Adolescent and young adult stress and coping during COVID-19: the utility of a pediatric emergency department screener

Abstract Background COVID-19 altered lives, especially adolescents and young adults who lost their emotional and social support systems and may be suffering. Objective In response to the coronavirus pandemic, a questionnaire was created and administered to Pediatric Emergency Department (PED) patients in order to identify psychosocial stress and coping abilities. Methods A 12-question (yes/no) quality improvement (QI) paper-based questionnaire was administered by PED providers to assess psychosocial stress and coping among patients 12 years and greater who presented to the PED at a tertiary Children’s Hospital, March-September 2020. Questions were asked/recorded to determine rates of distress and provide social work intervention, if needed. Analysis-Chi-squared, Fisher’s exact, and Mann-Whitney U tests. Results Among 1261 PED patients who participated in the study, the mean age was 15.4 years (SD = 2.4), (58% female, 41.5% male, 0.6% missing data). We identified 611 patients (48.5%) who admitted to feeling scared about contracting the disease, 876 patients (69.5%) who were concerned about the health of their families, and 229 patients (18.2%) who screened positive for food insecurity. In addition, 596 patients (47.3%) felt anxiety, 333 patients (26.4%) felt depressed, and 13 patients (1%) admitted to having suicidal ideation because of COVID-19. The majority of patients, 1165 (92.4%), felt supported during the pandemic. Social work was consulted for 235 (18.6%) of patients participating. Conclusions While patients typically present to PEDs for a somatic complaint, screening their psychosocial and emotional states may reveal underlying mental health concerns that require intervention and at times, assistance from social workers.

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Adolescent and Young Adult Stress and Coping During COVID-19: The Utility of a Pediatric Emergency Department Screener

10.21203/rs.3.rs-245776/v1 ◽

2021 ◽

Author(s):

Alan L Nager ◽

Ji-Ting Janet Yau

Keyword(s):

Emergency Department ◽

Social Work ◽

Psychosocial Stress ◽

Pediatric Emergency ◽

Stress And Coping ◽

Adolescent And Young Adult ◽

Pediatric Emergency Department ◽

Emotional States ◽

Chi Squared ◽

And Coping

Abstract Background: COVID-19 altered lives, especially adolescents and young adults who lost their emotional and social support systems and may be suffering. Objective: In response to the Coronavirus pandemic, a questionnaire was created and administered to Pediatric Emergency Department (PED) patients in order to identify psychosocial stress and coping abilities. Methods: A 12-question (yes/no) Quality Improvement (QI) paper-based questionnaire was administered by PED providers to assess psychosocial stress and coping among patients 12 years and greater who presented to the PED at a tertiary Children’s Hospital, March - September 2020. Questions were asked/recorded to determine rates of distress and provide social work intervention, if needed. Analysis-Chi-squared, Fisher’s exact, and Mann-Whitney U tests. Results: Among 1261 PED patients who participated in the study, the mean age was 15.4 years (SD=2.4), (58% female, 41.5% male, 0.6% missing data). We identified 611 patients (48.5%) who admitted to feeling scared about contracting the disease, 876 patients (69.5%) who were concerned about the health of their families, and 229 patients (18.2%) who screened positive for food insecurity. In addition, 596 patients (47.3%) felt anxiety, 333 patients (26.4%) felt depressed and 13 patients (1%) admitted to having suicidal ideation because of COVID-19. The majority of patients, 1165 (92.4%), felt supported during the pandemic. Social work was consulted for 235 (18.6%) of patients participating. Conclusions: While patients typically present to PEDs for a somatic complaint, screening their psychosocial and emotional states may reveal underlying mental health concerns that require intervention and at times, assistance from social workers.

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Effects of Social Work Intervention on Nonemergent Pediatric Emergency Department Utilization

Health & Social Work ◽

10.1093/hsw/29.4.263 ◽

2004 ◽

Vol 29 (4) ◽

pp. 263-273 ◽

Cited By ~ 11

Author(s):

J. W. Ross ◽

D. Roberts ◽

J. Campbell ◽

K. S. Solomon ◽

B. H. Brouhard

Keyword(s):

Emergency Department ◽

Social Work ◽

Pediatric Emergency ◽

Emergency Department Utilization ◽

Pediatric Emergency Department ◽

Work Intervention

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Headache in the pediatric emergency department: A 5-year retrospective study

Cephalalgia ◽

10.1177/0333102417748907 ◽

2017 ◽

Vol 38 (11) ◽

pp. 1765-1772 ◽

Cited By ~ 5

Author(s):

Roberta Rossi ◽

Antonia Versace ◽

Barbara Lauria ◽

Giulia Grasso ◽

Emanuele Castagno ◽

...

Keyword(s):

Emergency Department ◽

Cranial Nerves ◽

Primary Headache ◽

Pediatric Emergency ◽

Secondary Headache ◽

Pediatric Emergency Department ◽

Red Flags ◽

Exact Test ◽

Headache Centre ◽

Chi Squared

Aim To determine the red flags for serious organic causes of headache in children, to analyze if the management of headache in the Pediatric Emergency Department is appropriate, and whether the follow-up may limit repeated visits to the Emergency Department. Methods All the patients ≤ 18 years referred to our pediatric Emergency Department for non-traumatic headache over 5 years were retrospectively reviewed. The patients followed up by the Pediatric Headache Centre were also screened. Statistical analysis was undertaken using the Chi-squared test or Fisher’s exact test and multivariate analysis; significance at p < 0.05. Results 1833 patients (54.6% males) accessed our Emergency Department 2086 times; 62.1% had primary headache, 30.0% had secondary headache, 7.8% received inconsistent diagnosis. Among those with secondary headache, 24 (1.1% of total visits) were diagnosed with serious disorders. The clinical red flags for “serious headache” were: Cranial nerves palsy, strabismus, and drowsiness. One hundred and eighty four patients (8.8 %) underwent neuroimaging (rate of pathological findings: 7.1 %); 37.2 % of the patients received analgesic therapy. One hundred and fifteen patients (6.2 %) returned within three months; 24 of these were referred to the Headache Centre, with only one accessing the Emergency Department again. Conclusions The vast majority of headaches referred to the Pediatric Emergency Department are benign, and primary forms prevail. “Serious headache” is rare and shows typical clinical features and abnormal neurologic evaluation; specific clinical red flags, along with suggestive personal history, should lead the pediatrician to prescribe only appropriate neuroimaging. Pain relief is still insufficient in the Pediatric Emergency Department despite appropriate guidelines. Last, the collaboration with the Headache Centre is crucial to limit repeated visits.

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