None listed
Conditions
Brief summary
The effect of cumulative stress and trauma on children and families has been demonstrated to lead to compromised outcomes in health and well-being for the child. Cumulative stress or trauma can arise from multiple co-existing or recurrent experiences such as poverty, inappropriate housing, unemployment, ill-health or injury, family breakdown, family violence, parental substance misuse, abuse or neglect. Acute paediatric health services play a unique role in contributing to the maintenance and improvement of child’s health and well-being and support of their families. They have been identified as playing a crucial role in the identifying children as risk of suffering deleterious effects of the cumulative stress and trauma. This study aims: 1) To describe the health and well-being of children admitted to The Royal Children’s Hospital (RCH) and identified by clinical staff as being vulnerable to the effects of cumulative stress or trauma 2) To compare the health and well-being of participants in this study to Australian reference data (using data from Growing Up in Australia: The Longitudinal Study of Australian Children) 3) To trial and evaluate an enhanced assessment and intervention program in an acute paediatric setting for children identified as being vulnerable to the effects of cumulative stress and trauma 4) To identify the interdisciplinary professional decision making processes of RCH health professionals working with clinical presentations of cumulative stress and trauma. This study will use a sequential comparison group design, collecting both quantitative and qualitative data, to address the above aims. Data will be collected by questionnaire, interview and hospital Unit Record audit at two time points: entry to study (T1); discharge from hospital (T2) and six months post-discharge (T3). Participating families will be recruited from children admitted to select Medical Units in The Royal Children’s Hospital Melbourne.
Interventions
This study will use a sequential, comparision group design. In the first part of the study, a cohort will be recruited into a Usual Care group (n=25). The Usual Care group will be delivered standard care for children experiencing cumulative stress and trauma as a result of multiple co-existing and/or recurrent family stress in addition to childhood illness. The Usual Care group will complete standardised measures (at entry to study and 6 months post-discharge), participate in qualitative in
This study will use a sequential, comparision group design. In the first part of the study, a cohort will be recruited into a Usual Care group (n=25). The Usual Care group will be delivered standard care for children experiencing cumulative stress and trauma as a result of multiple co-existing and/or recurrent family stress in addition to childhood illness. The Usual Care group will complete standardised measures (at entry to study and 6 months post-discharge), participate in qualitative interviews (at discharge from hospital and 6 months post-discharge) and an audit of the child's medical file will be conducted (at discharge from hospital and 6 months post-discharge). In the second part of the study, a second cohort will be recruited into an Enhanced Care group (n=25). The Enhanced Care cohort will receive the following intervention: 1) A comprehensive psycho-social assessment conducted by the Hospital Social Work Department. This assessment will assess the following domains: family history; family functioning; personal history of parent/s; child’s developmental history; parent-child relationship; family networks and supports including past Department of Human Services (DHS) - Child Protection involvement. The assessment will be conducted by interviewing the parents of the child, and the child, as appropriate. The assessment will be conducted within 24 hours of recruitment to the study (approximately sixty to ninety minutes duration). 2) A comprehensive medical and developmental assessment conducted by forensic paediatric specialists within 24 hours of recruitment to the study. The assessment will include both an interview with parents and medical/developmental assessment of the child (approximately sixty to ninety minutes in duration). 3) The comprehensive psychosocial assessment and the comprehensive medical and developmental assessment wil be discussed in a multi-disciplinary evaluation and planning meeting attended by Unit medical, nursing and allied health staff as well that the specialist from the Victorian Forensic Paediatric Medical Service who conducted the comprehensive medical and developmental assessment and the social worker who conducted the comprehensive psychosocial assessment (approximately 30-45 minutes duration). 4) The recommendations of the multi-disciplinary evaluation and planning meeting will be discussed with the family in a formal family case planning meeting where a individualised plan for the child and family will be devised (approximately sixty to ninety minutes duration). The Enhanced Care group will complete standardised measures (at entry to study and 6 months post-discharge), participate in qualitative interviews (at discharge from hospital and 6 months post-discharge) and an audit of the child's medical file will be conducted (at discharge from hospital and 6 months post-discharge). The overall duration of the study will be 12 months to 18 months, dependent on the recruitment rate.
Sponsors
Royal Children's Hospital, Melbourne, Australia
Study design
Allocation
Non-randomised trial
Intervention model
Other
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
0 to 12 Years
Healthy volunteers
No
Inclusion criteria
1. Children admitted to select medical Units of the Royal Children's Hospital, Melbourne, Victroia, Australia 2. Assessed by Unit medical, nursing or social work staff to be at risk of experiencing the impact of cumulative stress or trauma
Exclusion criteria
1. Children identified as Aboriginal and Torres Strait Island descent. 2. Children who are current clients of Department of Human Services (DHS) - Child Protective Services 3. Parents unable to consent due to cognitive impairment 4. Parents under the age of 18 5. Parent who are unable to consent due to psychiatric illness
Outcome results
None listed