Article Text

Original research
Qualitative study of the needs of injured children and their families after a child’s traumatic injury
  1. Samantha Jones1,2,3,
  2. Sarah Tyson1,3,
  3. Naomi Davis2,3,
  4. Janelle Yorke1,3
  1. 1Division of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
  2. 2Department of Paediatric Trauma & Orthopaedics, Manchester University NHS Foundation Trust, Royal Manchester Children's Hospital, Manchester, UK
  3. 3Manchester Academic Health Science Centre Manchester, Manchester, UK
  1. Correspondence to Samantha Jones; samantha.jones-3{at}manchester.ac.uk

Abstract

Objective To explore the needs of children and their families after a child’s traumatic injury.

Design Semi-structured qualitative interviews with purposeful sampling for different types of injuries and a theoretical thematic analysis.

Participants 32 participants; 13 children living at home after a traumatic injury, their parents/guardians (n=14) and five parents whose injured child did not participate.

Setting Two Children’s Major Trauma Centres (hospitals) in England.

Results Interviews were conducted a median 8.5 months (IQR 9.3) postinjury. Injuries affected the limbs, head, chest, abdomen, spine or multiple body parts. Participants highlighted needs throughout their recovery (during and after the hospital stay). Education and training were needed to help children and families understand and manage the injury, and prepare for discharge. Information delivery needed to be timely, clear, consistent and complete, include the injured child, but take into account individuals’ capacity to absorb detail. Similarly, throughout recovery, services needed to be timely and easily accessible, with flexible protocols and eligibility criteria to include injured children. Treatment (particularly therapy) needed to be structured, goal directed and of sufficient frequency to return injured children to their full function. A central point of contact is required after hospital discharge for advice, reassurance and to coordinate ongoing care. Positive partnerships with professionals helped injured children and their families maintain a sense of hope and participate in joint decision making about their care.

Conclusion Throughout the full trajectory of recovery injured children and their families need family centred, accessible, flexible, coordinated health services, with more effective harmonious, communication between professionals, the child and their family. There is a requirement for support from a single point of contact and a system that monitors the needs of the injured child and their family after hospital discharge.

  • trauma management
  • rehabilitation medicine
  • paediatrics
  • qualitative research
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This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors All authors (SJ, ST, ND and JY) contributed to the conception and design of the work, monitoring progress, critical appraisal and approval of the final version of the manuscript. SJ is the guarantor of the study and led the design of the work, data collection, data analysis, interpretation of the data and produced the manuscript drafts. ST and JY contributed to the design of the work, data analysis and interpretation of the data. ST contributed to drafting the manuscripts. ND contributed to the interpretation of the data.

  • Funding SJ is funded by a National Institute for Health Research (NIHR), (ICA Programme Clinical Doctoral Research Fellowship (Grant reference ICA-CDRF-2016-02-021)) for this research project. This publication presents independent research funded by the National Institute for Health Research (NIHR).

  • Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the National Health Service, North West - Greater Manchester South Research Ethics Committee (REC reference 17/NW/0615) and the Health Research Authority.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as online supplemental information.

  • Author note All authors (SJ, ST, ND, JY) contributed to the conception and design of the work, monitoring progress, critical appraisal and approval of the final version of the manuscript. SJ is the guarantor of the study and led the design of the work, data collection, data analysis, interpretation of the data and produced the manuscript drafts. ST and JY contributed to the design of the work, data analysis and interpretation of the data. ST contributed to drafting the manuscripts. ND contributed to the interpretation of the data.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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