Psychosoziale Aspekte thermischer Verletzungen im Kindes- und Jugendalter

Abstract

Thermal injuries are a major hazard in the early childhood. The aim of our study was to determine psychological behavioural disorders following burn and scald injuries in the childhood and to estimate their dependence on the formation of scar tissue and the social background of the children. 83 patients aged 0 to 18 years who had been treated for thermal injuries in our clinic between September 2002 and December 2005 were included in the follow-up study. The standardised questionnaires CBCL/4-18 and TACQOL-PF were used to evaluate psychological behavioural disorders and quality of life. The follow-up examinations also served to gain information about the social status of the patient's parents and the current physical complaints. Scars were assessed by the Vancouver Scar Scale (VSS). 50 out of 83 patients took part in our follow-up examinations. 21 children suffered from physical complaints following thermal injury. Dryness of the skin as well as heat and cold intolerance were named most frequently. Internalising (p < 0.04) and externalising (p < 0.03) behavioural problems correlated significantly with the severity of scar formation defined by the VSS. Quality of life and social status were inferior to the comparison group. The incidence of thermal injuries is highest in the first three years of childhood. The risk for burn and scald injuries is augmented by a poor social status. In children who suffered such injuries we observed a higher rate of internalising and externalising behavioural problems which correlated with the extent of scar formation.