Parent experiences and psychosocial support needs 6 months following paediatric critical injury: A qualitative study

Kim Foster; Rebecca Mitchell; Alexandra Young; Connie Van; Kate Curtis

doi:10.1016/j.injury.2019.01.004

Parent experiences and psychosocial support needs 6 months following paediatric critical injury: A qualitative study

Injury. 2019 May;50(5):1082-1088. doi: 10.1016/j.injury.2019.01.004. Epub 2019 Jan 10.

Authors

Kim Foster¹, Rebecca Mitchell², Alexandra Young³, Connie Van³, Kate Curtis⁴

Affiliations

¹ Australian Catholic University, School of Nursing, Midwifery & Paramedicine, 115 Victoria Parade, Fitzroy, Victoria, 3065, Australia; Northwestern Mental Health, Melbourne Health, Grattan Street, Parkville, Victoria, 3050, Australia; Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, Faculty of Health and Medicine, The University of Sydney, 88 Mallett Street, Camperdown NSW 2006, Australia. Electronic address: Kim.Foster@acu.edu.au.
² Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, Macquarie University NSW 2109, Australia.
³ Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, Faculty of Health and Medicine, The University of Sydney, 88 Mallett Street, Camperdown NSW 2006, Australia.
⁴ Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, Faculty of Health and Medicine, The University of Sydney, 88 Mallett Street, Camperdown NSW 2006, Australia; Illawarra Shoalhaven Local Health District, Wollongong Hospital, Loftus Street, Wollongong NSW 2500, Australia; Illawarra Health and Medical Research Institute, Building 32, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia; The George Institute for Global Health, Level 5, 1 King Street, Newtown NSW 2042, Australia.

PMID: 30655002
DOI: 10.1016/j.injury.2019.01.004

Abstract

Introduction: Parents of critically injured children can experience high levels of psychological distress post-injury, however little is known about their experiences and needs following injury. This study aimed to explore parent experiences and psychosocial support needs in the six months following child critical injury.

Methods: An interpretive qualitative design was used. Semi-structured interviews were conducted with 30 parents of 23 critically injured children. Interviews explored parent experiences and psychosocial support needs. Qualitative data were managed using NVIVO 10 and analysed thematically.

Results: Four themes were identified: integrating back into home life; adjusting mentally and emotionally to injury; coping with injury as a family; and navigating resources to meet family needs. Parents and families experienced substantial ongoing emotional impacts at 6 months following child injury. Parents were unprepared for the negative changes in their child's psychological wellbeing and behaviour post injury, and parents' mental health was negatively impacted, with mothers more likely to seek emotional support than fathers. Parents reported receiving no psychosocial follow-up from the hospital and limited information about community services and accessing local community resources on returning home.

Conclusions: There is a need to include all family members in discharge planning, and to use a family-centred continuity-of-care approach from the time of child injury through to post-discharge recovery. To strengthen parent and family wellbeing, a biopsychosocial holistic approach is recommended, including cognitive-behavioural and other psychological strategies to help reduce distress for parents and all family members and strengthen their coping capacity. A dedicated family support coordinator role to facilitate care over the child recovery trajectory, and development of accessible online and e-psychosocial support resources for parents and families are recommended.

Keywords: 6-month; Family; Paediatric critical injury; Parent; Psychosocial; Qualitative.

MeSH terms

Adaptation, Psychological
Adolescent
Adult
Child
Child, Hospitalized / psychology*
Child, Preschool
Critical Illness* / psychology
Disabled Children
Female
Health Services Needs and Demand
Humans
Interviews as Topic
Life Change Events
Male
Middle Aged
Parents / psychology*
Professional-Family Relations
Qualitative Research
Social Support
Stress, Psychological / psychology*
Wounds and Injuries / psychology
Wounds and Injuries / therapy*