By integrating an understanding of traumatic stress in their routine interactions with children and families (i.e., providing "trauma-informed" pediatric care), providers can change how children and families respond to and cope with emotional reactions to illness and injury.
Providing Patient Centered Care and Trauma Informed Care for Children
Trauma can be both a medical and psychological event in the eyes of children and families experiencing serious illnesses, injuries, or painful procedures. By integrating an understanding of traumatic stress into their routine interactions with children and families, health care providers can:
- reduce the impact of difficult or frightening medical events, and
- help children and families cope with emotional reactions to illness and injury.
Traumatic stress reactions, left unaddressed, can have serious implications for medical treatment and health outcomes and can represent a "hidden cost" to the health care system. Traumatic stress symptoms have been associated with:
- adverse health outcomes
- poorer treatment and medication adherence
- worse functional outcomes
How to Provide Trauma Informed and Patient Centered Care in Pediatrics:
1. Minimize traumatic aspects of medical care
- Pay attention to the child’s and family’s experience of medical care, and do what you can to reduce frightening or painful aspects of necessary care and procedures.
2. Provide all pediatric patients with basic support and information
- Ask children (and parents) about their fears and worries, optimize pain management, and work with parents to help them provide effective support for their child. The D-E-F protocol offers specific guidance and suggestions.
3. Screen to identify those who may need more help
- Provide anticipatory guidance about stress reactions and ways of coping. Assess for more severe distress or risk factors, and make appropriate referrals for additional services if warranted.
4. Maximize continuity of care
- Help ensure that all those caring for a child are aware of any traumatic stress reactions as well as effective coping resources.
5. Remain aware of one’s own stress
- Pay attention to the challenges of caring for ill and injured children, and promote good self-care.
Protocol for Implementing Trauma Informed Care for Children - While Providing Patient Centered Care
Doctor and nurses familiar with providing patient centered care already have many of the basic skills required to provide trauma informed care for children
The D-E-F protocol provides a simple way to remember key elements of trauma-informed care:
After attending to the basics of children’s physical health (the A-B-C’s), pay attention to the next steps - "D-E-F".
- Reduce DISTRESS
- Promote EMOTIONAL SUPPORT
- Remember the FAMILY
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