"In a Constant State of Upheaval": Experiences Caring for Hospitalized Children in State Custody

Area of Science:

• Pediatric Healthcare
• Child Welfare Services
• Healthcare Provider Experience

Background:

• Children in state custody frequently require hospitalization, yet best practices for their care remain underexplored.
• This study investigates healthcare providers' perspectives on the needs of hospitalized children under state care.

Purpose of the Study:

• To explore healthcare providers' experiences and perceptions regarding hospitalized children in state custody.
• To identify key challenges and needs in caring for this vulnerable pediatric population.

Main Methods:

• Semi-structured interviews were conducted with 25 healthcare providers at an urban children's hospital.
• Interviews were audio-recorded, transcribed, and analyzed using inductive thematic coding.

Main Results:

• Providers reported stressors related to the Department of Children's Services and experienced emotional distress.
• Key themes included limited support resources, challenges in multidisciplinary care coordination, and patient-centered care considerations.
• Additional findings highlighted the complexity of medical and developmental needs, isolation, extended hospitalizations, and a perceived lack of control.

Conclusions:

• Healthcare providers face significant challenges when caring for hospitalized children in state custody.
• Enhancing outcomes necessitates prioritizing collaborative care coordination and implementing trauma-informed practices.
• Addressing identified stressors and improving support systems are crucial for optimizing care for these children.