Abstract
In this dissertation, we focused on the psychological consequences of pediatric burns on children and parents, relationships within the family (parent-child, mother-father subsystems), and potential benefits from burn camp participation. Results of a literature review study showed that many children displayed at least some symptoms of traumatic stress or disturbed
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behavior during hospitalization. The synthesized long-term results suggested that most children seemed to adapt well to their situation. However, the predominant use of cross-sectional study designs and generic child outcomes limits our understanding of potential difficulties and challenges that children with burns may be faced with in the course of development. Suggested important topics for future longitudinal research involve appearance related matters and children’s experiences in social life. Findings from our family studies demonstrated that a significant proportion of parents experienced posttraumatic stress symptoms as a result of their child burn event, with mothers generally reporting more symptoms than fathers. At 18 months after the injury, at least one parent in every 5 families was at risk for clinically significant stress symptoms. Parental appraisal of the life threatening character of the injuries and feelings of guilt and anger linked to the burn event, mostly more strongly present in mothers than in fathers, may be helpful to early detect parents at risk for high levels of traumatic stress in the longer run. Moreover, scarring in the child was found to accelerate the influence of guilt feelings on persistent maternal stress symptoms after many years. The interrelatedness within couples in terms of avoidance symptoms and the interrelatedness between parent- and child symptoms stresses the need for a broad family focus in pediatric burn care. Finally, a bioecological perspective on child postburn adjustment, that acknowledges the importance of the child’s different ecologies, was hypothesized to be a useful framework to arrange interventions to support child postburn recovery. Supporting parents, with particular attention for the interplay between mothers and fathers and between parents and children, and strengthening the existent skills and resources of families are recommended as essential components of postburn support. In addition, the reported gains for the children from meeting and learning from other children with burns seems promising and may for instance be translated to group-based interventions for young burn survivors. Although it is recognized that many psychosocial topics in the field of pediatric burns are still in need of thorough investigation and this dissertation has raised suggestions for future research as well, it is hoped that the results from this dissertation may contribute to further development of a comprehensive pediatric burn aftercare program.
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