008960:Models, Psychological; D000067073:Psychological Trauma / Q000209:etiology*; D014947:Wounds and Injuries / Q000523:psychology*
keywords: families; illness; injury; medical traumatic stress; pediatric; traumatic stress