The psychological impact of paediatric burn injuries: a systematic review

Abstract

Objective To review and synthesise qualitative literature regarding the psychological outcomes following paediatric burn injuries, and to determine if children and adolescents who experience a burn injury have elevated risk of psychopathology following the injury. Design Systematic review of quantitative and qualitative studies. Data sources Informit health, Medline, Embase, and PsycINFO were searched from January 2010 to December 2020. Data extraction and synthesis Two reviewers screened articles, and one reviewer extracted data (with cross-checking from another reviewer) from the included studies and assessed quality using an established tool. Narrative synthesis was used to synthesise the findings from the quantitative studies, and thematic synthesis was used to synthesise the findings of included qualitative studies. Results Searches yielded 1240 unique titles, with 130 retained for full-text screening. Forty-five studies from 17 countries were included. The psychological outcomes included in the studies were mental health diagnoses, medication for mental illness, depression, anxiety, stress, fear, post-traumatic stress, post-traumatic growth, emotional issues, self-harm, self-esteem, self-concept, stigmatisation, quality of life, level of disability, resilience, coping, and suicidality. Conclusions Our findings highlight paediatric burn patients as a particularly vulnerable population following a burn injury. Studies suggest elevated anxiety and traumatic stress symptoms, and higher rates of psychopathology in the long-term. Further research is recommended to determine the psychological outcomes in the other mental health domains highlighted in this review, as findings were mixed. Clinical care teams responsible for the aftercare of burn patients should involve psychological support for the children and families to improve outcomes.

Global trends in pediatric burn injuries and care capacity from the World Health Organization Global Burn Registry

“…Burn injuries can have significant psychological, social, and economic impacts on a child's life and the lives of their caregivers ( 16 ). Data regarding pediatric global burn trends is inconsistent and frequently extrapolated from single-center or country-specific studies that fail to provide a clear understanding of the global problem ( 15 , 17 ).…”

Impact of childhood burns on academic performance: a matched population-based cohort study

“…Consequences of burn injuries can extend beyond the acute healing phase3 with lasting effects on health, including hypermetabolism and an increased risk of chronic disease leading to a reduced life span 4. Additionally, burn injuries may result in worsened social and psychological outcomes such as anxiety, post-traumatic stress, depression and reduced quality of life 5…”

Resilience and Posttraumatic Growth after Burn: A Review of Barriers, Enablers, and Interventions to Improve Psychological Recovery

“…It is recognized that burn injuries are traumatic experiences that can detrimentally impact an individual's psychological and emotional wellbeing. Posttraumatic stress disorder occurs in 8 to 30% of the adult burn population [2], and 11 to 13% of child burn populations [3], and routine clinical practice accepts the absence of a mental health disorder as an acceptable goal. However, research has shown that postburn hospital admission rates for mental health conditions were 3.52-6.79 times as high compared to a matched uninjured cohort, suggesting that the absence of a diagnosed mental health is not adequate for optimal mental health recovery [4].…”