Parrish Carisa, Shields Ashley, Morris Adam, George Anna, Reynolds Elizabeth, Borden Lindsay, Hankinson Jessica, Ziegfeld Susan, Stewart Dylan, Ostrander Rick
Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD.
Department Cardiology, Children's Hospital of Wisconsin, Milwaukee, WI.
J Burn Care Res. 2019 Jan 1;40(1):79-84. doi: 10.1093/jbcr/iry048.
Parents commonly report elevated distress following a child's burn injury, yet limited research has identified child or injury characteristics that may explain parent distress. The main goal of the current study is to examine prevalence and predictors of parent distress following children's burn injuries by evaluating distress symptoms in a clinic sample of parents whose children present for evaluation and treatment at a regional burn center. Participants included parents of 407 children who experienced a burn injury. Of this sample, follow-up data at a second time point was obtained for 130 children and their caregivers. Parents completed a measure of distress. Clinical and demographic variables were extracted retrospectively from the medical chart. Clinical and at risk levels of distress were reported by nearly 19% of parents at Time 1. Parent distress at Time 1 was associated with child minority race, fewer days since burn injury, and greater burn size. A propensity score was used to account for potential differences between parents with data at Time 1 only versus those with data at Time 2. Parents with Time 2 data tended to have higher levels of distress at Time 1. Of parents with Time 2 data, 17% continued to report elevated distress, and Time 1 distress was the best predictor of later distress. A proportion of parents report elevated distress following their children's burn injuries. Our results suggest that best practices should include routine screening of parent distress following pediatric burn injuries to guide appropriate interventions.
家长们普遍表示，孩子烧伤后他们的痛苦程度会增加，但针对可能导致家长痛苦的儿童或损伤特征的研究却很有限。本研究的主要目的是，通过评估在一家地区烧伤中心接受评估和治疗的儿童的家长临床样本中的痛苦症状，来研究儿童烧伤后家长痛苦的发生率及其预测因素。参与者包括407名经历过烧伤的儿童的家长。在这个样本中，获得了130名儿童及其照顾者在第二个时间点的随访数据。家长们完成了一项痛苦程度测量。临床和人口统计学变量是从病历中回顾性提取的。在时间1时，近19%的家长报告有临床痛苦水平和处于痛苦风险水平。时间1时家长的痛苦与儿童的少数族裔、烧伤后天数较少以及烧伤面积较大有关。使用倾向得分来解释仅在时间1有数据的家长与在时间2有数据的家长之间的潜在差异。有时间2数据的家长在时间1时往往有更高水平的痛苦。在有时间2数据的家长中，17%继续报告痛苦程度升高，且时间1时的痛苦是后期痛苦的最佳预测因素。一部分家长在孩子烧伤后报告痛苦程度升高。我们的结果表明，最佳做法应包括对小儿烧伤后家长的痛苦进行常规筛查，以指导适当的干预措施。
