Utility of a Pediatric Psychosocial Screener in an Outpatient Burn Clinic.

Abstract

Psychosocial concerns are common among youth who sustained a burn injury. Detecting psychosocial distress early is essential to ensure appropriate treatment and referrals. Thus far, research has focused largely on the long-term outcomes of pediatric burn survivors. The current quality improvement initiative details the implementation and outcomes of brief, pragmatic screening to assess psychosocial concerns among pediatric burn survivors in an outpatient setting. A primary caregiver completed an age-appropriate psychosocial screener for youth aged 4-10 years (n = 69), while patients aged 11-17 years (n = 72) completed a self-report screener. Total scores were used to categorize patients as acute risk (i.e., emotional concerns requiring immediate attention), moderate risk (i.e., elevated symptoms, but no immediate safety concerns), or low risk (i.e., endorsing few to no symptoms). Patients with acute risk were evaluated by medical staff to determine the need for immediate psychiatric intervention or social services referrals. Patients with moderate risk met with the on-site psychology team during their clinic visit or were contacted by telephone within 1 week. Patients in the low-risk category warranted no additional follow-up post-screening. Most patients scored in the low-risk category (n = 120; 85%), while 11% (n = 16) and 4% (n = 5) endorsed symptoms consistent with moderate and acute risk, respectively. Results demonstrate the utility of implementing pediatric psychosocial screening in an outpatient burn clinic, the importance of detecting psychosocial concerns in this context, and usage of referrals to address concerns. Findings also shed light on key caveats of psychosocial screening, barriers to accessing psychosocial support, and the potential benefits of embedded psychological support during medical visits.