Research In Action

After an injury, many children experience a decreased quality of life. Pediatric nurses play a key role in helping children recover. They are in a unique position to help reduce and screen for posttraumatic stress symptoms (PTSS) that may contribute to decreased quality of life in children with injury.

To help pediatric nurses further support this injury recovery, I recently published a study in the Journal for Specialists in Pediatric Nursing with colleagues from the University of Maryland Baltimore County, Akron’s Children’s Hospital, and Texas Tech University that examined PTSS and the role of hope in impacting quality of life after injury.

For the study, 60 injured children ages 7 to 13 from three pediatric hospitals completed measures of PTSS, hope, and quality of life while receiving injury treatment. We found that each specific PTSS cluster (re-experiencing, avoidance, arousal) significantly predicted quality of life, but hope (belief in achieving recovery goals) did not.

Although our study is the first to explore hope in relation to quality of life in injured children ages 7 to 13, these results are surprising:

• Our findings suggest that hope does not significantly predict quality of life. This may be because other factors, such as physical pain and medications, may have influenced how participants responded to the hope scale.
• Further research is needed to better understand these relationships.
• Hope remains an important avenue for future pediatric injury research since it has the potential to allow nurses to build on patients’ existing strengths to overcome injury-related challenges.

Nurses’ Role in Promoting Quality of Life

While this study is exploratory and more research is needed, our results suggest that pediatric nurses’ awareness of PTSS may help medical teams in identifying children that are at risk for impaired functional recovery, including quality of life, post-injury. To improve care, we recommend:

• Practice trauma-informed care, which includes recognizing pre-existing trauma, addressing acute traumatic stress reactions associated with the traumatic event, minimizing potentially traumatic aspects of treatment, and identifying children who need additional monitoring or referrals for more help.
• Access specific trauma-informed care education and training at HealthCareToolbox.org.
• Advocate for the integration of PTSS screeners into standard medical care.
• Continue to evaluate referral options for children that may benefit from additional mental health or other services.

Pediatric nurses may also want to share resources with families on how to cope after an injury. AfterTheInjury.org offers evidence-based tips and other information from experts at Children’s Hospital of Philadelphia.