Effects of Pediatric Head Trauma for Children, Parents, and Families

Abstract

SUMMARYSevere pediatric head injury has negative consequences for children of all ages. Even mild and moderate head injury results in residual impairment for school-age children and adolescents. Data are needed on the effects of these less severe insults, especially for preschoolers. Although research on the impact of the child's head injury on the parent-child relationship and family functioning is limited, the experience is likely to be very stressful for the parent and the family. Indeed, family integrity may be at risk. Research is needed that examines the effects of a child's head injury for the parent and the family over time and identifies factors related to these outcomes.Accidental injury is the leading cause of death and acquired disability for children over 1 year of age. Children under 15 years of age account for 22.4% of over 35 million emergency department visits each year that result from injury. 42 Head injuries account for 29% of children's hospitalizations caused by injury. 34 Most pediatric head injuries are caused by accidental falls and motor vehicle accidents for 1-to 9-year olds and sports injuries for 5-to 9-year olds. 28 Continued progress in emergency medical care has led to increased survival of children with traumatic brain injury, but many survivors are at high risk for acute and chronic impairments in functioning. Thus, brain-injured children and their families face significant challenges because of impairment that affects the children's daily lives, their school performance, their future, and frequently, the well-being of family members and the family system. When a preschool child suffers an accidental head injury, families are suddenly faced with fears about the child's survival and current condition and uncertainty about the child's future. Hospitalization in a pediatric intensive care unit (PICU) may exacerbate these fears. 64, 66 Severely brain-injured school-age children and adolescents are often left with significant disabilities. 16 Even school-age children and adolescents with mild traumatic brain injuries experience decreased functional status initially and problems with neurobehavioral abilities, such as attention deficit and memory loss, for at least a year after the injury. 47 The stress associated with adapting to a "new" child with continuing but subtle deficits is likely to have negative effects for the parent's mental health, with potential deterioration of the parent-child and family relationships. The purpose of this article is to review the research on effects of head injury for the injured child, the parents, and the family.Address reprint requests to

Experiences and needs of parents of critically injured children during the acute hospital phase: A qualitative investigation

“…Parents play a vital role in children's post-injury psychological outcomes [29], with a corresponding relationship between parent and child mental health. Poorer parental mental health and adjustment is associated with children's poorer psychological adjustment [30]. A related finding was that a number of parents in this study deferred or ignored their own emotional needs during the acute hospital phase.…”

Impact of Pediatric Critical Illness and Injury on Families: A Systematic Literature Review

“…10,12 Negative impact on marital and domestic-partner relationships has been described elsewhere. 11 In contrast, Philichi 61 found no difference in family cohesion, and this finding was confirmed by another study. 67 The commonly expected financial stress, employment loss, and overall negative socioeconomic impact on families with a critically ill child were documented by only one study in our review.…”

“…Minimizing the discrepancy between expectations and reality was found to be a central element. 11,[87][88][89][90] …”

“…[10][11][12] This is a subject of considerable interest in the pediatric palliative care literature. 13 Substantially fewer studies are found about the impact of the disability and chronic illness on families that more often characterize child health after PICU discharge.…”

Group interventions for the prevention of injuries in young children: a systematic review

“…1 2 Such injuries result in significant human and societal costs, with both short and long term consequences ranging from interruptions in school/sports activities to significant cognitive and behavior disorders, depression, and deterioration of family functioning, physical morbidity, and sometimes death. [3][4][5][6][7] However, researchers have long advocated that as much as 90% of injuries could be prevented through coordinated and effective education, engineering, legislation, and enforcement strategies. 7 8 …”