Observations from the paediatric outpatients unit: Parent emotions, behaviour and child distress

Erin A. Brown1, Justin Kenardy2, Alexandra De Young3, Roy Kimble4

1 Centre for Children’s Burns and Trauma Research, and School of Psychology, UQ-CHRC, Level 7, Centre for Children’s Health Research Building, The University of Queensland, St Lucia, Qld, 4067, e.brown5@uq.edu.au
2 Recover Injury Research Centre and School of Psychology, The University of Queensland, St Lucia, Qld, 4072, j.kenardy@uq.edu.au
3 Centre for Children’s Burns and Trauma Research, UQ-CHRC, Level 7, Centre for Children’s Health Research Building, The University of Queensland, St Lucia, Qld, 4067, adeyoung@uq.edu.au
4 Centre for Children’s Burns and Trauma Research, UQ-CHRC, Level 7, Centre for Children’s Health Research Building, The University of Queensland, St Lucia, Qld, 4067, royk@uq.edu.au

Young children are the highest risk age group for incurring burn injuries. A burn injury and the following medical procedures are painful and potentially traumatic, for child and parent alike. Child and parent psychological functioning post-injury is related (De Young et al. 2014), which suggests family dynamics during dressing changes may influence recovery.

This research aimed to evaluate the role of parent emotions (i.e. anxiety, depression, posttraumatic stress, guilt) on parenting coping-promoting (e.g. engaging the child in play) and distress-promoting (e.g. restraining the child) behaviours during a dressing change, and the subsequent impact on child distress, pain, and anxiety. Seventy-five parents of children aged 1-6 years completed questionnaires, and the first dressing change was observed.

Analyses of the self-report measures indicated 10% of parents were experiencing anxiety and depression, 11% acute PTSS, 32% high guilt, and these symptoms were positively correlated (ps<.015). Parent and child state anxiety levels were positively correlated before, during, and after the dressing change (ps<.024). Regression analyses found parents with anxiety and depression demonstrated reduced coping-promoting behaviour (ps=.045). Parent coping-promoting and distress-promoting behaviours impacted child coping, and distress (ps<.001), as well as child pain and anxiety scores (ps<.033), during the dressing change.

The role of the parent during dressing changes are critical to the child’s immediate and long term outcomes. Parent acute emotions and behaviours impact child distress, pain and anxiety. Thus, there is need for tailored psychoeducational and behavioural interventions for parents, to increase supportive behaviour and reduce negative child experiences, and improve long-term outcomes.

Key Words

Parent Child Distress Behaviour Guilt Anxiety

Biography

Erin Brown is a PhD scholar, investigating the impact of parental distress on child’s recovery from a burns injury, with the Centre of Children’s Burns and Trauma Research. She has been researching the psychological impact of injury at Recover Injury Research Centre as a research assistant since 2012. Erin graduated B.PsySc with first class Honours.

About ANZBA

ANZBA is a not for profit organisation and the peak body for health professionals responsible for the care of the burn injured in Australia and New Zealand. ANZBA encourages higher standards of care through education, performance monitoring and research.

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