Pediatric Injury; Modules to Manage Medical Stress

儿科损伤；

基本信息

批准号：
10424535
负责人：
LINDA EWING-COBBS
金额：
$ 58.26万
依托单位：
UNIVERSITY OF UTAH
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-08-10 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10424535
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 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 Reduce health disparities 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 Community Urban Population Youth aged behavioral health brief intervention comparison group coping desensitization design disability eHealth evidence base experience falls follow-up health related quality of life high risk implementation barriers innovation iterative design multidisciplinary physical conditioning pilot test post-traumatic stress post-traumatic symptoms programs psychoeducational psychologic psychological distress recruit satisfaction screening skills sociodemographics symptom management trauma care trauma centers trauma exposure traumatic event treatment comparison treatment effect treatment program usability ward webinar

项目摘要

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.

项目概要/摘要创伤后应激症状 (PTSS) 和相关的心理障碍影响着 25% 至 57% 的人儿童受伤后，会导致健康相关的生活质量恶化。因为儿童PTSS的出现当他们出院回家后，他们往往不会被创伤系统所察觉，也不会受到伤害。被发现也没有治疗。尽管存在针对 PTSS 的循证治疗，但家长的认识和认识有限获得训练有素的提供者的机会阻碍了社区的准入。该项目的目标是提供研究和用于管理住院一段时间的儿童的心理困扰的治疗资源身体创伤。在目标 1 中，我们将开发一种创新、简短的电子健康方法来治疗 PTSS 设计为通过创伤系统传递。我们将创建基于网络的交互式心理教育专为学龄儿童（8 至 11 岁）和青少年（12 至 16 岁）量身定制的模块与经过培训的治疗师进行同步电子健康治疗课程一起使用。模块将针对两个证据基础治疗方法：认知行为疗法应对技巧（coping CBT）和直接暴露通过创伤叙述来提醒创伤。所有模块都将与父母、孩子和每一步都纳入专家从业者的意见。我们将开发陪伴孩子的家长模块解决家长担忧的治疗计划，包括管理自己的压力、养育技巧和如何帮助儿童解决常见的伤害问题：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，我们将执行试点三臂随机对照试验，检验两项简报的可行性、可接受性和初步疗效治疗（应对 CBT 和创伤叙述）与未经治疗的对照组 (N = 54) 进行比较。受伤将从三个参与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，提供使用手动疗法和在线疗法的培训模块。