Childhood trauma among school-age children in Palestine: Maternal awareness and preventive attitudes

J Pediatr Nurs. 2025 Nov 27;86:409-417. doi: 10.1016/j.pedn.2025.11.036. Online ahead of print.

ABSTRACT

PURPOSE: The study aimed to identify the prevalence of trauma-related symptoms among Palestinian school-age children and to examine the association between trauma exposure and various sociodemographic characteristics, as well as to evaluate maternal awareness and attitudes toward trauma in children.

DESIGN AND METHODS: A cross-sectional descriptive correlation study was conducted. The study included 593 mothers and their school-age children (aged 9-17 years) from governmental and non-governmental schools in the Ramallah and Jerusalem governorates in Palestine. Data collection involved a caregiver (mother) and child questionnaire composed of three sections: sociodemographic data, trauma exposure items, and the Child Trauma Screen (CTS), which is a validated tool with strong psychometric properties (child report α = 0.78, caregiver report α = 0.82). The study utilized SPSS version 24 for data analysis with a confidence interval of 95 %.

RESULTS: A total of 593 mothers and their school-aged children participated in the study. Trauma-related symptoms were reported in 17.5 % of children based on self-assessments and in 13.3 % based on maternal assessments. The most commonly reported trauma exposure was witnessing domestic violence, cited by 55.8 % of children and 54 % of mothers. Significant associations were found between higher trauma scores and several variables, including: older child age (15-17 years), lower academic performance, maternal age over 46 years, maternal education limited to elementary or middle school, being raised by a divorced or widowed mother, the child’s perception that their body weight or height contributed to their trauma, child awareness of trauma, and maternal unawareness of the presence of a school nurse. A multiple linear regression analysis was performed. Significant predictors of higher Childhood Trauma Scale (CTS) scores included maternal education level, maternal marital status, maternal age, the child’s perception of their weight or height as contributing factors, and the child’s age.

CONCLUSION: The study revealed a concerning prevalence of trauma-related symptoms among Palestinian school-aged children. Key risk factors included older child age, lower academic performance, maternal characteristics (such as older age, limited education, and non-married status), body image concerns, and limited maternal awareness of school health services. These findings underscore the urgent need for early identification of trauma and the implementation of targeted interventions to mitigate psychological harm and support healthier developmental trajectories in children.

PRACTICE IMPLICATIONS: Nurses play a vital role in the recognition and management of childhood trauma. They are central to conducting early screening, implementing school-based support programs, and working collaboratively within multidisciplinary teams to assess, monitor, and support affected students.

PMID:41314152 | DOI:10.1016/j.pedn.2025.11.036