After a Child's Injury: Parents & Stress

January 11, 2010 — According to research by The Children's Hospital of Philadelphia (CHOP) recently published in the Journal of Traumatic Stress, one month after their child was injured 37 percent of parents experienced acute stress disorder or significant traumatic stress symptoms, including:

• Re-experiencing the incident
• Avoiding reminders of the incident
• Increased general anxiety
• Jumpiness

Of those parents, 15 percent displayed longer-term symptoms of post traumatic stress disorder (PTSD) more than six months after the initial injury. 

Parents play an important role in their child's recovery

"Research consistently shows the important role that parents play in a child's recovery. So, in addition to all the things parents do to help their child recover, it's very important that they also take good care of themselves," says Nancy Kassam-Adams, PhD, the study's lead author and director of the behavioral science core at CHOP's Center for Injury Research and Prevention. "To help families understand and deal with their reactions to a child's injury, we created a website called After the Injury: Helping Parents Help Their Kids Recover. 

"It is natural for parents to feel very upset or anxious in the first days and weeks following a child's injury," explains Flaura Koplin Winston, MD, PhD, a co-author of the study and co-scientific director of CHOP's Center for Injury Research and Prevention. "But, when traumatic stress reactions go on for longer than a month, worsen, or get in the way of normal life, it is important for parents to seek support for themselves." 

"It's harder to help your child if you — the parent — are feeling nervous, worried, upset or overwhelmed," says Dr. Kassam-Adams. "Parents need to take time to talk about their concerns or feelings with loved ones, take a break, and recognize when outside help might be needed." 

About the study

In this study, the researchers worked with 334 parents of children who had suffered road traffic injuries requiring hospital care. The researchers identified factors that predicted the severity of ASD (acute trauma symptoms rated in the first month) and PTSD (longer-lasting trauma symptoms rated about six months later) in parents of the injured children. Highlights from these findings include:

• The severity of parents' PTSD six months after the injury was strongly associated with the severity of their traumatic symptoms within one month after the injury.
• Parents who had experienced a previous trauma had more severe traumatic stress symptoms immediately after their child's injury and six months later.
• Parents' traumatic stress symptoms were linked to their experience of the injury. Those that experienced more severe and persistent symptoms were present when their child was injured, perceived their child to be in pain, or thought that their child's life was in danger.
• Parents' traumatic stress symptoms were linked to their child's symptoms. They were more likely to experience PTSD if their child was in poorer physical health six months after the injury than they were before the injury, or when their child reported more severe acute traumatic stress symptoms. 

"The focus after an injury is on the child's physical recovery. Our previous research demonstrated that a child's full recovery plan needs to address physical and emotional needs. This study points to the needs of parents of injured children, which might be overlooked," says Dr. Winston. "Parents need to know how to find the help and support they need so that they can give help and support to their injured child."

Resources to help parents cope with traumatic stress

AfterTheInjury.org is a parent-friendly website designed by experts at The Children's Hospital of Philadelphia to help parents ensure that they — and their kids — achieve a full physical and emotional recovery. The site includes expert tips and help for parents on how to manage hospital visits, making the transition to home, how to help children with fears and worries, and how to help return to life as usual. 

Based on this research, the researchers have created a tip sheet for parents dealing with the aftermath of a child's injury. This fact sheet, along with a host of additional resources for families, are available on the After the Injury site. The website also includes resources for physicians who are helping families to cope with the aftermath of an injury.

About The Center for Injury Research and Prevention

The Center for Injury Research and Prevention (CIRP) at The Children's Hospital of Philadelphia (CHOP) was established in 1998 to advance the safety of children and young adults through science. Operating with the central belief that children are not small adults, the Center's multidisciplinary team of researchers work to reduce injuries — the leading cause of death and acquired disability among the young.

CIRP research is organized around three disciplines: epidemiology/biostatistics, engineering and behavioral science. Based on the research questions at hand, the Center draws from CHOP and University of Pennsylvania-based experts in emergency medicine; pediatric trauma; surgery; nursing; social work; pediatric and adolescent medicine; epidemiology and biostatistics; bioengineering; computational engineering; psychology; behavioral science; communications; and health education.

CIRP findings are published in scientific journals and translated into recommendation and education tools for parents, educators, policymakers and product manufacturers. A signature initiative of the Center is The Partners for Child Passenger Study, which was a decade-long research collaboration with State Farm Insurance Companies®.