Child burn survivors are more troubled by psychological scars than physical wounds

Children and young adult burn survivors are more troubled by staring, bullying, and uncomfortable questions than the actual physical discomfort and memories of their accidents, according to research that was selected to be presented at the American Burn Association's Annual Meeting and published in the Journal of Burn Care & Research. While treatment is typically focused primarily on acute care for physical wounds, the surveys suggest that survivors are left with few tools to handle social anxieties and traumatizing memories.

Over the years, we have made many advancements in treating the physical wounds of burn survivors, but more needs to be done to treat the social and emotional wounds that come from these injuries. Our research shows that the most difficult issue that children and young adult survivors deal with is the reaction they get from other people. Giving them the tools to handle these interactions is critical to their well-being."

Ruth Rimmer, Ph.D., CLCP, volunteer and former director of psychosocial research for the Arizona Burn Center at Valleywise Health in Phoenix

The findings come from two studies that asked more than 200 young adult (17-25 years old) and child (10-16 years old) burn survivors to reflect on the key challenges they faced while recovering and growing up.

In the first study, 64 young adults were asked to respond to the statement: "The hardest thing about being burned is..." Their reactions identified seven primary themes common to burn survivors:

• People staring
• Being bullied
• Memories of being burned
• Needing additional surgeries
• Self-consciousness about scars
• Getting unwanted questions about burns
• Pain and itching

In the second study, 147 child burn survivors and 81 young adult survivors were asked to rate the level of difficulty they experienced for each of those seven themes on a four-point scale. More than 70% of respondents said they were bothered by staring and bullying, with 72% identifying bullying as the most painful reaction, and 71% identifying staring. More than half of respondents reported issues with scars (65%), memories of being burned (52%) and pain and itching (50%). Girls were bothered significantly more than boys by their scars.

The top mean scores for child burn survivors on the four-point scale included: Remembering the Burn (61%) & Getting Unwanted Questions (61%). Some significant differences emerged between the two age groups. Child burn survivors were more likely than young adults to report being troubled by "Getting Unwanted Questions," (61% vs. 43%) while the young adults were significantly more likely than child burn survivors to report pain from "Being Bullied" (63% vs. 46%).

"While both groups of survivors have to cope with unwanted stares and comments, it's interesting that bullying seems to be less of a problem for survivors today than a few years ago," said Rimmer. "This suggests that there may be a shift in how child burn survivors are treated by their peers and that bullying programs in schools should be supported and perhaps expanded."

As a result of these findings, the researchers suggest that burn units should incorporate supportive strategies, such as psychological or social interventions such as burn camp to complement surgical and medical treatments. By providing survivors with constructive coping strategies, the researchers suggest that it will help to improve burn-injured youth's social interactions and overall quality of life.