Pediatric Injury; Modules to Manage Medical Stress

儿科损伤；

• 批准号: 9761555
• 负责人: LINDA EWING-COBBS
• 金额: $ 58.44万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-10 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9761555
• 关键词: 16 year old; Accreditation; Address; Adolescent; Affect; Age; American College of Surgeons; Awareness; Cause of Death; Characteristics; Child; Child Rearing; Childhood Injury; Chronic; Clinical Trials Design; Cognitive Therapy; Communities; Companions; Coping Skills; Data; Development; Disadvantaged; Enrollment; Evidence based intervention; Evidence based treatment; Face; Family; Feedback; Future; Goals; Health Services; Health Services Accessibility; Health system; Home environment; Hospitals; Impairment; Improve Access; Injury; Inpatients; Insurance Coverage; Intervention; Link; Manuals; Medical; Mental Health; Methods; Multimedia; Online Systems; Outcome; Parents; Participant; Physical Function; Procedures; Process; Provider; Psychology; Public Health; Research; Resources; Risk; Rural Community; Rural Population; School-Age Population; Schools; Secondary Prevention; Severities; Site; Sleep; Stress; System; Testing; Training; Translations; Trauma; Traumatic injury; United States; Urban Population; Youth; aged; behavioral health; brief intervention; comparison group; coping; desensitization; design; disability; eHealth; evidence base; experience; falls; follow-up; health disparity; health related quality of life; high risk; injured children; innovation; iterative design; multidisciplinary; physical conditioning; post-traumatic stress; programs; psychoeducational; psychologic; psychological distress; recruit; satisfaction; screening; skills; sociodemographics; stress symptom; symptom management; trauma care; trauma centers; trauma exposure; traumatic event; treatment effect; treatment program; usability; ward; webinar

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.

项目摘要 /摘要 创伤后压力症状（PTSS）和相关的心理障碍影响25％至57％ 受伤后的儿童并导致与健康相关的生活质量较差。因为儿童的PTSS出现了 从医院出院后，它们通常是创伤系统看不见的，也不是 检测或处理。尽管存在基于循证的PTS的循证治疗，但父母的意识有限和 访问受过训练的提供商阻碍了社区的访问。该项目的目的是提供一项研究， 治疗资源用于治疗心理困扰的儿童的治疗资源 身体创伤。在AIM 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 设计用于通过创伤系统交付。我们将创建基于互动网络的心理教育 针对学龄儿童（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电子卫生疗法课程。模块将针对两个证据 基于治疗方法：认知行为疗法应对技巧（应对CBT），直接暴露于 创伤通过创伤叙事提醒。所有模块将与父母，孩子和 专业的从业者输入在每个步骤中都合并。我们将开发孩子伴随的父母模块 解决父母疑虑的治疗计划，包括管理自己的压力，育儿技能和 如何帮助特定于伤害的儿童睡眠。将设计治疗资源 专门用于便于传播并融入创伤系统。在AIM 2中，我们将执行 飞行员三臂RCT检查了这两个简介的可行性，可接受性和初步疗效 与未经处理的比较组相比，治疗（应对CBT和创伤叙事）（n = 54）。受伤 儿童及其家人将被招募在三个参与地点的住院病房中参与。 该治疗计划将作为随后的大型临床试验的研究资源 确认功效并检查潜在的治疗修饰符。帮助传播这种治疗 资源，我们将创建一个网络研讨会，为使用手动疗法和在线使用培训 模块。