Which factor ımpacts medical traumatic stress for pediatric patients: Scoping review

Abstract

Purpose: The objective of this scoping review was to systematically map, categorize, and synthesize the existing research identifying the factors associated with the development of medical traumatic stress in pediatric patients receiving clinical care. Methods: This review followed the methodological framework proposed by Booth et al. (2021) and adhered to the PRISMA-ScR guidelines. Six electronic databases (PubMed, Web of Science, Cochrane Library, MEDLINE, CINAHL, and Scopus) were systematically searched until December 12, 2024. Results: Fourteen primary studies were included, covering diverse pediatric populations exposed to surgical procedures, intensive care admissions, chronic illnesses, oncological treatments, and severe infections. PMTS symptom frequency among pediatric patients ranged from 8.6 % to 60 % across studies. Key child-related risk factors included younger age, pre-existing emotional difficulties, hospitalization-related anxiety, and fear of death. Family-related factors such as parental PTSD symptoms, caregiver stress, and poor family functioning significantly influenced outcomes. Medical-related factors such as perceived life threat, emergency surgeries, repeated interventions, and hospitalization duration heightened PMTS risk. Socio-environmental influences, including low socioeconomic status, minority background, pandemic-related isolation, and social disruptions, further exacerbated vulnerability. Conclusion: Pediatric medical traumatic stress arises from a complex interplay of psychological, familial, medical, and socio-environmental factors. The findings highlight the critical need for trauma-informed, family-centered care approaches in pediatric healthcare settings. Clinical implications: The multidimensional nature of PMTS risk factors emphasizes the urgent need for early screening, trauma-informed pediatric care, and family-centered interventions tailored to the child's developmental, psychological, and sociocultural context. © 2025 Elsevier B.V., All rights reserved.