Pediatric Injury; Modules to Manage Medical Stress

项目摘要/摘要 创伤后应激症状(PTSS)和相关的心理障碍影响从25%到57% 儿童受伤后，会导致与健康相关的生活质量下降。因为儿童的PTSS出现了 当他们从医院出院回家后，创伤系统通常看不到他们，他们既不是 未检测到也未治疗。尽管存在对PTSS的循证治疗，但有限的父母意识和 接触训练有素的提供者阻碍了社区的接触。该项目的目标是提供一项研究和 住院一年儿童心理困扰管理的治疗资源 身体创伤。在目标1中，我们将开发一种创新的、简短的电子健康方法来治疗PTSS 被设计成通过创伤系统输送。我们将创建基于网络的互动心理教育 为学龄儿童(8至11岁)和青少年(12至16岁)量身定做的模块 与训练有素的治疗师同步进行电子健康治疗。模块将针对两个证据 基础治疗方法：认知行为疗法、应对技能(应对CBT)和直接暴露于 通过创伤叙事提醒创伤。所有模块都将与父模块、子模块和 每一步都纳入了专家从业者的意见。我们将开发伴随孩子的家长模块 解决父母问题的治疗计划，包括管理他们自己的压力，育儿技能和 如何帮助孩子们有一个共同的伤情，那就是睡眠。将设计治疗资源 特别是为了便于传播和纳入创伤系统。在目标2中，我们将执行 试点三臂RCT，以审查两份简报的可行性、可接受性和初步效果 治疗(应对CBT和创伤叙述)与未治疗的对照组(N=54)进行比较。受伤 将从三个参赛地点的住院病房招募儿童及其家人参加。 该治疗计划将作为后续大型临床试验的研究资源，旨在 确认疗效并检查潜在的治疗改良剂。帮助传播这种治疗方法 资源，我们将创建一个网络研讨会，提供使用手动疗法的培训和在线 模块。

PROJECT SUMMARY / ABSTRACT Post-traumatic stress symptoms (PTSS) and associated psychological impairment affect from 25 to 57% of children after an injury and contribute to worse health related quality of life. Because children's PTSS emerge after they are discharged home from the hospital, they are often invisible to the trauma system and are neither detected nor treated. Although evidence-based treatment for PTSS exists, limited parental awareness and access to trained providers hinder community access. The goal of this project is to provide a research and treatment resource for the management of psychological distress in children who have been hospitalized for a physical trauma. In Aim 1, we will develop an innovative, brief e-health approach to treatment of PTSS designed to be delivered through the trauma system. We will create interactive web-based psychoeducational modules that are developmentally tailored for school age children (8 to 11 years) and youth (12 to 16 years) for use with synchronous e-health therapy sessions with a trained therapist. Modules will target two evidence based treatment methods: cognitive behavioral therapy coping skills (coping CBT) and direct exposure to trauma reminders through a trauma narrative. All modules will be piloted iteratively with parent, child, and expert practitioner input incorporated at each step. We will develop parent modules that accompany the child treatment programs that address parent concerns including managing their own stress, parenting skills and how to help children with a common injury-specific concern, sleep. Treatment resources will be designed specifically for ease of dissemination and incorporation into the trauma system. In Aim 2, we will perform a pilot three-armed RCT to examine the feasibility, acceptability and preliminary efficacy of the two brief treatments (coping CBT and trauma narrative) compared to an untreated comparison group (N = 54). Injured children and their families will be recruited to participate from the inpatient wards of the three participating sites. The treatment program will serve as a research resource for a subsequent large clinical trial designed to confirm efficacy and to examine potential treatment modifiers. To aid in dissemination of this treatment resource, we will create a webinar that provides training in the use of the manualized therapies and online modules.