title: Caregiver Reports of Children's Activity Participation Following Serious Injury.
abstract: Paediatric trauma can result in significant levels of on-going disability. The aim of this study was to explore the restrictions on activity participation that children experience following serious injury from the perspective of their caregivers. We performed a thematic analysis of transcripts of semi-structured in-depth interviews with the caregivers of 44 seriously injured children, conducted three-years after the injury, and purposively sampled from a population-based cohort study. Both temporary and on-going restrictions on school, sport, leisure and social activities were identified, some of which were imposed by caregivers, schools, or recommended by health providers. The perceived risk of further injury, physical restrictions, emotional state and fatigue levels were important influences on degrees of activity restriction. Children who were socially less engaged, especially those who were more severely injured, had difficulty making and retaining friends, and exhibited signs of depression or social withdrawal. The activities of pre-school children were strongly regulated by their caregivers, while school age children faced obstacles with participation in aspects such as study, sport, and peer and teacher relationships, affecting learning, school attendance and enjoyment. The findings highlight the need for primary prevention and reducing the impacts of serious injury throughout the continuum of care.
authors.affiliation: School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia. sandra.braaf@monash.edu.
authors.forename: Sandra
authors.initials: S
authors.lastname: Braaf
authors.affiliation: Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland 1072, New Zealand. s.ameratunga@auckland.ac.nz.
authors.forename: Shanthi
authors.initials: S
authors.lastname: Ameratunga
authors.affiliation: Trauma Service, The Royal Children's Hospital, Melbourne 3004, Australia. warwick.teague@rch.org.au.|Department of Paediatrics, University of Melbourne, Melbourne 3004, Australia. warwick.teague@rch.org.au.|Surgical Research Group, Murdoch Childrens Research Institute, Melbourne 3004, Australia. warwick.teague@rch.org.au.
authors.forename: Warwick
authors.initials: W
authors.lastname: Teague
authors.affiliation: Trauma Service, The Royal Children's Hospital, Melbourne 3004, Australia. Helen.Jowett@rch.org.au.
authors.forename: Helen
authors.initials: H
authors.lastname: Jowett
authors.affiliation: School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia. belinda.gabbe@monash.edu.|The Farr Institute @ CIPHER, Swansea University Medical School, Swansea University, Singleton Park, Swansea SA2 8PP, UK. belinda.gabbe@monash.edu.
authors.forename: Belinda
authors.initials: B
authors.lastname: Gabbe
mesh_terms: D000293:Adolescent; D017028:Caregivers / Q000523:psychology*; D002648:Child; D000067576:Child Health; D002675:Child, Preschool; D015331:Cohort Studies; D019988:Children with Disabilities / Q000523:psychology*; D015444:Exercise / Q000523:psychology*; D005260:Female; D033062:Friends; D006801:Humans; D007899:Leisure Activities; D008297:Male; D010379:Peer Group; D012574:Schools; D014947:Wounds and Injuries / Q000523:psychology*
keywords: activity restriction; caregivers; disability; injury; paediatrics; qualitative interviews; trauma