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Original article
Impact of child death on paediatric trainees
  1. Clare E Hollingsworth1,
  2. Carla Wesley1,
  3. Jaymie Huckridge2,
  4. Gabrielle M Finn3,
  5. Michael J Griksaitis1
  1. 1 Paediatric Intensive Care Unit, Southampton Children’s Hospital, Southampton, UK
  2. 2 Child and Adolescent Mental Health Service, London, UK
  3. 3 Hull York Medical School, Center for Medical Education, York, Heslington, UK
  1. Correspondence to Dr Michael J Griksaitis, Southampton Children’s Hospital, Paediatric Intensive Care Unit, D-Level, Southampton SO16 6YD, UK; Michael.Griksaitis{at}uhs.nhs.uk

Abstract

Objective To assess the prevalence of symptoms of acute stress reactions (ASR) and post-traumatic stress disorder (PTSD) in paediatric trainees following their involvement in child death.

Design A survey designed to identify trainees’ previous experiences of child death combined with questions to identify features of PTSD. Quantitative interpretation was used alongside a χ2 test. A p value of <0.05 was considered significant.

Setting 604 surveys were distributed across 13 UK health education deaneries.

Participants 303/604 (50%) of trainees completed the surveys.

Results 251/280 (90%) of trainees had been involved with the death of a child, although 190/284 (67%) had no training in child death. 118/248 (48%) of trainees were given a formal debrief session following their most recent experience. 203/251 (81%) of trainees reported one or more symptoms or behaviours that could contribute to a diagnosis of ASR/PTSD. 23/251 (9%) of trainees met the complete criteria for ASR and 13/251 (5%) for PTSD. Attending a formal debrief and reporting feelings of guilt were associated with an increase in diagnostic criteria for ASR/PTSD (p=0.036 and p<0.001, respectively).

Conclusions Paediatric trainees are at risk of developing ASR and PTSD following the death of a child. The feeling of guilt should be identified and acknowledged to allow prompt signposting to further support, including psychological assessment or intervention if required. Clear recommendations need to be made about the safety of debriefing sessions as, in keeping with existing evidence, our data suggest that debrief after the death of a child may be associated with the development of symptoms suggestive of ASR/PTSD.

  • psychology
  • death
  • palliative care
  • occupational health
  • intensive care

https://doi.org/10.1136/archdischild-2017-313544

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    Footnotes

    • Twitter Michael J Griksaitis @MJGriksaitis

    • Contributors CEH and CW were involved in survey design, data analysis and production of the first draft of the paper. JH was involved in survey design and contributed to the psychological aspects of the project. GMF was involved in study design, ethics application and contributed to educational aspects of the paper. MJG was involved with project design, data analysis, survey design/distribution and supervised production of the manuscript. All authors read, contributed and approved the final manuscript.

    • Competing interests None declared.

    • Ethics approval Hull York Medical School Ethics Board.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Data sharing statement All data are included in the paper.

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