Trauma-informed care for children in the ambulance: international survey among pre-hospital providers.
Background:Pre-hospital providers, such as paramedics and emergency medical technicians, are in a position to provide key emotional support to injured children and their families.Objective:Our goal was to examine (a) pre-hospital providers' knowledge of traumatic stress in children, attitudes towards psychosocial aspects of care, and confidence in providing psychosocial care, (b) variations in knowledge, attitudes, and confidence according to demographic and professional characteristics, and (c) training preferences of pre-hospital providers regarding psychosocial care to support paediatric patients and their families.Method:We conducted a cross-sectional, online survey among an international sample of 812 pre-hospital providers from high-income countries. The questionnaire was adapted from a measure for a similar study among Emergency Department staff, and involved 62 items in 7 main categories (e.g. personal and work characteristics, knowledge of paediatric traumatic stress, and confidence regarding 18 elements of psychosocial care). The main analyses comprised descriptive statistics and multiple regression analyses.Results:On average, respondents answered 2.7 (SD= 1.59) out of seven knowledge questions correctly. Respondents with higher knowledge scores were more often female, parent of a child under 17, and reported that at least 10% of their patients were children. A majority of participants (83.5%) saw all 18 aspects of psychosocial care as part of their job. Providers felt moderately confident (M= 3.2,SD= 0.45) regarding their skills in psychosocial care, which was predicted by gender (female), having more experience, having a larger proportion of child patients, and having received training in psychosocial care in the past five years. Most respondents (89.7%) wanted to gain more knowledge and skills regarding psychosocial care for injured children. In terms of training format, they preferred an interactive website or a one-off group training.Conclusions:There appears to be both a need and an opportunity for education initiatives regarding paediatric traumatic stress in the pre-hospital context.
Monash University Accident Research Centre, Monash University, Clayton, Australia; Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland.
Eva
E
Alisic
School of Psychological Science and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Australia; School of Psychology and Public Health, Department of Psychology and Counselling, La Trobe University, Melbourne, Australia.
Mark P
MP
Tyler
Institute of Safety, Compensation & Recovery Research, Melbourne, Australia; Caulfield Pain Management & Research Centre, Caulfield Hospital, Caulfield, Australia; Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia.
Melita J
MJ
Giummarra
College of Science and Technology, Temple University , Philadelphia , PA , USA.
Rahim
R
Kassam-Adams
Impact, National Knowledge and Advice Centre for Psychosocial Care Concerning Critical Incidents, Partner in Arq Psychotrauma Expert Group, Diemen, The Netherlands; Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands.
Juul
J
Gouweloos
Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland; Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland.
Markus A
MA
Landolt
Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA; School of Medicine, University of Pennsylvania Perelman, Philadelphia, PA, USA.
Nancy
N
Kassam-Adams
D-E-F protocol; PFA; PTSD; Psychological First Aid; emergency care; medical traumatic stress toolkit; paediatric injury; paramedics; traumatic stress