Experiences and needs of parents of critically injured children during the acute hospital phase: A qualitative investigation.
BACKGROUND
Physical injury is a leading cause of death and disability among children worldwide and the largest cause of paediatric hospital admission. Parents of critically injured children are at increased risk of developing mental and emotional distress in the aftermath of child injury. In the Australian context, there is limited evidence on parent experiences of child injury and hospitalisation, and minimal understanding of their support needs. The aim of this investigation was to explore parents' experiences of having a critically injured child during the acute hospitalisation phase of injury, and to determine their support needs during this time.


METHODS
This multi-centre study forms part of a larger longitudinal mixed methods study investigating the experiences, unmet needs and well-being of parents of critically injured children over the two-year period following injury. This paper describes parents' experiences of having a child 0-13 years hospitalised with critical injury in one of four Australian paediatric hospitals. Semi-structured interviews were conducted with forty parents and transcribed verbatim. The data were managed using NVIVO 10 software and thematically analysed.


RESULTS
Forty parents (26 mothers and 14 fathers) of 30 children (14 girls and 16 boys aged 1-13 years) from three Australian States participated. The majority of children were Australian born. Three main themes with sub-themes were identified: navigating the crisis of child injury; coming to terms with the complexity of child injury; and finding ways to meet the family's needs.


CONCLUSIONS
There is a need for targeted psychological care provision for parents of critically injured children in the acute hospital phase, including psychological first aid and addressing parental blame attribution. Parents and children would benefit from the implementation of anticipatory guidance frameworks informed by a family-centred social ecological approach to prepare them for the trauma journey and for discharge. This approach could inform care delivery throughout the child injury recovery trajectory. The development and implementation of a major trauma family support coordinator in paediatric trauma centres would make a tangible difference to the care of critically injured children and their families.
School of Nursing, Midwifery & Paramedicine, Australian Catholic University & Northwestern Mental Health, Melbourne Health, Australia; Sydney Nursing School, The University of Sydney, Australia.
Kim
K
Foster
Sydney Nursing School, The University of Sydney, Australia. Electronic address: alexandra.young@sydney.edu.au.
Alexandra
A
Young
Australian Institute of Health Innovation, Macquarie University, Australia.
Rebecca
R
Mitchell
Sydney Nursing School, The University of Sydney, Australia.
Connie
C
Van
Sydney Nursing School, The University of Sydney, Australia; St. George Hospital, Sydney, Australia.
Kate
K
Curtis
D000223:Adaptation, Psychological; D000293:Adolescent; D001315:Australia / Q000453:epidemiology; D002648:Child; D002673:Child, Hospitalized / Q000523:psychology*; D002675:Child, Preschool; D004644:Emotions; D005190:Family; D005260:Female; D006301:Health Services Needs and Demand / Q000458:organization & administration; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008016:Life Change Events; D008297:Male; D010290:Parents / Q000523:psychology*; D011368:Professional-Family Relations; D036301:Qualitative Research; D012944:Social Support; D013315:Stress, Psychological; D014947:Wounds and Injuries / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy
Children; Emotional well-being; Family; Hospital; Injury; Interview; Parents; Psychological distress; Qualitative research; Trauma