Denise F Lillvis, Brooks Harmon, Hector Osei, Bonnie M Vest, Brian M Clemency, Kunal Chadha, Carroll M Harmon, Jihnhee Yu, Gregory G Homish, Tamara D Simon, E Brooke Lerner
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引用次数: 0
Abstract
Objective: Children and youth with special healthcare needs (CYSHCN) are those who have one or more chronic conditions necessitating medical, educational, and/or social services use. Of the 15 million CYSHCN, a quarter report accessing emergency care annually, some of whom have physical injuries. This study examines the perspectives, challenges, and opportunities identified by prehospital and hospital clinicians delivering injury care to CYSHCN.
Methods: Qualitative interviews were conducted with 23 hospital and 13 prehospital clinicians in one geographic region. All interviews were recorded and transcribed; interviews were analyzed using multiple coders and rapid analysis procedures to identify themes.
Results: One intrapersonal theme pertaining to clinicians' prior experiences and six interpersonal themes capture the factors characterized by the participating EMS- and hospital-level clinicians. Identified interpersonal themes include: 1) how prior experiences of injured CYSHCN shape future encounters with emergency care, 2) communication challenges specific to CYSHCN, 3) parental expertise and guidance during care, 4) emotional support, 5) trust-building, and 6) the need to balance accommodations pertaining to the child's special healthcare need in the emergent care context.
Conclusions: In prehospital and hospital settings, injured CYSHCN may need care for both their physical injury and their special healthcare need. Prehospital and hospital clinicians, who likely have not previously provided care for the child, are mindful of the opportunities and challenges this situation presents. These results inform an understanding of how clinicians approach care of injured CYSHCN in the emergency setting and indicate opportunities for future exploration, such as how to effectively leverage family strengths in this context.
期刊介绍：
Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.
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