Els van Meijel

43 Acute pain and posttraumatic stress symptoms | Chapter 3 account clinical and demographic factors (gender, presence of an extremity fracture, injury severity, length of hospitalization) potentially related to pain or posttraumatic stress. As the prevalence and the risk of PTSD differs between boys and girls (Alisic et al., 2014; Stallard et al., 2004; Winston et al., 2003), we also examined associations between the variables of interest separately for boys and girls. Methods Participants and procedures For the current study, we used data that were collected as part of the STEPP study in the Netherlands. In the STEPP study we evaluated a screening instrument (Screening Tool for Early Predictors of PTSD; STEPP) for risk of PTSD in children who had been injured due to accidental trauma (van Meijel et al., 2015). The STEPP study was performed at two academic hospitals in Amsterdam, the Netherlands: Academic Medical Center (AMC) and VU Medical Center (VUmc). Both hospitals are Level 1 trauma centers. The Medical Ethical Committees of both hospitals approved the study. We used the registry systems of the Trauma surgery and Emergency Departments to identify children eligible for this study. We contacted children from 8 to 18 years old (usually via their parents), who had been injured in an accident and were screened for trauma in the trauma room of the emergency department. If children had already been discharged from the hospital, we phoned and asked for an appointment at home. If children were hospitalized, we first consulted the responsible nurse. Participation was only possible after written informed consent was obtained from parents (until the age of 16) and children themselves (from the age of 12). Children were excluded if they had stayed on Intensive Care Units (pediatric or regular) for more than one week, or if they were incapable of answering the questions or completing the questionnaires due to cognitive limitations. The first assessment took place after consent was provided. The mean number of days between the accident and the first assessment was 5.8 (SD = 3, range 1–14). The first two authors (EM and MRG) recruited participants, completed informed consent procedures and collected the data. The sample size for the STEPP study was 161; for the current study, 135 participants with pain data were included in the analysis. Details on recruitment and retention are provided in (van Meijel et al., 2015). Demographic and clinical child characteristics are reported in Table 3.1.