Hospitalization can have traumatic effects on children and their families, highlighting the importance of trauma-informed care in pediatric nursing. Post-hospitalization trauma, anxiety, and depression are frequently observed in both children and parents, negatively affecting health outcomes and treatment adherence. Since trauma-informed care requires a child- and family-centered, safe, and sensitive approach, educating nursing students on this topic is essential. However, this training is often insufficient in nursing curricula, and its abstract and emotionally challenging nature may hinder students' learning. In this context, the LEGO® Serious Play® method, which helps concretize abstract experiences and supports interactive learning, may serve as an effective educational tool. This study aims to evaluate the effects of trauma-informed pediatric care education delivered through the LSP method on nursing students' knowledge, self-confidence, and satisfaction.
Hospitalization is a stressful and traumatic experience for children and their families. Although most children recover physically after hospitalization, many develop psychological problems such as depression, anxiety, and post-traumatic stress. Recent studies indicate that traumatic experiences related to childhood hospitalization are highly prevalent and influence long-term health outcomes. In the systematic review conducted by Stanzel and Sierau (2021), it was found that 13% of pediatric patients exhibited symptoms consistent with post-traumatic stress disorder and 6-8% showed symptoms of depression or anxiety following hospitalization and medical procedures. In the study by Tang et al. (2025), the prevalence of post-traumatic stress in children after hospitalization ranged between 13% and 84.6%, with medical procedures, child-related factors, and the family environment identified as risk factors. Hospitalization negatively affects treatment adherence in children due to pediatric medical traumatic stress and also leaves traumatic effects on parents. In the study by Terp and Sjöström (2017), it was determined that parents vividly remembered their child's hospitalization even two years later and continued to experience strong feelings of helplessness and fear. The study emphasized that parents who witnessed their child's struggle for life experienced more severe trauma, which led to post-traumatic stress symptoms. In the study by Stremler et al. (2017), 24% of parents of hospitalized children experienced severe anxiety, 51% experienced major depression, and 26% had significant difficulties in decision-making. The traumatic effects of illness and hospitalization on children and their families have led to increased emphasis on "trauma-informed pediatric care" in pediatric nursing. Trauma-informed pediatric care is based on assessing trauma in every clinical encounter with children and their families. This approach is defined as recognizing the widespread effects of trauma on individuals, identifying trauma symptoms in patients, families, healthcare professionals, and others within the system, integrating this knowledge into policies, procedures, and practices, and preventing re-traumatization. Trauma-informed care is a comprehensive approach grounded in principles of safety, transparency and trustworthiness, peer support, collaboration, empowerment, and cultural sensitivity. Given the profound effects of trauma on children and families, it is essential for pediatric nurses to adopt and implement a trauma-informed pediatric care approach that centers on the trauma experienced by the child and family, the emotional support they need, and their specific needs. Healthcare professionals should improve their knowledge, attitudes, and skills regarding trauma-informed care. One way to achieve this is through the integration of trauma-informed pediatric care into pediatric nursing curricula. However, most nursing programs do not systematically incorporate this training into their curricula. Furthermore, because trauma-informed care often involves abstract and emotionally intense concepts, it may lead to resistance, avoidance, or superficial learning among students. Therefore, it is important to use interactive and innovative methods in the teaching process that support students' emotional safety and facilitate the expression of their thoughts. One such method is LEGO® SERIOUS PLAY® (LSP). LEGO® SERIOUS PLAY® (LSP) is a facilitation method initially designed for strategic planning and development and later applied in various fields such as education and research. This method involves participants building models with LEGO® bricks under the guidance of a facilitator, using these models to externalize abstract ideas and experiences, and then sharing the stories of their models with the group. The process typically begins with warm-up activities, followed by participants creating individual models, sharing their stories, and collaboratively developing shared meanings through group models. In this respect, LSP is an effective pedagogical tool that promotes reflective thinking, supports creative exploration, and enables participants to develop new perspectives based on their own knowledge and experiences. The literature indicates that LSP is a suitable method for the education of nursing students who frequently encounter complex clinical situations. This method has been reported to increase knowledge levels, enhance analytical and reflective thinking skills, promote resilience, and improve self-confidence. In the study conducted by Hayes and Graham (2019) with nursing students, LSP was found to help students think deeply and clearly interpret their learning journey. In the study by McCusker (2019), the use of metaphors such as LSP in education was found to help overcome cultural and traditional barriers, foster understanding and appreciation, and allow for interaction among different ideas and perspectives. There is no study in the literature in which trauma-informed pediatric nursing care has been taught to nursing students using the LSP method. This study aims to evaluate the effects of trauma-informed pediatric care taught using the LSP method on the knowledge, self-confidence, and satisfaction levels of nursing students taking a pediatric nursing course. By doing so, it seeks to address an important gap in the literature by demonstrating the effectiveness of the LSP method in teaching trauma-informed pediatric care in nursing education.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
DOUBLE
Enrollment
88
Participants learn trauma-informed care principles and different developmental stages in a hands-on way by designing hospital models with LEGO® bricks. Unlike traditional teaching methods, this approach aims to enhance participants' creativity, engagement, and learning motivation."
Ankara Medipol University
Ankara, Turkey (Türkiye)
TIC Provider Survey
This form based on research findings on post-traumatic stress following traumatic medical events in children. The survey consists of 38 items and includes five categories: 1) knowledge about trauma-informed pediatric care (11 items); 2) attitudes and beliefs about trauma-informed pediatric care (6 items); 3) self-efficacy (10 items); 4) trauma-informed care practices (7 items); and 5) perceived barriers to implementing trauma-informed care (4 items). Items assessing knowledge, attitudes, self-efficacy, and perceived barriers were evaluated using 3- or 4-point Likert-type scales appropriate to each category; for example, potential barriers were rated as "not a barrier," "somewhat a barrier," or "significant barrier." Cronbach's alpha values were found to be in the moderate to excellent range for knowledge (0.66), attitude. Higher score indicates a higher level of trauma-informed care knowledge.
Time frame: 2 weeks
Student Satisfaction and Self-Confidence in Learning Scale
This scales Cronbach's alpha value was found to be 0.94 for the satisfaction subscale and 0.87 for the self-confidence subscale. The scale consists of two subscales: "Satisfaction with Current Learning" (5 items) and "Self-Confidence in Learning" (7 items), with items rated on a 5-point Likert scale. The total score is obtained by summing the responses to each item of the scale and dividing by the number of items. The minimum score is 1 and the maximum score is 5. A higher score indicates greater satisfaction and higher self-confidence.
Time frame: 2 weeks
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.