title: The effect of family characteristics on the recovery of burn injuries in children.
abstract: BACKGROUND
  Interactions between family members and characteristics of family life and function may affect a child's recovery from burn injury. We prospectively examined the relationship between family characteristics and physical and psychosocial recovery from burns.
  
  
  METHODS
  The families of 399 burned children aged 5 years to 18 years admitted to one of four Shriners Hospitals for Children for management of acute burns completed the Family Environment Scale within 7 days of admission and then the American Burn Association/Shriners Hospitals for Children Burn Outcome Questionnaire (BOQ) at baseline, 3, 6, 12, 18, 24, 36, and 48 months. Generalized estimating equations with random effects for the time since burn were used to track recovery of the BOQ patient-centered domains associated with baseline family characteristics during the course of the study.
  
  
  RESULTS
  The children had a mean age of 11 years and burn size of 32% total body surface area burned. Higher Family Environment Scale scores in cohesion, independence, organization, and active recreational orientation were associated with significantly better rates of recovery in multiple BOQ domains of health-related quality of life. Higher scores in conflict and achievement orientation predicted statistically significant impaired recovery. Higher expressiveness predicted greater difficulty with school reentry.
  
  
  CONCLUSIONS
  Family characteristics affect the recovery of children after serious burns. Some of these may be amenable to focused anticipatory family interventions to help optimize outcomes. In particular, those characteristics that impair school reentry should be targeted.
authors.affiliation: Shriners Hospitals for Children, and Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Sheridan
authors.forename: Austin F
authors.initials: AF
authors.lastname: Lee
authors.forename: Lewis E
authors.initials: LE
authors.lastname: Kazis
authors.forename: Matthew H
authors.initials: MH
authors.lastname: Liang
authors.forename: Nien-Chen
authors.initials: NC
authors.lastname: Li
authors.forename: Michelle I
authors.initials: MI
authors.lastname: Hinson
authors.forename: Helena
authors.initials: H
authors.lastname: Bauk
authors.forename: Walter J
authors.initials: WJ
authors.lastname: Meyer
authors.forename: Teresa K
authors.initials: TK
authors.lastname: Stubbs
authors.forename: Tina L
authors.initials: TL
authors.lastname: Palmieri
authors.forename: Ronald G
authors.initials: RG
authors.lastname: Tompkins
mesh_terms: D000293:Adolescent; D001830:Body Surface Area; D002056:Burns / Q000523:psychology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005191:Family Characteristics; D005260:Female; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D008297:Male