Prior Trauma Exposure and Serious Illness at End of Life: A National Study of Children in the U.S. Foster Care System From 2005 to 2015
| Autor: | Lisa C. Lindley, Elspeth Slayter |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
Child abuse medicine.medical_specialty Critical Illness Developmental Disabilities media_common.quotation_subject Poison control Vulnerable Populations Occupational safety and health Foster Home Care Neglect 03 medical and health sciences 0302 clinical medicine Child of Impaired Parents 030225 pediatrics Injury prevention Prevalence medicine Humans 0501 psychology and cognitive sciences Child Abuse Longitudinal Studies Child Psychiatry General Nursing Retrospective Studies media_common Terminal Care business.industry 05 social sciences United States Anesthesiology and Pain Medicine Foster care Child Preschool Female Neurology (clinical) business Psychosocial Stress Psychological 050104 developmental & child psychology |
| Zdroj: | Journal of Pain and Symptom Management. 56:309-317 |
| ISSN: | 0885-3924 |
| DOI: | 10.1016/j.jpainsymman.2018.06.001 |
| Popis: | Context. Children in foster care suffer with serious illness at end of life. However, the relationship between prior trauma exposure and serious illness has received little empirical attention. Objectives The objectives were to examine the prevalence and type of trauma exposure, and investigate the relationship between prior trauma and serious illness among foster children at end of life. Methods We used national longitudinal foster care data. We included children who were less than 18 years with residence in the United States. Serious illness (i.e., physical health, mental/behavioral health, developmental disabilities) was measured via the foster care files. Three measures of prior trauma exposure (i.e., maltreatment, drug/alcohol exposure, psychosocial stressors) were created. Using multivariate logistic regressions, we evaluated the influence of prior trauma on serious illness at end of life, while controlling for demographic, geographic, and foster care support characteristics. Results Sixty-eight percent of children experienced maltreatment, 28% exposure to parental drug/alcohol misuse, and 39% psychosocial stressors prior to entering foster care. Maltreatment was positively associated with physical health and developmental disabilities, while parental drug/alcohol exposure was inversely related to developmental disabilities. Psychosocial stressors contributed to the prediction of poor physical, mental, and developmental health. Conclusions These findings suggest that trauma-informed end-of-life care may be a critical need among children in foster care with serious illness. Future directions are discussed, including collaboration between end-of-life clinicians and social service workers and the importance of future research to understand and improve the quality of health at end of life for this underserved population. |
| Databáze: | OpenAIRE |
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