Screening of Acute Traumatic Stress Disorder and Posttraumatic Stress Disorder in Pediatric Trauma Patients: A Pilot Study

Abstract

Background: Children who experience traumatic physical injuries are at risk of developing acute stress disorder and posttraumatic stress disorder (PTSD). Early identification and treatment of these high-risk children can lead to improved mental health outcomes in this population. Objective: This study assesses the feasibility of a study protocol that compares 3 screening tools for identifying patients at a high risk of later development of acute stress disorder or PTSD among pediatric trauma patients. Methods: This pilot study compared 3 questionnaires used as screening tools for predictors of later development of PTSD in a convenience sample of pediatric trauma patients aged 7–17 years. Patients were randomized to one of 3 screening tools. Families were contacted at 30, 60, and 90–120 days postinjury to complete the Child Report of Post-Traumatic Symptoms questionnaire. The sensitivity and negative predictive value of the screening tools were compared for the diagnosis of PTSD defined using the Child Report of Post-Traumatic Symptoms questionnaire. Results: Of the 263 patients identified for possible enrollment, 52 patients met full inclusion criteria and agreed to participate. Only 29 (55.7%) patients completed at least one follow-up questionnaire. The prevalence of acute stress disorder and PTSD in our population was 41% (95% CI [24, 61]) and 31% (95% CI [15, 51]), respectively. Conclusions: In this pilot study, we sought to determine the utility of the 3 commonly used screening instruments for measuring traumatic stress symptoms in pediatric trauma patients to predict the diagnosis of acute stress disorder or PTSD. Limitations include the use of the Child Report of Post-Traumatic Symptoms screening tool as the gold standard for calculating test characteristics and lack of 24/7 enrollment capabilities. As such, a significant portion of patients were discharged prior to our teams' engagement for enrollment.

Nursing Methods and Experience of Local Anesthesia Patients under Arthroscope

“…It can not only provide standardized medical care services for patients but also develop targeted care plans. It not only provides high-quality care to patients during hospitalization but also takes into account the continuous care of patients after they return home to ensure that patients can receive whole-process, continuous, and high-quality care [ 16 ]. After the knee arthroscopy, patients often experience limb pain and swelling several hours after surgery.…”

Examining the incidence of acute stress in pediatric trauma patients

“…Our findings further support literature indicating that ASD is a prevalent reaction that children experience following an injury. 10 11 Although traumatic injuries are common among the pediatric population, proper screening, early identification, and treatment can lead to improved mental health outcomes among children and adolescents postinjury. 11 …”

“…In addition, evidence-based models of care that attend to the behavioral health needs of pediatric trauma patients in hospital settings is sparse, despite the literature suggesting that exposure to acute trauma within pediatric populations is common. [6][7][8][9][10][11] Results from Mazo et al 10 revealed that when pediatric trauma patients were assessed for acute stress disorder (ASD) and PTSD in 52 patients following a traumatic event, around 41% of patients met criteria for ASD, and 31% met criteria for PTSD. Similarly, Ridings et al 11 found that 35.5% of a sample of 90 pediatric trauma patients experience clinically significant symptoms of PTSD when assessed at 30 days postinjury.…”

“…Pediatric populations can be significantly impacted emotionally by exposure to acute trauma and these traumatic experiences may negatively impact long-term functioning and lead to an increase in overall mental health distress. 10 11 While some youth exhibit resilience in connection with traumatic experiences, many others remain vulnerable to the onset of acute stress reaction or ASD. A vast amount of literature has shown that children and adolescents who display symptoms of ASD are at greater risk for developing long-term effects associated with PTSD.…”

“…Literature focused on addressing the mental health needs of pediatric hospital patients is particularly lacking. In addition, evidence-based models of care that attend to the behavioral health needs of pediatric trauma patients in hospital settings is sparse, despite the literature suggesting that exposure to acute trauma within pediatric populations is common 6–11. Results from Mazo et al 10 revealed that when pediatric trauma patients were assessed for acute stress disorder (ASD) and PTSD in 52 patients following a traumatic event, around 41% of patients met criteria for ASD, and 31% met criteria for PTSD.…”