Barriers to Emergency Department Clinicians' Confidence in Providing Paediatric Trauma-Informed Care

Nimrah Afzal, Mark David Lyttle (Editor), Eva Alisic (Editor), David Trickey (Editor), Rachel Hiller (Editor), Sarah Halligan (Editor)

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Background: It has been estimated that around 31% of children will experience a traumatic event during childhood, most commonly serious accidents that lead to hospitalisation. Around 15% of children who experience such events go onto develop post-traumatic stress disorder (PTSD). Emergency department clinicians have a unique opportunity to intervene during the early peri-trauma period, which can involve incorporating a trauma-informed approach within their care. The available evidence indicates that clinicians internationally need further education and training to enhance their knowledge and confidence in providing trauma-informed psychosocial care (Alisic et al., 2016). However, UK/Ireland specific knowledge is limited.
Methods: The current study analysed the UK and Irish subset of data (N = 434) that was collected as part of an international survey of emergency department clinicians (Alisic et al., 2016). Questionnaires indexed clinician confidence in providing psychosocial care, and a range of potential barriers to providing that care. Hierarchical linear regression was used to identify predictors of clinician confidence.
Results: Clinicians reported moderate levels of confidence in providing psychosocial care to injured children and families (M = 3.19, SD = 0.46). Regression analyses identified negative predictors of clinical confidence, including a lack of training, worrying about further upsetting children and parents, and low levels of perceived departmental performance in providing psychosocial care (R2 = .389).
Conclusions: The findings highlight the need for further training in psychosocial care for emergency department clinicians. Future research must identify nationally relevant pathways to implement training programmes for clinicians, in order to improve their skills in relation to paediatric traumatic stress and to reduce the perception of barriers identified in the present study.
Original languageEnglish
Article numbere12091
JournalJCPP Advances
Issue number3
Early online date21 Jul 2022
Publication statusPublished - 30 Sept 2022
EventBABCP 50th Annual Conference - London, UK United Kingdom
Duration: 20 Jul 202223 Jul 2022

Bibliographical note

Funding statement: Funding for the original data collection has been described in Alisic et al., 2016, JPeds (doi: 10.1016/j.jpeds.2015.10.067). For the current manuscript, Nimrah Afzal is supported by an ESRC Economic and Social Research Council PhD Studentship (ED-PS1259).


  • Emergency department
  • Trauma
  • PTSD
  • Post-traumatic stress
  • Trauma Informed Care and Practice

ASJC Scopus subject areas

  • Developmental and Educational Psychology


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