Enablers of psychosocial recovery in pediatric burns: perspectives from the children, parents and burn recovery support staff

Abstract

Background Pediatric burn injuries are a major cause of death and injury, occurring mainly in resource poor environments. Recovery from burns is widely reported to be constrained by physical, psychological, relationship and reintegration challenges. These challenges have been widely described, but not the enablers of psychosocial recovery. This is especially true in pediatric burn research, with few multi- perspective studies on the recovery process. Methods This qualitative study involved 8 focus group discussions (four with 15 children post-burn injury, four with 15 caregivers) and 12 individual interviews with staff working in pediatric burns that explored the psychosocial needs of children after a burn and the enablers of their recovery. Purposive sampling was utilized and recruitment of all three categories of participants was done primarily through the only hospital burns unit in the Western Cape, South Africa. The interviews focused on factors that supported the child’s recovery and were sequentially facilitated from the child and the family’s experiences during hospitalization, to the return home to family and friends, followed by re-entry into school. Thematic analysis was used to analyze verbatim interview transcripts. Results The recovery enablers that emerged included: (i) Presence and reassurance; indicating the comfort and practical help provided by family and close friends in the hospital and throughout the recovery process; (ii) Normalizing interactions and acceptance; where children were treated the same as before the injury to promote the acceptance of self and by others especially once the child returned home; and (iii) Sensitization of others and protection; signifying how persons around the child had assisted the children to deal with issues in the reintegration process including the re-entry to school. Conclusions This study indicates that the psychosocial recovery process of children hospitalized for burns is enabled by the supportive relationships from family members, close friends and burn staff, present during hospitalization, the return home, and school re-entry. Support included comfort and physical presence of trusted others and emotional support; affirmation of the child’s identity and belonging despite appearance changes; and the advocacy and protection for the re-entry back into the school, and more generally the community.

Effect of precise partial scab removal on the repair of deep partial-thickness burn wounds in children: a retrospective study

“…In addition, children may suffer traumatic emergency syndrome and possible psychological problems after burns and scalds (12). The psychosocial rehabilitation of burned hospitalized children depends largely on the family members, close friends, and burn staff (13). Some research indicates that children's accidental burns and scalds can also affect the mental health of their parents (14).…”

The Potential Role of Child Life Specialists in the South African Healthcare Sector

“…A number of South African paediatric units have already established the practice of incorporating psychosocial care and well-being into the management of their paediatric patients. Van Niekerk et al 16 described some of the enablers of psychosocial recovery in the paediatric burn unit at The Red Cross Children's' War Memorial Hospital in Cape Town, South Africa. Some of these enablers included allowing the family in the ward with the child to help reassure the child, as well as having the nursing staff provide emotional support to the child.…”

“…Some of these enablers included allowing the family in the ward with the child to help reassure the child, as well as having the nursing staff provide emotional support to the child. They also promoted involving the child in certain aspects of the decision making of their care, thus allowing them to feel some sense of control during a painful and frightening experience 16 . Volunteers who were burn victim survivors also decreased the anxiety levels of children by reading to them and being a role model of survival for the child 16 .…”

“…They also promoted involving the child in certain aspects of the decision making of their care, thus allowing them to feel some sense of control during a painful and frightening experience 16 . Volunteers who were burn victim survivors also decreased the anxiety levels of children by reading to them and being a role model of survival for the child 16 . This approach follows many of the guiding principles of CLS.…”

Lived experiences of mothers caring for children with burn-induced disabilities

“…1 Burn injury is one of the most damaging, painful, and stressful experiences with disruptive effects on normal life, accompanied by social, economic, and public health outcomes due to the physical consequences and stigma related to disability and disfigurement in many cases. 2 Burns are a type of local damage with a complex systemic disease. They are difficult to treat and involve a significant resulting disability.…”