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J Pediatr. 2016 Mar;170:227-33.e1-6. doi: 10.1016/j.jpeds.2015.10.067. Epub 2015 Dec 17.

Psychosocial Care for Injured Children: Worldwide Survey among Hospital Emergency Department Staff.

Collaborators (170)

Osmond M, Plint A, Freedman S, Johnson D, Murray D, Williamson-Urquhart S, Curran J, Dixon A, Meckler G, Bialy L, Doan Q, Stang A, Dixon A, Mater A, Beer D, Joubert G, Crocco A, Davis A, Moore A, Alqurashi W, Dubrovsky S, Trottier E, Blanchet M, Hurley K, Porter R, Auerbach M, Chang T, Cruz A, Macias CG, Florin TA, Kharbanda AB, Mahajan P, Mistry R, Schnadower D, Stanley R, Nigrovic L, Michelson K, Zorc J, Lyttle M, Maconochie I, Hartshorn S, Foster S, Bevan C, O'Sullivan R, Mitchelson M, Maney JA, Hartshorn S, Bevan C, Potter S, Younge P, Powell CV, O'Sullivan R, Robinson G, Blackburn C, Bolger T, McNamara R, Leonard P, Reuben A, Choudhery V, Mulligan J, Alcock R, Davies F, Mehta B, Parikh A, Ross J, Criddle J, Sutherland E, Sajjanhar T, Wong S, Thiagarajan J, Maconochie I, Rowland A, Potier K, Dieppe C, Thomas L, Smith J, Vorwerk C, Lenton K, Burke D, Barling J, Mullen N, Dickson-Jardine K, Mintegui Raso S, Gómez B, Da Dalt L, Gervaix A, Maconochie I, Moll H, Waisman Y, Parri N, Titomanlio L, Parri N, Benito J, Yilmaz HL, Da Dalt L, Teksam O, Srivastava G, Bognar Z, Gervaix A, Moldovan D, Luaces-Cubells C, Qureshi N, Cheron G, Kreier F, Velasco R, Titomanlio L, Waisman Y, Leroy S, Moll H, Simon G, Van de Voorde P, Mintegi S, Stanley R, Ruddy R, Dayan P, Hickey R, Kuppermann N, Chamberlain J, Dean JM, Lerner EB, Rogers A, Mahajan P, Cohen D, Babcock L, Schnadower D, Brousseau D, Kwok M, Macias C, Cruz A, Bajaj L, Hickey R, Chun T, Bennett J, Tzimenatos L, Zorc J, Nelson D, Brown K, Powell E, Nigrovic L, Cheng N, Zhang M, Craig S, Babl FE, Dalziel S, Sinn K, McCaskill M, George S, Zhang M, Jocelyn Neutze, Phillips N, Craig S, Borland M, Babl FE, Dalziel S, Barrow L, Rao A, Furyk J, Kochar A, Kuppermann N, Lyttle M, O'Sullivan R, Mintegui Raso S, Van de Voorde P, Osmond M, Johnson D, Chamberlain J, Macias C, Kharbanda A, Babl F, Dalziel S.

Author information

Monash Injury Research Institute, Monash University, Melbourne, Australia; Murdoch Childrens Research Institute, Melbourne, Australia. Electronic address:
School of Psychological Sciences, Monash University, Melbourne, Australia.
Children's Hospital of Philadelphia, Philadelphia, PA; University of Pennsylvania, Philadelphia, PA.
Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland; Department of Child and Adolescent Health Psychology, Institute of Psychology, University of Zurich, Zurich, Switzerland.
Departments of Pediatrics and Emergency Medicine and Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada.
Department of Pediatric Emergency Medicine, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN.
Emergency Department, Bristol Royal Hospital for Children, Bristol, United Kingdom; Faculty of Health and Applied Science, University of the West of England, Bristol, United Kingdom.
Department of Emergency Medicine and Trauma Center, Meyer University Children's Hospital, Florence, Italy.
Department of Emergency Medicine, University of Michigan, Ann Arbor, MI.
Royal Children's Hospital, Murdoch Childrens Research Institute and University of Melbourne, Melbourne, Australia.



To examine emergency department (ED) staff's knowledge of traumatic stress in children, attitudes toward providing psychosocial care, and confidence in doing so, and also to examine differences in these outcomes according to demographic, professional, and organizational characteristics, and training preferences.


We conducted an online survey among staff in ED and equivalent hospital departments, based on the Psychological First Aid and Distress-Emotional Support-Family protocols. Main analyses involved descriptive statistics and multiple regressions. Respondents were 2648 ED staff from 87 countries (62.2% physicians and 37.8% nurses; mean years of experience in emergency care was 9.5 years with an SD of 7.5 years; 25.2% worked in a low- or middle-income country).


Of the respondents, 1.2% correctly answered all 7 knowledge questions, with 24.7% providing at least 4 correct answers. Almost all respondents (90.1%) saw all 18 identified aspects of psychosocial care as part of their job. Knowledge and confidence scores were associated with respondent characteristics (eg, years of experience, low/middle vs high-income country), although these explained no more than 11%-18% of the variance. Almost all respondents (93.1%) wished to receive training, predominantly through an interactive website or one-off group training. A small minority (11.1%) had previously received training.


More education of ED staff regarding child traumatic stress and psychosocial care appears needed and would be welcomed. Universal education packages that are readily available can be modified for use in the ED.

[Indexed for MEDLINE]

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