Blending Family-Centered Care and the Neuman Systems Model in Caring for Children Experiencing Traumatic Stress.

Abstract

Child traumatic stress disorders occur when children are exposed to (i.e.experience, witness, confronted by) traumatic events or situations that overwhelm their ability to cope. This exposure can be acute or chronic. At least a quarter of a million children are admitted to an ICU each year in the United states and it is thought that as many as on third of these children ultimately will develop symptoms of acute stress disorder(ASD)or of post-traumatic stress disorder (PTSD). Therefore it is imperative that nurses be on the alert for risk factors and clinical manifestations of ASD/PTSD plus actively prevent the development of childhood traumatic stress disorders throughout the ICU stays and beyond. PURPOSE: In the 1980's a multidisciplinary group including the nurses, child-life specialists, physicians, and other therapists identified eight elements of family-centered care which have become a hallmark of pediatric nursing care in today's healthcare system. The purpose of this presentation is to explore the phenomenon of traumatic stress disorder in critically ill children by merging the elements of family centered care with the Neuman Systems Model (NSM). Approach: Regardless of age, traumatic illness can be a powerful stressor that affects children in all areas of their lives, in both immediate and long term ways, and in both obvious and subtle respects. The practice of family centered care is a key component of care for all children and their families. Using the Neuman Systems Model promotes holistic assessment of the child regardless of age and regardless of the source of the stressor(s).Nursing interventions an be divided into three categories based on the NSM-measures to prevent the development of ASD/PTSD ;early identification of children experiencing ASD/PTSD, and meeting immediate needs in the ICU; and ongoing support following hospitalization.