The Initial Experience After Pediatric Firearm Injury: A Multifaceted Qualitative Approach

IF 1.8 3区 医学 Q2 SURGERY Journal of Surgical Research Pub Date : 2024-10-18 DOI:10.1016/j.jss.2024.09.057
Jennifer M. Schuh MD , Christina Georgeades MD , Taylor Schleusner BS , Carisa Bergner PhD , Samantha Leonard MD , Patricia Marik PsyD , Matthew Jandrisevits PhD , David Gourlay MD, FAAP, FACS , Katherine Flynn-O’Brien MD, MPH, FAAP, FACS
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Abstract

Introduction

Firearm victims sustain a disproportionate mental health burden. Inpatient pediatric psychology consult liaison (CL) services provide comprehensive evaluation after injury. We aim to explore CL documentation qualitatively to better understand the initial psychological experience after firearm injury in children compared to motor vehicle crash (MVC) injury. We hypothesized that meaningful differences between the cohorts would be evident by thematic, sentiment, and word cloud analyses of CL notes.

Materials and methods

This single-institution, retrospective study at a level I pediatric trauma center identified 5-17-y-old children who sustained firearm injuries and were admitted for ≥48 h from January 1, 2016 to March 31, 2021. Firearm-injured children were propensity score-matched to MVC-injured children. Thematic, sentiment, and word cloud analyses were completed for all CL notes.

Results

98 firearm-injured children were identified. The CL service evaluated 71% of firearm-injured children and 65% of MVC-injured children. Domains of resources, encountering the medical system, prior psychological and legal influences, immediate cognitive reactions, and social influences were identified based on extracted themes. Sentiment analysis revealed more negative than positive words for both firearm- (3318 versus 2190 words) and MVC-injured children (2225 versus 1994 words). Word cloud showed that firearm-injured child notes more frequently mentioned “trauma”, while MVC-injured child notes more frequently mentioned “family” and “support”.

Conclusions

The pediatric CL note analysis suggests that the experience after firearm injury differs from that after MVC injury in reference to family and support. CL notes covered a breadth of topics beyond the psychological impact alone. Understanding the experiences of injured children in relation to injury mechanism offers opportunity for focused intervention strategies.
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小儿枪伤后的最初经历:多方面定性方法。
导言:枪伤受害者承受着过重的心理健康负担。住院儿科心理咨询联络(CL)服务可提供受伤后的全面评估。我们旨在对 CL 文档进行定性研究,以便更好地了解与机动车碰撞 (MVC) 伤害相比,儿童在枪支伤害后最初的心理体验。我们假设,通过对CL记录进行主题、情感和词云分析,可以明显看出组群之间存在有意义的差异:这项在一级儿科创伤中心进行的单一机构回顾性研究确定了 2016 年 1 月 1 日至 2021 年 3 月 31 日期间遭受枪伤且入院时间≥48 小时的 5-17 岁儿童。枪伤儿童与机动车交通事故受伤儿童进行了倾向得分匹配。对所有CL记录进行了主题、情感和词云分析:结果:确定了 98 名枪伤儿童。CL服务评估了71%的枪伤儿童和65%的机动车碰撞受伤儿童。根据提取的主题,确定了资源、遇到医疗系统、先前的心理和法律影响、即时认知反应和社会影响等领域。情感分析显示,枪伤儿童(3318 字对 2190 字)和机动车碰撞受伤儿童(2225 字对 1994 字)的负面词语多于正面词语。词云显示,枪伤儿童的记录中更多地提到了 "创伤",而车祸受伤儿童的记录中更多地提到了 "家庭 "和 "支持":儿科 CL 笔记分析表明,在提及家庭和支持时,枪支伤害后的经历与机动车碰撞伤害后的经历有所不同。CL记录涉及的主题非常广泛,不仅仅是心理影响。了解受伤儿童在受伤机制方面的经历为制定有针对性的干预策略提供了机会。
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来源期刊
CiteScore
3.90
自引率
4.50%
发文量
627
审稿时长
138 days
期刊介绍: The Journal of Surgical Research: Clinical and Laboratory Investigation publishes original articles concerned with clinical and laboratory investigations relevant to surgical practice and teaching. The journal emphasizes reports of clinical investigations or fundamental research bearing directly on surgical management that will be of general interest to a broad range of surgeons and surgical researchers. The articles presented need not have been the products of surgeons or of surgical laboratories. The Journal of Surgical Research also features review articles and special articles relating to educational, research, or social issues of interest to the academic surgical community.
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