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Risk factors for extended disruption of family function after severe injury to a child
1Department of Surgery, Hospital for Sick Children, Toronto, ON.
Insights
Pediatric trauma significantly disrupts family function, especially for single-parent families and those with maternal mental health issues. Early identification of these risk factors is crucial for providing timely support.
Area of Science:
- Pediatric trauma research
- Family psychology
- Child health outcomes
Background:
- Severe pediatric trauma can profoundly impact family dynamics and functioning.
- Understanding long-term family disruption is essential for effective support.
Purpose of the Study:
- To identify pre-trauma risk factors for sustained disruption of family function after pediatric trauma.
- To inform interventions aimed at mitigating negative family outcomes.
Main Methods:
- Prospective, exploratory study involving 105 families of children with severe trauma.
- Interviews conducted at admission, 6 months, and 1 year post-discharge.
- Assessed family function, demographics, injury severity, maternal psychologic disorder, child behavior, and child functional status.
Main Results:
- 45% of families reported not returning to normal function at 6 months, and 23% at 1 year.
- Single-parent families had significantly higher odds (4-5 times) of prolonged disruption.
- Maternal psychologic disorders and older child age were associated with extended disruption.
Conclusions:
- Severe pediatric injury poses a significant strain on family life.
- Single parents and mothers with psychologic disorders require targeted support.
- Early intervention and counseling can aid families in coping with trauma.
Objective:
To identify risk factors for long-lasting disruption of family function following pediatric trauma that can be measured at the time of trauma.
Design:
Prospective, exploratory study. Personal interviews were conducted at the time of admission and 6 months and 1 year after discharge.
Setting:
Level I regional pediatric trauma centre.
Participants:
One hundred and five families (86% of those eligible) with a child admitted to hospital for severe trauma with an Abbreviated Injury Scale (AIS) score of 4 or higher or with two or more injuries in different body parts and AIS scores of 2 or higher were recruited; 13 families were lost to follow-up at 6 months or 1 year, so their data were not included in the analyses.
Main Outcome Measures:
Family function status (normal or abnormal compared with function before the injury), demographic characteristics of the parents and child, injury severity, presence of maternal psychologic disorder, presence of child behaviour abnormality and functional status of the child.
Main Results:
At 6 months and at 1 year 41 families (45%) and 21 families (23%) respectively reported that their family lives had not returned to normal. The relative odds for disruption of family life were about five times higher (95% confidence limits [CL] 1.4 and 19.7) and four times higher (95% CL 1.1 and 14.0) for single-parent families than for families with married parents living together at 6 months and 1 year respectively. The presence of maternal psychologic disorders at admission and increased age of the injured child were also significantly associated with extended disruption of family function. Injury severity and functional status at discharge were not good predictors of family function.
Conclusions:
Severe injury to a child places a heavy strain on normal family function. In particular, single parents and parents experiencing mental or emotional problems at the acute stage of the injury need help in coping with their reactions to the trauma and may benefit from individual or group counseling.