Abstract
Paediatric trauma can result in significant levels of on-going disability. The aim of this study was to explore the restrictions on activity participation that children experience following serious injury from the perspective of their caregivers. We performed a thematic analysis of transcripts of semi-structured in-depth interviews with the caregivers of 44 seriously injured children, conducted three-years after the injury, and purposively sampled from a population-based cohort study. Both temporary and on-going restrictions on school, sport, leisure and social activities were identified, some of which were imposed by caregivers, schools, or recommended by health providers. The perceived risk of further injury, physical restrictions, emotional state and fatigue levels were important influences on degrees of activity restriction. Children who were socially less engaged, especially those who were more severely injured, had difficulty making and retaining friends, and exhibited signs of depression or social withdrawal. The activities of pre-school children were strongly regulated by their caregivers, while school age children faced obstacles with participation in aspects such as study, sport, and peer and teacher relationships, affecting learning, school attendance and enjoyment. The findings highlight the need for primary prevention and reducing the impacts of serious injury throughout the continuum of care.
Highlights
Injury in childhood has the potential to cause devastating short- and long-term consequences.Seriously injured children typically have multiple injuries, require admission to intensive care or urgent surgery
One quarter were funded by the Transport Accident Commission (TAC), the state’s “no fault” insurer for road injury
She wants to work with disabled children, or disabled people, and so we were able to get her a placement . . . which is just brilliant for her, because it’s given her a reason to do things, and the reason for her to go to school, is to get the certificate that she needs to be able to go on with the work that she wants to do.” (12–16 years, female, head and other injuries; Mother). In this large qualitative study based on caregiver perceptions, most children experienced some restriction on their activities following serious injury
Summary
Injury in childhood has the potential to cause devastating short- and long-term consequences.Seriously injured children typically have multiple injuries, require admission to intensive care or urgent surgery. Injury in childhood has the potential to cause devastating short- and long-term consequences. In the years following serious injury, children can experience on-going disability and reduced health-related quality of life, which can restrict their daily activities [1,2]. As participation in activities for children is critical for normal physical and psychosocial development, confidence and identity building, and establishing and maintaining friendships, restricted activities can negatively affect enjoyment, wellbeing, quality of life and childhood development [3,4]. Previous studies examining activity restrictions among children with disabilities [4,5,6,7,8,9] have largely focused on children with chronic health conditions such as cerebral palsy, specific activities. Public Health 2016, 13, 652; doi:10.3390/ijerph13070652 www.mdpi.com/journal/ijerph
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