The intersection of trauma-informed care and pediatric emergency nursing in Ghana: A critical interpretive synthesis

This critical interpretive synthesis (CIS) examines how trauma-informed care can be embedded in pediatric emergency nursing in Ghana to reduce pediatric medical traumatic stress in resource-limited settings. CIS is a qualitative synthesis methodology that integrates diverse literature through iterative interpretation to generate new conceptual understandings beyond what any single study provides. The review maps evidence on the psychological impact of pediatric acute care, identifies major knowledge and implementation gaps among nurses in low- and middle-income countries, and distills core trauma-informed principles into concrete, low-cost communication and care strategies feasible in overcrowded Ghanaian emergency departments. Particular attention is given to developmentally appropriate explanations, non-pharmacological pain and anxiety management, psychological first aid, and family involvement, alongside organizational barriers and opportunities for task-shifting and quality improvement. It should be noted that some intervention-level recommendations, including narrative therapy and psychological first aid, are primarily derived from non-Ghanaian contexts and require culturally adapted validation before generalization. Drawing on evidence spanning qualitative, observational, and review study designs, the synthesis concludes with three prioritized recommendations: (1) embedding trauma-informed communication training within existing pre-service and in-service nursing education; (2) integrating brief, validated psychological screening into emergency discharge workflows; and (3) building sustained multi-system collaboration between emergency departments, community health workers, and traditional support networks.