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Peng F, Chung CH, Koh WY, Chien WC, Lin CE. Risks of mental disorders among inpatients with burn injury: A nationwide cohort study. Burns 2024; 50:1315-1329. [PMID: 38519375 DOI: 10.1016/j.burns.2024.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 01/29/2024] [Accepted: 02/26/2024] [Indexed: 03/24/2024]
Abstract
OBJECTIVE This investigation identified the association between burn injuries and the risk of mental disorders in patients with no documented pre-existing psychiatric comorbidities. We also examined the relationship of injury severity and the types of injury with the likelihood of receiving new diagnoses of mental disorders. METHODS This population-based retrospective cohort study used administrative data extracted from the Taiwanese National Health Insurance Research Database (NHIRD) between 2000 and 2013. In total, 10,045 burn survivors were matched with a reference cohort of 40,180 patients without burn injuries and were followed to determine if any mental disorder was diagnosed. Patients diagnosed with mental disorders in the five years before study initiation were excluded to ensure incident diagnoses throughout the research duration. Generalized estimating equations in Cox proportional hazard regression models were used for data analysis. RESULTS In general, burn injury survivors have a 1.21-fold risk of being diagnosed with new mental disorders relative to patients without burn injuries. Total body surface area (TBSA) of ≧ 30% (aHR: 1.49, 95% CI: 1.36-1.63) and third- or fourth-degree burns (aHR: 1.49, 95% CI: 1.37-1.63) had a significantly greater risk of being diagnosed with mental disorders in comparison to the reference cohort. Patients TBSA 10-29% (aHR: 0.85, 95% CI: 0.77-0.93) and first- or second-degree burn victims (aHR: 0.89, 95% CI: 0.81-0.97) had relatively lower risk of mental disorders than the reference cohort. CONCLUSION Burn injuries were associated with an increased risk of mental disorders. Additional research in this field could elucidate this observation, especially if the inherent limitations of the NHIRD can be overcome.
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Affiliation(s)
- Fan Peng
- Department of Psychiatry, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan, ROC; School of Post-baccalaureate Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, Taipei, Taiwan, ROC; School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Wan-Ying Koh
- School of Post-baccalaureate Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Department of General Medicine, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan, ROC
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, Taipei, Taiwan, ROC; School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC; Graduate Institute of Life Science, National Defense Medical Center, Taiwan, ROC.
| | - Ching-En Lin
- Department of Psychiatry, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan, ROC; School of Medicine, Tzu Chi University, Hualien, Taiwan, ROC.
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Karahan S, Ay Kaatsiz MA, Erbas A, Kaya Y. A Qualitative Analysis on the Experiences of Mothers of Children in Burn Intensive Care Unit: "She burned on the outside, me inside...". J Burn Care Res 2024; 45:120-129. [PMID: 37625120 DOI: 10.1093/jbcr/irad129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Indexed: 08/27/2023]
Abstract
Mothers closely follow the complex process due to the burning of their children. Caring for and supporting the child can pose various challenges for mothers. With the phenomenological method, this study was conducted to investigate mothers' experiences staying with their children in the pediatric burn intensive care unit. Twelve mothers participated in the study. The semistructured face-to-face interviews obtained data. After each interview, the research team transcribed the interviews verbatim. Interpretive Phenomenological Analysis was used to analyze the data. The experiences of the mothers were classified in four contexts as a result of the interpretative phenomenological analysis; "first reactions to burn trauma" related to the awareness that the child has been burned, "being a mother in the burn intensive care unit" related to caring for the child as a companion in the burn intensive care unit, "coping" related to how they cope with the problems throughout the whole process, and "requirements" regarding the subjects it needs in the process. It was determined that mothers went through a physically and emotionally challenging process from the beginning of the burn trauma and throughout the intensive care unit. During this challenging process, it was observed that mothers could not use effective coping methods and did not receive the necessary professional support. In line with these results, it is recommended that psychological support programs be applied to the mothers and that care focused on the needs of the mothers should be provided.
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Affiliation(s)
- Sabri Karahan
- Surgical Nursing Department, Harran University Faculty of Health Science, 63100 Sanliurfa, Turkey
| | - Melike Ayça Ay Kaatsiz
- Psychiatric Nursing Department, Hacettepe University Faculty of Nursing, 06100 Ankara, Turkey
| | - Atiye Erbas
- Surgical Nursing Department, Duzce University Faculty of Health Science, 81000 Duzce, Turkey
| | - Yunus Kaya
- Department of Child Development, Faculty of Health Science, Aksaray University, 68000 Aksaray, Turkey
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3
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Hocking P, Broadhurst M, Nixon RDV, Gannoni A. Validation of the Psychosocial Assessment Tool 2.0 for paediatric burn patients. Burns 2023; 49:1632-1642. [PMID: 37211476 DOI: 10.1016/j.burns.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 04/26/2023] [Accepted: 05/02/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVE The Psychosocial Assessment Tool 2.0 (PAT-B) is an adaptation of an existing screening tool with the aim of the present study to examine its effectiveness and suitability to identify children and families at risk of emotional, behavioral, and social maladjustment following paediatric burns. METHODS Sixty-eight children aged between 6 months - 16 years (M = 4.40) admitted into hospital following paediatric burns, and their primary caregivers, were recruited. The PAT-B comprises several dimensions including family structure and resources, social support, as well as caregiver and child psychological difficulties. Caregivers completed the PAT-B and several standardized measures for validation purposes (e.g., caregiver reports of family functioning, child emotional and behavioural problems, caregiver distress). Children old enough to complete measures reported on their psychological functioning (e.g., posttraumatic stress and depression). Measures were completed within 3 weeks of child admission and then again at 3 months after burn. RESULTS The PAT-B demonstrated good construct validity, evidenced by moderate to strong correlations between the PAT-B Total and subscale scores and several criteria measures (family functioning, child behaviour and caregiver distress, child depressive symptoms, rs ranging from 0.33 -0.74). Preliminary support for criterion validity of the measure was observed when examined against the three tiers of the Paediatric Psychosocial Preventative Health Model. The proportion of families falling within these tiers of risk (Universal [low risk], 58.2%; Targeted, 31.3%; or Clinical range, 10.4%) was consistent with prior research. Sensitivity of the PAT-B to identify children and caregivers at high risk of psychological distress was 71% and 83%, respectively. CONCLUSION The PAT-B appears to be a reliable and valid instrument for indexing psychosocial risk across families who have sustained a paediatric burn. However, further testing and replication using a larger sample size is recommended before the tool is integrated into routine clinical care.
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Affiliation(s)
- Phoebe Hocking
- College of Education, Psychology and Social Work, Flinders University; Adelaide, South Australia, Australia
| | - Miriam Broadhurst
- College of Education, Psychology and Social Work, Flinders University; Adelaide, South Australia, Australia
| | - Reginald D V Nixon
- College of Education, Psychology and Social Work, Flinders University; Adelaide, South Australia, Australia; Flinders University Institute for Mental Health and Wellbeing, Flinders University; Adelaide, South Australia, Australia.
| | - Anne Gannoni
- Department of Psychological Medicine, Women's and Children's Hospital, Adelaide, South Australia, Australia
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Lenferink LIM, O'Connor M. Grief is a family affair: examining longitudinal associations between prolonged grief in parents and their adult children using four-wave cross-lagged panel models. Psychol Med 2023; 53:7428-7434. [PMID: 37154206 PMCID: PMC10719676 DOI: 10.1017/s0033291723001101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Losing a parent or spouse in adulthood may result in prolonged grief disorder (PGD) symptoms. PGD levels in parents may affect PGD levels in their adult offspring and the other way around. However, research on transmission of PGD in parent-child dyads is lacking. Consequently, we aimed to examine temporal associations between PGD levels in parent and adult children. METHODS In doing so, we analyzed longitudinal self-report data on PGD levels (using the PG-13) assessed at 2, 11, 18, and 26 months after loss in 257 adult parent-child dyads from Denmark. Cross-lagged panel modeling was used for data-analyses. RESULTS Changes in PGD levels in parents significantly predicted PGD levels in adult children, but not vice versa. Small through moderate cross-lagged effects (β = 0.05 through 0.07) were found for PGD levels in parents predicting PGD levels in adult children at a subsequent time-point. These cross-lagged effects were found while taking into account the association between PGD levels in parents and adult children at the same time-point as well as the associations between the same construct over time and relevant covariates. CONCLUSIONS Pending replication of these findings in clinical samples and younger families, our findings offer tentative support for expanding our focus in research and treatment of PGD from the individual to the family level.
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Affiliation(s)
- L. I. M. Lenferink
- Department of Psychology, Health, & Technology, Faculty of Behavioural, Management, and Social Sciences, University of Twente, Drienerlolaan 5, 7522 NB Enschede, the Netherlands
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, the Netherlands
- Department of Clinical Psychology, Faculty of Social Sciences, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, the Netherlands
| | - M. O'Connor
- Department of Psychology, Unit for Bereavement Research, Aarhus University, Aarhus, Denmark
- The Danish National Center for Grief, Copenhagen, Denmark
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Lynch T, Davis SL, Johnson AH, Gray L, Coleman E, Phillips SR, Soistmann HC, Rice M. Definitions, theories, and measurement of stress in children. J Pediatr Nurs 2022; 66:202-212. [PMID: 35868219 PMCID: PMC10085063 DOI: 10.1016/j.pedn.2022.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 06/30/2022] [Accepted: 07/08/2022] [Indexed: 11/28/2022]
Abstract
PROBLEM Stress in children remains a complex concept to examine due to the inherent subjectivity and lack of specific manifestations, as well as the multiple ways stress can be defined and measured in children. Because stress is multifactorial,is experienced daily by children, and undergirds adolescent health and early mental illness, it is crucial to have a clear understanding of stress and the effects of stress in children from infancy through age twelve years. ELIGIBILITY CRITERIA To be included in this review, literature must pertain to and highlight theories, definitions/classifications, and measurements of stress in children from infancy to 12 years of age. SAMPLE The most pertinent articles identified through database searches (PubMed, Scopus, PsycINFO, CINAHL, Google Scholar), gray literature sources (e.g., child health websites), and reference lists of identified articles were included in this narrative overview. RESULTS The results of this review are organized by themes and include: classifications and definitions of stress, stress-related theories, and tools to measure stress in children. CONCLUSIONS Research addressing stressors and stress in children is limited, and there is wide variation in how researchers define and classify stress in children. Existing measures of stress in children younger than 12 address physiological, psychological, and observational components, but may be inconsistent and threaten validity of otherwise well-designed and well-executed studies. IMPLICATIONS Improving the understanding and accurate measurement of stress in children enables researchers and clinicians to curtail undesirable health outcomes.
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Affiliation(s)
- Thuy Lynch
- University of Alabama in Huntsville, 301 Sparkman Drive, Huntsville, AL 35899, USA.
| | - Sara L Davis
- University of South Alabama, 5721 USA Drive, N., Mobile, AL 36688, USA.
| | - Ann Hammack Johnson
- Harris College of Nursing and Health Sciences, Texas Christian University, 2800 S. University Drive, Fort Worth, TX 76109, USA.
| | - Laura Gray
- Gordon E. Inman College of Health Sciences and Nursing, Belmont University, 1900 Belmont Boulevard, Nashville, TN 37212, USA.
| | - Elizabeth Coleman
- University of Alabama at Birmingham, 1701 University Boulevard, Birmingham, AL 35294, USA.
| | | | - Heather C Soistmann
- Penn State Health Children's Hospital, 500 University Drive, Hershey, PA 17033, USA.
| | - Marti Rice
- University of Alabama at Birmingham, 1701 University Boulevard, Birmingham, AL 35294, USA.
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Wei Y, Wang L, Zhou Q, Tan L, Xiao Y. Reciprocal effects between young children's negative emotions and mothers' mental health during the COVID-19 pandemic. FAMILY RELATIONS 2022; 71:FARE12702. [PMID: 35942048 PMCID: PMC9348407 DOI: 10.1111/fare.12702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 11/13/2021] [Accepted: 01/16/2022] [Indexed: 06/15/2023]
Abstract
Objective To investigate the relations between young children's negative emotions and their mothers' mental health during the COVID-19 pandemic. Background The COVID-19 pandemic caused the public a certain degree of psychological symptoms, and family environments and relations have been changed dramatically as a result. The relations between young children's negative emotions and their mothers' mental health have not been sufficiently determined for the context of a pandemic or other large-scale crises. Method A survey was administrated on 8119 Chinese mothers of 3- to 6-year-old children with the Symptom Checklist 90 and the Child Negative Emotion Questionnaire. Results The canonical correlation results indicated that there were covariation trends between young children's anger and their mother's obsessive-compulsive symptoms and hostility, children's fear and mothers' phobic anxiety, and children's tension and mothers' interpersonal sensitivity and depression. These correlations were all positively significant. Conclusion During the COVID-19 pandemic, the predictive power of young children's negative emotions to their mothers' mental health was greater than that of the reverse. Implications This study provides a scientific guidance on the regulation of young children's negative emotions and the improvement of mothers' mental health during the pandemic as well as potential emergencies in the future.
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Affiliation(s)
- Yonggang Wei
- Chongqing Early Childhood Education Quality Monitoring and Evaluation Research CenterChongqing Normal UniversityChongqingChina
| | - Lu Wang
- The Yubei KindergartenYubei District, ChongqingChina
| | - Qiao Zhou
- Chongqing Early Childhood Education Quality Monitoring and Evaluation Research CenterChongqing Normal UniversityChongqingChina
| | - Li Tan
- Chengdu Third KindergartenChengduSichuanChina
| | - Yao Xiao
- Chongqing Early Childhood Education Quality Monitoring and Evaluation Research CenterChongqing Normal UniversityChongqingChina
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Loos MLHJ, Meij-de Vries A, Nagtegaal M, Bakx R. Child abuse and neglect in paediatric burns: The majority is caused by neglect and thus preventable. Burns 2022; 48:688-697. [PMID: 34103201 DOI: 10.1016/j.burns.2021.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 05/05/2021] [Accepted: 05/14/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION It is complex to distinguish negligent burns from inflicted and non-intentional burns, especially since no deliberate action caused the burn. Its recognition is important to create a safe life without (future) burns for our loved-ones who cannot take care of themselves (yet). Our aim was to investigate the incidence and associated characteristics of negligent burns are among children treated at a burn center. METHODS We retrospectively reviewed medical files of all children attending a Dutch burn center with an acute burn between January 2013-December 2015. The conclusion of the Child Abuse and Neglect team (CAN) was used to define inflicted, negligent or non-intentional burns. The remaining cases were reviewed by an expert panel using a standardized protocol. Demographic and social data as well as clinical information about the burn were collected. RESULTS In total 330 children were included. Negligent burns accounted for 56%, non-intentional for 42% and inflicted for 2% of the burns. Negligent burns were associated with: hot beverages (OR 4.40, 95%CI 2.75-7.05), a younger age (p < 0.001), occurrence at home (OR 4.87 95%CI 2.80-8.45) and were located at the anterior trunk (OR 2.75, 95%CI 1.73-4.35) and neck (OR 1.98, 95%CI 1.12-3.50). CONCLUSION This study shows that neglect is a major factor in the occurrence of burns in young children, therefore we conclude that the majority of paediatric burns are preventable. Educational programs creating awareness and focussing on prevention of these burns should be aimed at households, since the majority of negligent as cause of preventable burns occur at home.
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Affiliation(s)
- Marie-Louise H J Loos
- Emma Children's Hospital, Paediatric Surgical Centre Amsterdam, Amsterdam UMC, University of Amsterdam & Vrije Universiteit Amsterdam, Department of Paediatric Surgery, Amsterdam, The Netherlands.
| | - Annebeth Meij-de Vries
- Emma Children's Hospital, Paediatric Surgical Centre Amsterdam, Amsterdam UMC, University of Amsterdam & Vrije Universiteit Amsterdam, Department of Paediatric Surgery, Amsterdam, The Netherlands; Red Cross Hospital, Burn Center Beverwijk, Vondellaan 13, 1942 LE, Beverwijk, The Netherlands.
| | - Michelle Nagtegaal
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam & Vrije Universiteit Amsterdam, Department of Social Paediatrics, Amsterdam, The Netherlands; Department of Forensic Medicine, Section on Forensic Paediatrics, Netherlands Forensic Institute, The Hague, The Netherlands.
| | - Roel Bakx
- Emma Children's Hospital, Paediatric Surgical Centre Amsterdam, Amsterdam UMC, University of Amsterdam & Vrije Universiteit Amsterdam, Department of Paediatric Surgery, Amsterdam, The Netherlands.
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Lernevall LST, Moi AL, Gjengedal E, Dreyer P. Parents' lived experiences of parental needs for support at a burn centre. Int J Qual Stud Health Well-being 2021; 16:1855749. [PMID: 33427115 PMCID: PMC7808374 DOI: 10.1080/17482631.2020.1855749] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/21/2020] [Indexed: 11/16/2022] Open
Abstract
Purpose: A burn injury to a child is a traumatic event and the parent's emotional reactions and coping strategies affect the child's adaptive outcome. It is therefore important that parents get the right support. The aim was to explore parents' lived experiences of their need for support when having a child admitted to a burn centre. Methods: Semi-structured face-to-face interviews were conducted with 22 parents of children age <12 years hospitalised with an accidental burn injury, 9 to 27 days after the burn accident, from April 2017 to July 2018. A Ricoeur-inspired textual analysis method was used. Results: Four themes emerged from the analysis and describe the parents' needs for support. The parents wanted to be taken care of as a whole family and feel safe in the hands of professionals. This, in turn, depended on being informed about the child's condition and treatment, but also on getting help in dealing with feelings of guilt. Not least, parents wanted opportunities to take care of their own fundamental needs in terms of hygiene, food, adequate rest and activities. Conclusion: As an overall understanding the healthcare providers should focus on the family as a whole in care and treatment.
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Affiliation(s)
- Lina S. T Lernevall
- Department of Plastic, Hand and Reconstructive Surgery, National Burn Centre, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - A. L. Moi
- Department of Plastic, Hand and Reconstructive Surgery, National Burn Centre, Haukeland University Hospital, Bergen, Norway
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - E. Gjengedal
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - P. Dreyer
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Public Health, Section of Nursing, Aarhus University, Aarhus C, Denmark
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Cyr S, Guo DX, Marcil MJ, Dupont P, Jobidon L, Benrimoh D, Guertin MC, Brouillette J. Posttraumatic stress disorder prevalence in medical populations: A systematic review and meta-analysis. Gen Hosp Psychiatry 2021; 69:81-93. [PMID: 33582645 DOI: 10.1016/j.genhosppsych.2021.01.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE PTSD is increasingly recognized following medical traumas although is highly heterogeneous. It is difficult to judge which medical contexts have the most traumatic potential and where to concentrate further research and clinical attention for prevention, early detection and treatment. The objective of this study was to compare PTSD prevalence in different medical populations. METHODS A systematic review of the literature on PTSD following medical traumas was conducted as well as a meta-analysis with final pooled result and 95% confidence intervals presented. A meta-regression was used to investigate the impact of potential effect modifiers (PTSD severity, age, sex, timeline) on study effect size between prevalence studies. RESULTS From 3278 abstracts, the authors extracted 292 studies reporting prevalence. Using clinician-administered reports, the highest 24 month or longer PTSD prevalence was found for intraoperative awareness (18.5% [95% CI=5.1%-36.6%]) and the lowest was found for epilepsy (4.5% [95% CI=0.2%-12.6%]). In the overall effect of the meta-regression, only medical events or procedures emerged as significant (p = 0.006) CONCLUSION: This review provides clinicians with greater awareness of medical contexts most associated with PTSD, which may assist them in the decision to engage in more frequent, earlier screening and referral to mental health services.
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Affiliation(s)
- Samuel Cyr
- Research Center, Montreal Heart Institute, Montreal, Quebec, Canada; Faculty of Pharmacy, Université de Montréal, Montreal, Quebec, Canada
| | - De Xuan Guo
- Research Center, Montreal Heart Institute, Montreal, Quebec, Canada
| | - Marie-Joëlle Marcil
- Research Center, Montreal Heart Institute, Montreal, Quebec, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Patrice Dupont
- Health Sciences Library, Université de Montréal, Montreal, Quebec, Canada
| | - Laurence Jobidon
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - David Benrimoh
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Marie-Claude Guertin
- Montreal Health Innovations Coordinating Center, Montreal, Montreal, Quebec, Canada
| | - Judith Brouillette
- Research Center, Montreal Heart Institute, Montreal, Quebec, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.
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Differences in parent-perceived and patient-reported quality of life among young adult burn patients: A prospective longitudinal study. Burns 2021; 47:1878-1889. [PMID: 33707088 DOI: 10.1016/j.burns.2021.02.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 02/17/2021] [Accepted: 02/22/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE This study examines the differences in parent-perceived and patient-reported quality of life (QoL) among young adult burn patients three years after injury and the factors affecting these differences. METHOD The sample comprised 35 burn patients from the Formosa Fun Coast Water Park dust explosion and their parents. The study was conducted from June 2016 to August 2018. We used self-report questionnaires to collect socio-demographic data, the adapted Chinese version of the Burn Specific Health Scale-Brief, and the Impact of Events Scale for Burn. RESULTS The analysis indicated that simple abilities recovered the fastest, while body image recovered the slowest. The variation trends of these factors were similar but parents' scores were lower than patients' scores. Parents' post-traumatic stress disorder (PTSD) scores were higher than that of patients, but were not statistically significant. Parents' gender and PTSD levels and patients' burn area affected differences in parent-perceived QoL among patients. PTSD levels were significantly higher among mothers. CONCLUSIONS For parents, PTSD is a common response to their children experiencing burn injuries. Parents' observations of warning signs enable early medical intervention. Establishing a family-centered care plan, providing psychological support for both parents and patients, and forming a continuous care system with efficient communication can support patients' return to society.
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11
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Sadeh Y, Dekel R, Brezner A, Landa J, Silberg T. Child and Family Factors Associated With Posttraumatic Stress Responses Following a Traumatic Medical Event: The Role of Medical Team Support. J Pediatr Psychol 2021; 45:1063-1073. [PMID: 32968802 DOI: 10.1093/jpepsy/jsaa070] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 06/13/2020] [Accepted: 07/23/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES This study examined the contribution of pretrauma psychosocial factors (child emotional functioning, family resources, family functioning, and social support) and environmental factors (mother's posttraumatic stress symptoms [PTSSs], medical team support [MTS]) to PTSSs of injured or seriously ill children within a pediatric rehabilitation setting. It was hypothesized that psychosocial variables would be strongly associated with child's PTSS; that mother's PTSS and MTS would mediate the association between psychosocial factors and child's PTSS; that mother's report on child's PTSS would mediate the association between mother's PTSS and child's PTSS. METHODS Participants were 196 children hospitalized following an injury/illness and assessed M = 47.7 days postevent. Children completed measures of PTSS, mothers completed measures of their own PTSS, child's PTSS, and pretrauma psychosocial factors. Family's therapist completed a MTS measure. Structural equation modeling was employed to evaluate the study hypotheses. RESULTS Pretrauma family structure and resources were associated with child's self-reported PTSS; each pretrauma variable and mother's report of child's PTSS was significantly associated. Although mother's PTSS was not directly associated with child's PTSS, this relationship was mediated by mother's report of child's PTSS. MTS mediated the relationship between pretrauma social support and mother's PTSS. CONCLUSION This study further explicates the utility of a biopsychosocial framework in predicting childhood PTSS. Findings confirm the role of pretrauma factors and environmental factors at the peritrauma period in the development of PTSS following a pediatric injury/illness. Mother's PTSS and MTS may be appropriate targets for prevention and early intervention.
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Affiliation(s)
- Yaara Sadeh
- The Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University.,Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center
| | - Rachel Dekel
- The Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University
| | - Amichai Brezner
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center
| | - Jana Landa
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center.,Sackler Faculty of Medicine, Tel-Aviv University
| | - Tamar Silberg
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center.,Holland Bloorview Kids Rehabilitation Hospital.,Department of Psychology, Bar-Ilan University
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Brown EA, Egberts M, Wardhani R, De Young A, Kimble R, Griffin B, Storey K, Kenardy J. Parent and Clinician Communication During Paediatric Burn Wound Care: A Qualitative Study. J Pediatr Nurs 2020; 55:147-154. [PMID: 32950822 DOI: 10.1016/j.pedn.2020.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 08/06/2020] [Accepted: 08/06/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To thematically describe parent-clinician communication during a child's first burn dressing change following emergency department presentation. DESIGN AND METHODS An observational study of parent-clinician communication during the first burn dressing change at a tertiary children's hospital. Verbal communication between those present at the dressing change for 87 families, was audio recorded. The recordings were transcribed verbatim and transcripts were analysed within NVivo11 qualitative data analysis software using qualitative content analysis. FINDINGS Three themes, underpinned by parent-clinician rapport-building, were identified. Firstly, knowledge sharing was demonstrated: Clinicians frequently informed the parent about the state of the child's wound, what the procedure will involve, and need for future treatment. Comparatively, parents informed the clinician about their child's temperament and coping since the accident. Secondly, child procedural distress management was discussed: Clinicians and parents had expectations about the likelihood of procedural distress, which was also related to communication about how to prevent and interpret procedural distress (i.e., pain/fear). Finally, parents communicated to clinicians about their own distress, worry and uncertainty, from the accident and wound care. Parents also communicated guilt and blame in relation to injury responsibility. CONCLUSIONS This study provides a description of parent-clinician communication during paediatric burn wound care. PRACTICAL IMPLICATIONS The results can assist healthcare professionals to be prepared for a range of conversations with parents during potentially distressing paediatric medical procedures.
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Affiliation(s)
- Erin A Brown
- Centre for Children's Burns and Trauma Research, The University of Queensland, QLD, Australia; School of Psychology, University of Queensland, The University of Queensland, QLD, Australia.
| | - Marthe Egberts
- Association of Dutch Burn Centres, Beverwijk, the Netherlands; Department of Clinical Psychology, Utrecht University, the Netherlands.
| | - Rachmania Wardhani
- School of Psychology, University of Queensland, The University of Queensland, QLD, Australia.
| | - Alexandra De Young
- Centre for Children's Burns and Trauma Research, The University of Queensland, QLD, Australia; School of Psychology, University of Queensland, The University of Queensland, QLD, Australia.
| | - Roy Kimble
- Centre for Children's Burns and Trauma Research, The University of Queensland, QLD, Australia; Pegg Leditschke Children's Burns Centre, Queensland Children's Hospital, Queensland Health, QLD, Australia.
| | | | - Kristen Storey
- Pegg Leditschke Children's Burns Centre, Queensland Children's Hospital, Queensland Health, QLD, Australia.
| | - Justin Kenardy
- School of Psychology, University of Queensland, The University of Queensland, QLD, Australia.
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13
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Bentivegna K, McCollum S, Wu R, Hunter AA. A state-wide analysis of pediatric scald burns by tap water, 2016-2018. Burns 2020; 46:1805-1812. [PMID: 32646547 DOI: 10.1016/j.burns.2020.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 06/05/2020] [Accepted: 06/09/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Unsafe tap water temperatures (>120 °F) are a risk factor for pediatric burns, which may disproportionally impact low-income, urban communities. We sought to estimate the incidence and demographic characteristics of tap water burns and their association with housing characteristics. METHODS We performed a secondary data analysis to summarize emergency department discharge records from 2016 to 2018 involving children <18 years with an ICD-10-CM code for tap water burn (X11), and town-level housing data from the American Community Survey. Unpaired student's t-test and spearman's correlation analysis were performed for comparative analyses. RESULTS A total of 146 tap water burn visits were identified, representing an incidence of 2 per 10,000 ED visits. The majority of cases were male, non-Hispanic White, of public insurance type, and from an urban CT town. The median age was 3 years, with 58% of cases <5 years. Towns with at least one tap water burn had a significantly higher average percentage of multi-family unit and renter housing as compared to towns with no tap water burns (p < 0.0001). CONCLUSIONS Our results identified a significant number of tap water burns in children. Primary prevention efforts targeting education or regulation of water temperatures may work to reduce burns in underserved areas.
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Affiliation(s)
- Kathryn Bentivegna
- University of Connecticut School of Medicine, Farmington, CT, United States
| | | | - Rong Wu
- Biostatistics Center, Connecticut Convergence Institute for Translation in Regenerative Engineering, UConn Health, Farmington, CT, United States
| | - Amy A Hunter
- Injury Prevention Center, Connecticut Children's and Hartford Hospital, Hartford, CT, United States; Department of Pediatrics, University of Connecticut, School of Medicine, Farmington, CT, United States; Department of Public Health Sciences, School of Medicine, Farmington, CT, United States; Trinity College, Hartford, CT, United States.
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14
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Veen D, Egberts MR, van Loey NEE, van de Schoot R. Expert Elicitation for Latent Growth Curve Models: The Case of Posttraumatic Stress Symptoms Development in Children With Burn Injuries. Front Psychol 2020; 11:1197. [PMID: 32625139 PMCID: PMC7314932 DOI: 10.3389/fpsyg.2020.01197] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 05/07/2020] [Indexed: 12/24/2022] Open
Abstract
Experts provide an alternative source of information to classical data collection methods such as surveys. They can provide additional insight into problems, supplement existing data, or provide insights when classical data collection is troublesome. In this paper, we explore the (dis)similarities between expert judgments and data collected by traditional data collection methods regarding the development of posttraumatic stress symptoms (PTSSs) in children with burn injuries. By means of an elicitation procedure, the experts' domain expertise is formalized and represented in the form of probability distributions. The method is used to obtain beliefs from 14 experts, including nurses and psychologists. Those beliefs are contrasted with questionnaire data collected on the same issue. The individual and aggregated expert judgments are contrasted with the questionnaire data by means of Kullback-Leibler divergences. The aggregated judgments of the group that mainly includes psychologists resemble the questionnaire data more than almost all of the individual expert judgments.
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Affiliation(s)
- Duco Veen
- Department of Methodology and Statistics, Utrecht University, Utrecht, Netherlands
| | - Marthe R. Egberts
- Department of Clinical Psychology, Utrecht University, Utrecht, Netherlands
| | - Nancy E. E. van Loey
- Department of Clinical Psychology, Utrecht University, Utrecht, Netherlands
- Association of Dutch Burn Centres, Beverwijk, Netherlands
| | - Rens van de Schoot
- Department of Methodology and Statistics, Utrecht University, Utrecht, Netherlands
- Optentia Research Program, North-West University, Potchefstroom, South Africa
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15
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Bayuo J, Wong FKY. Issues and concerns of family members of burn patients: A scoping review. Burns 2020; 47:503-524. [PMID: 32534893 DOI: 10.1016/j.burns.2020.04.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 02/24/2020] [Accepted: 04/23/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The issues and concerns that emerge in the families of burn patients have received minimal attention. OBJECTIVE To map out what is known about the challenges facing the family members of burn patients. METHODS The review followed the PRISMA Extension guidelines for scoping reviews and the review approach by Arksey and O'Malley to synthesize the available evidence. Twenty-six (26) papers from various database searches were identified and included in the review. The citation retrieval and retention methods are reported in a PRISMA statement. RESULTS Although most of the studies included parents (n=21), the evidence suggests that the shared concerns of family members include taking on new roles, and psychosocial and financial issues. Uniquely, parents had to endure blame, shame and guilt; partners/spouses were faced with difficulties in re-establishing an emotional connection with the patient; siblings simultaneously expressed jealousy and feelings of being outsiders; and children with a burn parent had to deal with feelings of exclusion from the care delivery process. Aside from these individuals, friends, neighbours and in-laws may also assume a caregiving role, with grandparents playing a supporting role. Family members are unprepared for their roles, as they are forced into them suddenly. Although distress may occur among family members, its determinants, severity, pattern and recovery process remain unclear. CONCLUSION A burn is a family injury that creates the need for family-centred care. Future studies need to explore the nature of psychological distress, family members' recovery pathways, and how family members can prepare for their roles in the period after discharge.
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Affiliation(s)
- Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong
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16
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Egberts MR, Engelhard IM, Schoot RVD, Bakker A, Geenen R, van der Heijden PGM, Van Loey NEE. Mothers' emotions after pediatric burn injury: Longitudinal associations with posttraumatic stress and depressive symptoms 18 months postburn. J Affect Disord 2020; 263:463-471. [PMID: 31969279 DOI: 10.1016/j.jad.2019.11.140] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/30/2019] [Accepted: 11/29/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Various emotions are implicated in posttraumatic stress disorder (PTSD). Longitudinal studies examining temporal associations between emotions and posttraumatic stress may reveal who is at risk of chronic psychological problems. This study examined the longitudinal relationships of mothers' trauma-related emotions with posttraumatic stress and depressive symptoms after pediatric burn injury. METHODS Data from two cohort studies were used (n = 296). Mothers reported the intensity of burn-related emotions within the first month (T1) and 12 months postburn (T2). The Impact of Event Scale (IES) and the Hospital and Anxiety Depression Scale (HADS-D; depression subscale) were administered at T1 and 18 months postburn (T3). RESULTS Based on two exploratory factor analyses, emotion variables were combined into acute and long-term basic emotions (fear, sadness, horror, anger) and self-conscious emotions (guilt, shame). The path model showed a positive relationship between acute and long-term basic emotions. Higher long-term basic emotions were related to persistence of posttraumatic stress and depressive symptoms. Acute self-conscious emotions showed associations with posttraumatic stress and depressive symptoms at T1 and were longitudinally related to depressive, but not posttraumatic stress, symptoms. LIMITATIONS The posttraumatic stress measure was not based on DSM-5 PTSD criteria and results require replication using these criteria. CONCLUSIONS This study suggests that mothers' acute self-conscious and long-term basic emotions in relation to their child's burn injury are involved in the development of posttraumatic stress and depressive symptoms. Clinically, assessing and monitoring parents' early posttraumatic stress, depressive symptoms and burn-related emotions may be useful to identify parents at risk.
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Affiliation(s)
- Marthe R Egberts
- Association of Dutch Burn Centres, Beverwijk, the Netherlands; Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands; Department of Methods and Statistics, Utrecht University, Utrecht, the Netherlands.
| | - Iris M Engelhard
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands
| | - Rens van de Schoot
- Department of Methods and Statistics, Utrecht University, Utrecht, the Netherlands; Optentia Research Program, Faculty of Humanities, North-West University, Vanderbijlpark, South Africa
| | - Anne Bakker
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, research institute(s), Amsterdam, the Netherlands
| | - Rinie Geenen
- Department of Psychology, Utrecht University, Utrecht, the Netherlands
| | - Peter G M van der Heijden
- Department of Methods and Statistics, Utrecht University, Utrecht, the Netherlands; S3RI, University of Southampton, Southampton, United Kingdom
| | - Nancy E E Van Loey
- Association of Dutch Burn Centres, Beverwijk, the Netherlands; Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands
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17
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Lernevall L, Moi A, Gjengedal E, Dreyer P. Staff Members’ Experience of Providing Parental Support in a National Burn Centre. Open Nurs J 2019. [DOI: 10.2174/1874434601913010211] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Paediatric burn injuries affect not only the child but the whole family, especially the parents. Knowledge of how parents are affected psychologically has increased, but there is an ongoing dearth of literature on parental support while hospitalised. There is also very little documentation of the ways in which burn staff members support parents.
Objectives
To explore staff members’ lived experiences of supporting parents with children hospitalised at a burn centre due to a burn injury.
Methods
Four focus group interviews were conducted in 2017 with a total of 21 staff members at the National Burn Centre in Norway. Seven different burn staff professions participated. Data were analysed using a Ricoeur-inspired method for text analysis and managed using NVivo 12Plus.
Results
Four themes were identified in the treatment trajectory: creating a safe, secure and trusting environment from the moment parents enter the burn centre; helping parents deal with feelings of guilt; helping parents navigate in their daily routines while continuing to be a mother or father; and gradually involving parents in wound treatment as preparation for discharge.
Conclusion
Staff must carefully consider their verbal and non-verbal (body) language and how to approach parents from the very moment they enter the burn ward. Most parents are affected by feelings of guilt and these feelings must be addressed and processed. During the treatment trajectory, parents are guided to participate in the daily care of their child and are gradually assisted in taking over the wound treatment prior to discharge.
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18
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Coy K, Brock P, Pomeroy S, Cadogan J, Beckett K. A Road Less Travelled: using Experience Based Co-Design to map children's and families' emotional journey following burn injury and identify service improvements. Burns 2019; 45:1848-1855. [PMID: 31395461 DOI: 10.1016/j.burns.2019.07.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 07/11/2019] [Accepted: 07/12/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND The emotional impact after a child's burn injury is poorly understood. Greater insight into the emotional journey can aid services' ability to meet patients/families' needs. To bridge the gap, this study employed an abbreviated form of Experience Based Co-Design (EBCD) to explore the emotional/experiential aspects of moderate to severe burn injuries in children. METHOD Following EBCD, parents and health professionals were invited to share their experiences. Interviews were analysed and a short film was produced and shown at a focus group event for health professionals and families. Both positive and negative aspects of the journey were identified along with potential service improvements. RESULTS Families' journeys could be described by the following five distinct phases: life overturned, dawning reality, riding the emotional roller-coaster, aftershocks and, adapting to a new normal. Key areas for improvements were: communication, isolation, dressing changes and managing expectations. DISCUSSION EBCD facilitated collaborative discussion between researchers, families and health professionals. Families felt empowered to shape the future of burn care and health professionals felt included. Study challenges were mainly in participant engagement and the scheduling of interviews and the focus event. Overall the study outcome was successful in generating ideas for service improvements, and the production of a training video for healthcare professionals.
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Affiliation(s)
- K Coy
- Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol, BS2 8BJ, United Kingdom.
| | - P Brock
- Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol, BS2 8BJ, United Kingdom.
| | - S Pomeroy
- Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol, BS2 8BJ, United Kingdom.
| | - J Cadogan
- Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol, BS2 8BJ, United Kingdom.
| | - K Beckett
- University of the West of England, Bristol, United Kingdom.
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19
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Brown EA, De Young A, Kimble R, Kenardy J. The role of parental acute psychological distress in paediatric burn re-epithelialization. Br J Health Psychol 2019; 24:876-895. [PMID: 31389153 DOI: 10.1111/bjhp.12384] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 06/24/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Following a paediatric burn, parents commonly experience high levels of acute psychological distress, which has been shown to increase child psychological distress as well as child procedural distress. The influence of psychological stress and perceived pain on wound healing has been demonstrated in several laboratory and medical populations. This paper investigates the influence of parental acute psychological distress and procedural behaviour on the child's rate of re-epithelialization, after controlling for child procedural distress. DESIGN A prospective observational study with longitudinal outcome. METHODS Eighty-three parents of children 1-6 years old reported acute psychological distress (post-traumatic stress symptoms [PTSS], guilt, pre-procedural fear, general anxiety/depression symptoms) in relation to their child's burn. A researcher observed parent-child behaviour at the first dressing change, and parents and nurses reported child procedural distress (pre-, peak-, and post-procedural pain and fear). These variables, along with demographic and injury information, were tested for predicting time to re-epithelialization. Date of re-epithelialization was determined by the treating consultant. RESULTS Days to re-epithelialization ranged from 3 to 35 days post-injury. A hierarchical multiple regression analysis found wound depth and size significantly accounted for 28% of the variance in time to re-epithelialization. In Block 2, child peak-procedural pain significantly accounted for 6% additional variance. In Block 3, parental PTSS significantly accounted for 5% additional variance. CONCLUSIONS Parental PTSS appears to be an important but under-recognized factor that may influence their child's burn re-epithelialization. Further investigation is required to understand the mechanisms contributing to this association. Statement of contribution What is already known on this subject? Psychological stress delays wound healing, and this relationship has been found in paediatric burn populations with procedural pain. Parental psychological stress is often present after a child's burn and is related to the child's procedural coping and distress. What does this study add? Parental post-traumatic stress is related to delayed child burn re-epithelialization. This association is in addition to procedural pain delaying re-epithelialization.
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Affiliation(s)
- Erin A Brown
- Centre for Children's Burns and Trauma Research, Child Health Research Centre, The University of Queensland, South Brisbane, Qld, Australia.,School of Psychology, The University of Queensland, St Lucia, Qld, Australia
| | - Alexandra De Young
- Centre for Children's Burns and Trauma Research, Child Health Research Centre, The University of Queensland, South Brisbane, Qld, Australia
| | - Roy Kimble
- Centre for Children's Burns and Trauma Research, Child Health Research Centre, The University of Queensland, South Brisbane, Qld, Australia.,Pegg Leditschke Children's Burns Centre, Queensland Children's Hospital, Children's Health Queensland, South Brisbane, Qld, Australia
| | - Justin Kenardy
- School of Psychology, The University of Queensland, St Lucia, Qld, Australia
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20
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de Haan A, Tutus D, Goldbeck L, Rosner R, Landolt MA. Do dysfunctional posttraumatic cognitions play a mediating role in trauma adjustment? Findings from interpersonal and accidental trauma samples of children and adolescents. Eur J Psychotraumatol 2019; 10:1596508. [PMID: 31069022 PMCID: PMC6493315 DOI: 10.1080/20008198.2019.1596508] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 03/07/2019] [Accepted: 03/09/2019] [Indexed: 11/10/2022] Open
Abstract
Background: Trauma adjustment varies in children and adolescents. Studies on objective risk factors of posttraumatic stress symptoms (PTSS) yielded inconsistent results. Dysfunctional posttraumatic cognitions (PTCs) might play a mediating role between risk factors and posttraumatic symptomatology. Objective: To investigate the interplay of the characteristics of the trauma (e.g. trauma type), the characteristics of the individual (e.g. age, sex), and the characteristics of the social environment (e.g. parental distress, marital status) on PTSS and depression, taking the child's dysfunctional PTCs into account as a possible mediator. Method: Structural equation modelling was used to better understand trauma adjustment in two heterogeneous samples of children and adolescents: a sample of 114 participants aged 7-16 after accidental trauma and a sample of 113 participants aged 6-17 after interpersonal trauma. Results: In the accidental trauma sample, dysfunctional PTCs mediated the positive associations of younger age and lower parental educational level on child PTSS, but not on depression. In the interpersonal trauma sample, being female positively predicted child depression. Furthermore, parental dysfunctional PTCs positively predicted both child PTSS and depression. No mediation effect of child dysfunctional PTCs was found in the interpersonal trauma sample. Child dysfunctional PTCs moderately to strongly predicted child PTSS and depression in both trauma samples. Conclusions: The impact of the characteristics of the individual and the characteristics of the social environment on child PTSS and depression might depend on the type of trauma experienced. Dysfunctional PTCs mediated between the characteristics of the individual and the characteristics of the social environment and the severity of PTSS in the aftermath of accidental trauma, but not of interpersonal trauma.
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Affiliation(s)
- Anke de Haan
- Department of Psychology - Division of Child and Adolescent Health Psychology, University of Zurich, Zurich, Switzerland.,Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland
| | - Dunja Tutus
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Lutz Goldbeck
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Rita Rosner
- Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany
| | - Markus A Landolt
- Department of Psychology - Division of Child and Adolescent Health Psychology, University of Zurich, Zurich, Switzerland.,Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland
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21
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Duke JM, Randall SM, Vetrichevvel TP, McGarry S, Boyd JH, Rea S, Wood FM. Long-term mental health outcomes after unintentional burns sustained during childhood: a retrospective cohort study. BURNS & TRAUMA 2018; 6:32. [PMID: 30460320 PMCID: PMC6233288 DOI: 10.1186/s41038-018-0134-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 10/17/2018] [Indexed: 01/29/2023]
Abstract
Background Burns are a devastating injury that can cause physical and psychological issues. Limited data exist on long-term mental health (MH) after unintentional burns sustained during childhood. This study assessed long-term MH admissions after paediatric burns. Methods This retrospective cohort study included all children (< 18 years) hospitalised for a first burn (n = 11,967) in Western Australia, 1980-2012, and a frequency matched uninjured comparison cohort (n = 46,548). Linked hospital, MH and death data were examined. Multivariable negative binomial regression modelling was used to generate incidence rate ratios (IRR) and 95% confidence intervals (CI). Results The burn cohort had a significantly higher adjusted rate of post-burn MH admissions compared to the uninjured cohort (IRR, 95% CI: 2.55, 2.07-3.15). Post-burn MH admission rates were twice as high for those younger than 5 years at index burn (IRR, 95% CI 2.06, 1.54-2.74), three times higher for those 5-9 years and 15-18 years (IRR, 95% CI: 3.21, 1.92-5.37 and 3.37, 2.13-5.33, respectively) and almost five times higher for those aged 10-14 (IRR, 95% CI: 4.90, 3.10-7.76), when compared with respective ages of uninjured children. The burn cohort had higher admission rates for mood and anxiety disorders (IRR, 95% CI: 2.79, 2.20-3.53), psychotic disorders (IRR, 95% CI: 2.82, 1.97-4.03) and mental and behavioural conditions relating to drug and alcohol abuse (IRR, 95% CI: 4.25, 3.39-5.32). Conclusions Ongoing MH support is indicated for paediatric burn patients for a prolonged period after discharge to potentially prevent psychiatric morbidity and associated academic, social and psychological issues.
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Affiliation(s)
- Janine M Duke
- 1Burn Injury Research Unit, Faculty Health and Medical Sciences, The University of Western Australia, M318 35 Stirling Highway, Crawley, Perth, Western Australia 6009 Australia
| | - Sean M Randall
- 2Centre for Data Linkage, Curtin University, Perth, Western Australia Australia
| | | | - Sarah McGarry
- 4School of Occupational Therapy Social work and Speech Pathology, Curtin University, Perth, Western Australia Australia
| | - James H Boyd
- 2Centre for Data Linkage, Curtin University, Perth, Western Australia Australia
| | - Suzanne Rea
- 1Burn Injury Research Unit, Faculty Health and Medical Sciences, The University of Western Australia, M318 35 Stirling Highway, Crawley, Perth, Western Australia 6009 Australia.,5Burns Service of Western Australia, Royal Perth Hospital and Princess Margaret Hospital, Perth, Western Australia Australia
| | - Fiona M Wood
- 1Burn Injury Research Unit, Faculty Health and Medical Sciences, The University of Western Australia, M318 35 Stirling Highway, Crawley, Perth, Western Australia 6009 Australia.,5Burns Service of Western Australia, Royal Perth Hospital and Princess Margaret Hospital, Perth, Western Australia Australia
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22
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Hawkins L, Centifanti LCM, Holman N, Taylor P. Parental Adjustment following Pediatric Burn Injury: The Role of Guilt, Shame, and Self-Compassion. J Pediatr Psychol 2018; 44:229-237. [DOI: 10.1093/jpepsy/jsy079] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 09/09/2018] [Indexed: 11/12/2022] Open
Affiliation(s)
- Laura Hawkins
- School of Psychology, University of Liverpool, Brownlow Hill, Liverpool, L69 3GB
| | - Luna C M Centifanti
- School of Psychology, University of Liverpool, Brownlow Hill, Liverpool, L69 3GB
| | - Natalie Holman
- Psychological Services, Alder Hey Children's NHS Foundation Trust, Eaton Road, Liverpool, L12 2AP
| | - Peter Taylor
- Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Sciences Centre, M13
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23
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Egberts MR, Geenen R, de Jong AE, Hofland HW, Van Loey NE. The aftermath of burn injury from the child's perspective: A qualitative study. J Health Psychol 2018; 25:2464-2474. [PMID: 30270662 PMCID: PMC7583444 DOI: 10.1177/1359105318800826] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
A burn injury event and subsequent hospitalization are potentially distressing for children. To elucidate the child’s experience of pediatric burn injury, children’s reflections on the burn event and its aftermath were examined. Semi-structured interviews were conducted with eight children (12–17 years old). Using thematic analysis, interview transcripts were coded and codes were combined into overarching categories. Three categories were identified: vivid memories; the importance of parental support; psychosocial impact and coping. Implications for care are discussed in terms of assessing children’s appraisals, paying attention to the parent’s role, and preparing families for potential psychological barriers after discharge.
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Affiliation(s)
- Marthe R Egberts
- Association of Dutch Burn Centres, The Netherlands.,Utrecht University, The Netherlands
| | | | - Alette Ee de Jong
- Association of Dutch Burn Centres, The Netherlands.,Burn Centre Red Cross Hospital, The Netherlands
| | | | - Nancy Ee Van Loey
- Association of Dutch Burn Centres, The Netherlands.,Utrecht University, The Netherlands
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