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Psychosocial Functioning Differences in Pediatric Burn Survivors Compared With Healthy Norms

Maskell, Jessica BSW*; Newcombe, Peter PhD; Martin, Graham MD, MBBS, MRCGP, FRANZCP, DPM; Kimble, Roy MD (Res), MBChB, FRCS, FRACS*

Journal of Burn Care & Research:
doi: 10.1097/BCR.0b013e31827217a9
Original Articles
Abstract

Burn injury is one of the most traumatic injuries a child or adolescent can experience. When a burn injury occurs, the child can suffer pain, uncertainty, fear, and trauma from acute treatment to rehabilitation and reintegration. He or she can also experience long-term psychosocial and psychological difficulties. The objective of the study was to compare health-related quality of life (HRQoL), psychopathology, and self-concept of children who have suffered a burn injury with a matched sample of healthy controls. Sixty-six children and adolescents with a burn injury, who were aged between 8 to 17 years, and a caregiver were recruited from six burn centers in Australia and New Zealand. Participants completed the Paediatric Quality of Life Inventory, the Strengths and Difficulties Questionnaire, and the Piers-Harris Self-Concept Scale (P-H SCS). Scores were compared with published normative data. As scarring and appearance are a distinct issue, the Paediatric Quality of Life Inventory cancer module perceived physical appearance subscale was also included. Pediatric burn survivors and their caregivers reported significantly higher emotional and behavioral problems and lower HRQoL, but no significant differences in self-concept compared with healthy counterparts. Pediatric burn survivors also reported significantly poorer perceived physical appearance than the matched pediatric cancer sample. Burned children reported lowered quality of life, particularly related to scarring and appearance; however, they reported normative self-concept. This may be because of self-concept being a psychological trait, whereas HRQoL is influenced by societal norms and expectations. Psychosocial support is necessary to build positive coping strategies and manage the unpleasant social experiences that may reduce quality of life.

Author Information

From the *The Centre for Children’s Burns and Trauma Research, Queensland Children’s Medical Research Institute, Department of Paediatrics and Child Health, The University of Queensland, Royal Children’s Hospital, Brisbane, QLD, 4029 and School of Social Work and Human Services, The University of Queensland, Brisbane, QLD, 4072; Associate Professor School of Social Work and Human Services, The University of Queensland, Brisbane, QLD, 4072; Department of Psychiatry, The University of Queensland, Herston, QLD 4029.

Address correspondence to Jessica Maskell, The Centre for Children’s Burns and Trauma Research, Queensland Children’s Medical Research Institute, University of Queensland, Royal Children’s Hospital, Brisbane QLD, Australia 4029 Email: j.maskell@uqconnect.edu.au.

© 2013 The American Burn Association