72 Parent Behavioral Responses to Children’s Itching following Unintentional Burns: Persevering Through Devastation. A Mixed-Methods Study

Abstract

Abstract Introduction Postburn itch is one of the disturbing symptoms that persist throughout the burn wound healing period. Parents often assume the responsibility to respond to their child’s symptoms; consequently, their responses to their child’s symptoms contributed to the child’s symptom experience and long-term outcomes. To date, literature examining parental behaviors in response to symptoms has been limited to children with pain. This study examined parents’ behavioral responses to itching in young children with burns. Methods:: This analysis was part of a larger descriptive study that examined parental behavioral and psychological responses to children’s itch following the child’s unintentional burn injury. Parents of young children with deep second or third-degree burns were recruited. Semi-structured interviews were conducted with parents to learn about parental behavioral responses to the child’s itching. The Adult Responses to Children’s Symptoms (ARCS) scale was used to evaluate parental responses as part of the interview. The ARCS scale consists of 29 items that allow parents to self-report their responses to children’s itch. However, four items were excluded: three items were not appropriate to the study sample; one item related to sleep because children’s sleep pattern has been dramatically disturbed. We used the inductive content analysis that adapted from Grounded Theory to analyze the data. Results Twenty parents of children 34 (±11.5) months with moderate to severe burns 11.2% (±8.7%) total burn surface area (TBSA) participated in the interview. The mean length of time since burn injury was 6.4 (±3.1) months. Persevering through Devastation was the core construct that captured the lived experience of parental itching management. Parental behavioral responses to their child’s itch involved shifting their children’s attention, touching the scar, and tending to the itching scar. Data triangulation revealed that the ARCS scale captured parent behaviors in response to their child’s itch that was not reported in the interview. Conclusions Parents were devastated when they struggled on their own to relieve their child’s incessant itching during the prolonged wound healing stage. They cared for children with perseverance in the face of traumatic burn event; however, some parents responded to their child’s distress and call for comfort with anger or reactive behavior.