Pediatric Injury; Modules to Manage Medical Stress

项目总结/摘要 创伤后应激症状（PTSS）和相关的心理障碍影响了25%至57%的 儿童受伤后，并有助于更差的健康相关的生活质量。因为儿童的创伤后应激障碍 在他们出院回家后，创伤系统往往看不到他们， 没有被发现也没有被治疗。虽然PTSS的循证治疗存在，但父母的认识有限， 获得训练有素的服务提供者阻碍了社区获得服务。该项目的目标是提供一个研究和 治疗资源，用于管理因疾病住院的儿童的心理困扰， 身体创伤在目标1中，我们将开发一种创新的、简短的电子医疗方法来治疗PTSS 设计成通过创伤系统输送我们将创建基于网络的交互式心理教育 为学龄儿童（8至11岁）和青少年（12至16岁）量身定制的模块， 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 基于治疗方法：认知行为疗法应对技能（应对CBT）和直接暴露于 通过创伤叙事来提醒创伤。所有模块都将通过父模块、子模块和 在每一步都纳入专家从业者的输入。我们将开发伴随孩子的父母模块 治疗计划，解决父母的关注，包括管理自己的压力，育儿技巧， 如何帮助孩子们解决一个常见的伤害问题，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 试验性三臂随机对照试验，以检查两种简要方法的可行性、可接受性和初步疗效 治疗（应对CBT和创伤叙述）与未治疗的对照组（N = 54）相比。受伤 将从三个参与研究中心的住院病房招募儿童及其家人参与研究。 该治疗方案将作为后续大型临床试验的研究资源， 确认疗效并检查潜在的治疗调节剂。为了帮助传播这种治疗方法 资源，我们将创建一个网络研讨会，提供培训，在使用手动治疗和在线 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.