How to support parents during young paediatric dressing changes

Ms Erin Brown1,2, Dr Alexandra De Young2, Prof Roy Kimble3, Prof Justin Kenardy1

1School of Psychology, The University Of Queensland, St Lucia, Australia, 2Centre for Burns and Trauma Research, Child Health Research Centre, The University of Queensland, South Brisbane, Australia, 3Centre for Burns and Trauma Research, Children’s Health Queensland, Lady Cilento Children’s Hospital, South Brisbane, Australia

Background. Paediatric burn dressing changes are distressing to the child and the parents. Young children particularly need support during dressing changes, as their coping skills are under-developed. Parents’ own distress impact their ability to assist their child. We wanted to identify specific parent behaviours that can be addressed or reinforced to maximise child coping during dressing changes.

Method. Ninety-two families of children aged 1-6 years old were recruited at the first dressing change appointment at the Pegg Leditschke Children’s Burns Centre, Lady Cilento Children’s Hospital, Brisbane, Australia. All adults and child behaviour were observed during the dressing change. Parents behaviour was coded for associations with child coping (i.e., playing and watching) and distress (i.e., screaming and kicking). The child’s highest pain, anxiety, coping, and distress scores were recorded by parents, nurses and researchers.

Results. Specific parent behaviours were found to influence child coping. Children of parents who demonstrated distress-promoting behaviours were more likely to experience higher pain, anxiety, and distress (βs>.32, ps<.05). Conversely, children of parents who demonstrated coping-promoting behaviours were more likely to experience higher coping and lower distress (βs>.38, ps<.01).

Conclusion. This research shows children may benefit from their parents receiving guidance regarding the best ways to support their child during dressing changes. As previously found, parent distress can impair a parent’s ability to support their child, and may need additional help themselves. This presentation will make specific recommendations regarding the content of parental coaching during a young child’s dressing change and how we are helping parents.

Ms Brown is completing a Doctor of Philosophy at the University of Queensland. Her work is investigating the impact of parent distress on child pain and anxiety during medical procedures, and longer term recovery, following a young child’s burn injury.


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