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Eur J Psychotraumatol. 2018 May 8;9(1):1468703. doi: 10.1080/20008198.2018.1468703. eCollection 2018.

Knowledge and training in paediatric medical traumatic stress and trauma-informed care among emergency medical professionals in low- and middle-income countries.

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School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neuroscience, Monash University, Melbourne, Australia.
Emergency Department, Royal Children's Hospital, Melbourne, Australia.
Emergency Research, Murdoch Children's Research Institute, Melbourne, Australia.
Department of Paediatrics, University of Melbourne, Melbourne, Australia, on behalf of the Paediatric Research in Emergency Departments International Collaborative (PREDICT) and the Pediatric Emergency Research Networks (PERN).
Centre for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Department of Pediatrics, University of Pennsylvania, Philadelphia, PA, USA.
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.
Department of Psychiatry and Mental Health University of Cape Town, Alan J. Flisher Centre for Public Mental Health, Cape Town, South Africa.
Departments of Pediatrics & Emergency Medicine & Women and Children's Health Research Institute, University of Alberta, Edmonton, Canada, on behalf of the Pediatric Emergency Research Canada (PERC).
Department of Pediatric Emergency Medicine, Children's Hospitals and Clinics of Minnesota, Minneapolis, USA, on behalf of the Pediatric Emergency Medicine Collaborative Research Committee of the American Academy of Pediatrics (PEMCRC).
Emergency Department, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol, UK, on behalf of the Paediatric Emergency Research in the UK and Ireland (PERUKI).
Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.
Department of Emergency Medicine and Trauma Center, Meyer University Children's Hospital, Florence, Italy, on behalf of the Research in European Pediatric Emergency Medicine (REPEM).
Department of Emergency Medicine, University of Michigan, Ann Arbor, USA, on behalf of the Pediatric Emergency Care Applied Research Network (PECARN).
Monash University Accident Research Centre, Monash University, Melbourne, Australia.


in English, Chinese, Spanish

Background: Provision of psychosocial care, in particular trauma-informed care, in the immediate aftermath of paediatric injury is a recommended strategy to minimize the risk of paediatric medical traumatic stress. Objective: To examine the knowledge of paediatric medical traumatic stress and perspectives on providing trauma-informed care among emergency staff working in low- and middle-income countries (LMICs). Method: Training status, knowledge of paediatric medical traumatic stress, attitudes towards incorporating psychosocial care and barriers experienced were assessed using an online self-report questionnaire. Respondents included 320 emergency staff from 58 LMICs. Data analyses included descriptive statistics, t-tests and multiple regression. Results: Participating emergency staff working in LMICs had a low level of knowledge of paediatric medical traumatic stress. Ninety-one percent of respondents had not received any training or education in paediatric medical traumatic stress, or trauma-informed care for injured children, while 94% of respondents indicated they wanted training in this area. Conclusions: There appears to be a need for training and education of emergency staff in LMICs regarding paediatric medical traumatic stress and trauma-informed care, in particular among staff working in comparatively lower income countries.


Paediatric injury; child traumatic stress; psychological first aid; psychosocial care; traumatic stress; • Emergency staff in low- and middle-income countries (LMICs) showed knowledge gaps with regard to paediatric medical traumatic stress associated with childhood injury.• Knowledge of paediatric medical traumatic stress in injured children was associated with having had training in psychosocial care and working in a higher income country within LMICs.• Emergency staff in LMICs demonstrated a need and desire for education on paediatric medical traumatic stress in injured children and training in trauma-informed care, with the majority preferring training be delivered online.

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