Els van Meijel

122 Chapter 7 | General discussion instruments for young children are scarce, there is a need for future research to develop age-appropriate assessment tools for young children. Fifth, to recommend the selection and timing of early interventions, more research on the effectiveness of early interventions after accidental trauma is needed, preferably a randomized controlled trial. Finally, systematic evaluation of the effectiveness of trauma-informed care in reducing pediatric medical stress and prevention of PTSD can yield the information needed for systematic implementation. Final conclusions In this thesis, we focused on posttraumatic stress following accidental injury in children and their parents. PTSD after accidental injury is clearly a serious problem for children and their parents. The short and long-term prevalence revealed in this thesis supports an active approach to prevent PTSD and promote resilience. Findings on associated factors such as severe acute pain and permanent physical impairment provide an opportunity to improve the care for accidentally injured children and their parents. This can be brought into practice by implementing a stepped care approach and trauma-informed care. Ongoing efforts are needed to increase awareness for psychological consequences of accidents in all those concerned, from patients to government agencies. This awareness, together with knowledge of the consequences of PTSD, is a precondition for the successful implementation of screening for risk, trauma-informed care and changes in hospital policies and protocols.