The Initial Experience After Pediatric Firearm Injury: A Multifaceted Qualitative Approach. J Surg Res 2024 Nov;303:519-531
Date
10/20/2024Pubmed ID
39426064DOI
10.1016/j.jss.2024.09.057Scopus ID
2-s2.0-85206501952 (requires institutional sign-in at Scopus site)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.
Author List
Schuh JM, Georgeades C, Schleusner T, Bergner C, Leonard S, Marik P, Jandrisevits M, Gourlay D, Flynn-O'Brien KAuthors
Carisa Bergner Biostatistician II in the Shared MCW CSG Administrative Services department at Medical College of WisconsinDavid M. Gourlay MD Chief, Professor in the Surgery department at Medical College of Wisconsin
Matthew Jandrisevits PhD Assistant Professor in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin
Patricia K. Marik PsyD, MA Assistant Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Accidents, TrafficAdolescent
Child
Child, Preschool
Female
Firearms
Humans
Male
Qualitative Research
Retrospective Studies
Trauma Centers
Wounds, Gunshot