Abstract
Pediatric burn survivors experience increased risk for bullying, stigmatization, body image concerns, and problematic social functioning. Although coping behaviors are associated with engagement in social supports and positive self-concept in multiple pediatric illness populations, their relation has not been examined in pediatric burns. This study examined coping in relation to social functioning and self-concept in 51 pediatric burn survivors aged 7–17years (M=12.54; SD=2.65). Survivors and their caregivers completed the Child Coping Strategies Checklist (CCSC; youth report); the Burn Injury Social Questionnaire (BISQ; parent and youth report); and the Piers-Harris Children’s Self-Concept Scale-2 (PH-2; youth report). Associations between coping, social functioning, self-concept, demographic features, and burn injury characteristics were examined via bivariate correlations. Hierarchical linear regressions examined whether coping strategies predicted social functioning and youth self-concept beyond burn injury and demographic variables. Social functioning concerns were positively correlated with total body surface area (TBSA; r=0.63 and 0.40, respectively). TBSA was the only significant predictor of parent-reported social concerns (β=0.65, p<0.001). Greater distraction coping predicted fewer youth-reported social concerns (β=−0.39, p=0.01). Greater active coping (B=0.67, p=0.002) and lower avoidance coping (B=−0.36, p=0.03) predicted better youth-reported self-concept. This study advances our understanding of coping as potentially protective for psychosocial adjustment. Clinicians working with child burn survivors should incorporate active coping interventions into treatment. Further research including larger and more diverse samples is needed to understand the role of coping approaches on psychological adjustment during burn healing.
Highlights
Burns are among the leading causes of injury and unintentional death in the United States (American Burn Association, 2018)
Families were recruited as part of a larger multi-project (e.g., Enlow et al, 2019) study examining the psychosocial outcomes of pediatric burn survivors
Pediatric burn survivors are at an increased risk of negative psychosocial outcomes such as anxiety, depression, acute stress disorder, PTSD, and deficits in self-concept and social functioning (Landolt et al, 2009; Bakker et al, 2013; Kazis et al, 2017)
Summary
Burns are among the leading causes of injury and unintentional death in the United States (American Burn Association, 2018). Burn care can be medically extensive, painful, and last months to years Along with their physical repercussions, burns are associated with impairments in psychosocial functioning that hinder healing, long-term adjustment, and overall well-being (Lavigne and Faier-Rouman, 1992; Pardo et al, 2008; Gill, 2010; Enlow et al, 2019). Problems with peers were more common in children who had sustained burn injuries compared to the general population (Willebrand et al, 2011). Despite these findings, the extant literature on social adjustment in pediatric burns is not extensive, and this is an area in need of additional study
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