96 Relation of Coping Strategies to Social Functioning and Self-Concept in Pediatric Burn Survivors

Abstract

Abstract Introduction Burn survivors can experience challenges in social functioning (e.g., bullying, stigmatization) and self-concept (e.g., body image concerns). Use of coping strategies is associated with engagement in social supports and positive self-concept in pediatric oncology and physical injury populations; however, their relation has not been examined in pediatric burn survivors. This study aims to explore coping as it relates to social functioning and self-concept in these youth. Methods Fifty-one pediatric burn survivors aged 7–17 years (M=12.53; SD=2.68), and their primary caregiver participated. Youth and caregivers completed questionnaires, including the Child Coping Strategies Checklist (CCSC; youth report); the Burn Injury Social Questionnaire (BISQ; parent & youth report; higher scores = more social problems); and the Piers-Harris Children’s Self-Concept Scale-2 (PH-2; youth report). Associations between the BISQ, coping strategies (Active, Avoidance, Distraction, Support), self-concept, yearly family income, and burn injury characteristics (e.g., total body surface area; TBSA, participant grafting) were examined via bivariate correlations. Hierarchical linear regression was used to examine whether coping strategies (with significant bivariate correlations) predicted BISQ and PH-2 scores above and beyond burn injury and demographic variables. Three hierarchical regression models were run, one each for parent- and youth-report BISQ and youth-report PH-2 scores. Results Our sample is predominantly male (62.7%) and Caucasian (82.4%) with average TBSA of 8.74% (SD=11.02). Parent- and youth-reports on the BISQ were positively correlated with TBSA (r=.61 and .37, respectively) and negatively correlated with family income (r=-.37 and -.36, respectively). Parents of youth who had a skin graft reported higher BISQ scores (rho=.34). Distraction coping was significantly associated with youth-reported BISQ scores (r=-.31); no coping strategies were correlated with parent-report BISQ scores. In regression models, TBSA significantly predicted of parent-report BISQ (B=.27, p< .001). Higher family income (B=-.40, p=.04) and greater distraction coping (B=-3.41, p=.004) significantly predicted better youth-report BISQ scores. Greater active coping significantly predicted better self-concept (B=6.21, p=.01). Conclusions Results suggest that use of positive coping strategies relates to better youth-reported social functioning and youth-reported self-concept after burn injury in addition to injury characteristics and socioeconomic variables.