Predicting functional outcome for children on admission after burn injury: do parents hold the key?
In this study, a predictive model about recovery postburn was developed for purposive case selection using explanatory case methodology. Seven cases (each comprising a child, caregiver, and teacher) participated. Children were aged 6 to 13 years with between 2% and 35% TBSA burned. Caregivers completed assessments of premorbid family and child-adaptive functioning, and family, parental, and child functioning during acute and postacute treatment periods. Teachers completed assessment of premorbid and postacute child-adaptive functioning. Children and their respective caregivers were interviewed to obtain further insights into outcomes. Assessments and interviews were completed before skin healing, on skin healing, and at 6 months postburn injury. Descriptive analysis of the quantitative data and content analysis of qualitative data was undertaken for individual cases and across all cases. In keeping with the explanatory case methodology, replication logic was applied to each case to determine the extent to which theoretical propositions based on the predictive model were supported. Findings suggest that children whose parents had high state anxiety in combination with ineffective coping strategies seemed most at risk of a nonadaptive outcome after a burn injury. There was little support for the rival explanations that child and family functioning or injury severity most consistently predicted outcome postburn injury.
Simons
Megan A
MA
Occupational Therapy Department, Royal Children's Hospital, Brisbane, Australia.
Ziviani
Jenny
J
Copley
Jodie
J
D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000293:Adolescent; D002056:Burns / Q000503:physiopathology* / Q000523:psychology* / Q000534:rehabilitation*; D002648:Child; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007407:Interviews as Topic; D008297:Male; D008962:Models, Theoretical; D017063:Outcome Assessment, Health Care; D010287:Parent-Child Relations; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014945:Wound Healing