ORIGINAL RESEARCH article
Front. Public Health
Sec. Children and Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1652569
This article is part of the Research TopicSevere Mental Illnesses in Children: Unravelling Developmental Trajectories, Neuropsychiatric Impairments, and Chronic PainView all articles
Mental Health Outcomes and Rehabilitation Challenges in Children with Orthopedic Trauma: A Public Health Survey from Pediatric Rehabilitation Center
Provisionally accepted
- Anhui Provincial Cancer Hospital, Hefei, China
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Objectives: To quantify mental-health outcomes and rehabilitation challenges among Chinese children with orthopedic trauma and to elucidate multilevel determinants and causal pathways underlying these outcomes. Methods: A single-center cross-sectional survey with a one-year prospective study over the enrolled children at Anhui Provincial Children’s Hospital, China. Validated Chinese instruments assessed PTSD, depression, anxiety, QoL, persistent pain, sleep disturbance, and social support, supplemented by electronic injury and rehabilitation data. Analyses included conventional (single-level) regression, mediation, moderation, propensity-score matching, and clustering, adjusted for sociodemographic and clinical factors. Results: Among 2,103 children with orthopedic trauma, PTSD, depression, and anxiety prevalences were not directly reported as percentages; mean scores were 8.4, 12.2, and 4.0, respectively; 26.6% reported persistent pain and sleep disturbance data not directly provided. Rural Hukou independently predicted higher PTSD (β = 0.47; 95% CI: −0.08 to 1.01) and lower health‑related quality of life (QoL) (β = −0.67; 95% CI: −1.25 to −0.10), even after adjusting for injury severity and income. Higher income was not significantly protective (PTSD β = −0.17; QoL β = −0.02). Acute pain intensity mediated 38.9% of the income–depression link (indirect β = 0.007; p < 0.001). Social support moderated the ISS–depression association (interaction β = −0.08; p = 0.001). Early rehabilitation (≤14 days) reduced PTSD (Δ = −0.91; p < 0.001), pain odds (OR = 0.81; p = 0.04), and improved recovery. Cluster analysis identified a rural high-risk subgroup (proportion unknown) with elevated PTSD, pain, and depression, underscoring the need for targeted psychosocial support. Conclusion: Socioeconomic disadvantage, rural residence, and injury severity jointly worsen psychological outcomes and hinder rehabilitation, highlighting the need for timely rehabilitation and targeted psychosocial support to reduce disparities and enhance recovery in eastern Chinese pediatric settings.
Keywords: Pediatric orthopedic trauma, Post-Traumatic Stress Disorder (PTSD), rehabilitation adherence, socioeconomic disparities, Mental health outcomes
Received: 23 Jun 2025; Accepted: 22 Sep 2025.
Copyright: © 2025 Zheng, Cheng, Li, Wu and Fang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jihong Fang, fangjihong510@126.com
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