The Initial Experience After Pediatric Firearm Injury: A Multifaceted Qualitative Approach
Jennifer M Schuh1, Christina Georgeades2, Taylor Schleusner2
1Division of Pediatric Surgery, Children's Hospital of Wisconsin, Milwaukee, Wisconsin; Medical College of Wisconsin, Milwaukee, Wisconsin.
The Journal of Surgical Research
|October 19, 2024
Summary
Pediatric psychology notes reveal firearm injuries impact children differently than motor vehicle crashes, with less mention of family and support. Understanding these differences can improve interventions for injured children.
Area of Science:
- Pediatric Psychology
- Trauma Care
- Mental Health Research
Background:
- Firearm injuries disproportionately affect children's mental health.
- Inpatient pediatric psychology consult liaison (CL) services offer crucial post-injury evaluations.
- Understanding the initial psychological impact of different injury types is vital for targeted care.
Purpose of the Study:
- To qualitatively explore CL documentation to understand the initial psychological experience of pediatric firearm injury survivors.
- To compare the psychological experiences of children injured by firearms versus motor vehicle crashes (MVCs).
- To identify differences in themes, sentiment, and key terms within CL notes for firearm- versus MVC-injured children.
Main Methods:
- Retrospective study at a level I pediatric trauma center (2016-2021).
- Inclusion of children aged 5-17 years admitted for ≥48 hours.
- Propensity score matching of firearm-injured children to MVC-injured children.
- Thematic, sentiment, and word cloud analyses of CL notes.
Main Results:
- CL services evaluated 71% of firearm-injured and 65% of MVC-injured children.
- Identified themes included resources, medical system encounters, prior influences, cognitive reactions, and social factors.
- Sentiment analysis showed more negative than positive words for both groups, with firearm injuries having a higher negative word count.
- Word clouds indicated "trauma" was more frequent in firearm injury notes, while "family" and "support" were more frequent in MVC injury notes.
Conclusions:
- Pediatric CL notes suggest firearm injuries and MVCs lead to different patient experiences, particularly regarding family and support.
- CL documentation encompasses a wide range of issues beyond immediate psychological impact.
- Recognizing injury-mechanism-specific experiences can inform the development of focused intervention strategies for pediatric trauma survivors.
Related Concept Videos
01:26Flail Chest-II
Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
Assessment:
1. Clinical Evaluation:
History:
01:28Traumatic Brain Injury l: Introduction
DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...