Impact of Parental Acute Psychological Distress on Young Child Pain-Related Behavior Through Differences in Parenting Behavior During Pediatric Burn Wound Care

Abstract

Pediatric burn injuries and subsequent wound care can be painful and distressing for children and their parents. This study tested parenting behavior as a mediator for the relationship between parental acute psychological distress and child behavior during burn wound care. Eighty-seven parents of children (1–6-years-old) self-reported accident-related posttraumatic stress symptoms (PTSS), pre-procedural anxiety, general anxiety/depression symptoms, and guilt before the first dressing change. Parent–child behavior was observed during the first dressing change. Mediation analyses identified three indirect effects. Parental PTSS predicted more child distress, mediated through parental distress-promoting behavior. Parental guilt predicted more child distress, mediated through parental distress-promoting behavior. Parental general anxiety/depression symptoms predicted less child coping, mediated through less parental coping-promoting behavior. Parents with accident-related psychological distress have difficulty supporting their child through subsequent medical care. Nature of parental symptomology differentially influenced behavior. Increased acute psychological support for parents may reduce young child procedural pain-related distress.

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Acknowledgements

The authors would like to acknowledge research assistants Krittika Vongkiatkajorn and Gillian Montague for their assistance with data collection, and Jacelle Warren for statistical guidance. We would also like to thank the families that allowed us insight into their experiences, and the medical staff at the Pegg Leditschke Children’s Burns Centre who opened their unit to this research.

Funding

E.A.B received funding from the Australian Government Research Training Program Scholarship, the Children’s Hospital Foundation, and the Pain in Child Health (PICH) strategic training initiative for health research. No other authors have funding to declare.

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Correspondence to Erin A. Brown.

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The authors Erin A. Brown, Alexandra De Young, Roy Kimble, and Justin Kenardy declare that they have no conflict of interest.

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All procedures were in accordance with the ethical standards of the institutional research committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Brown, E.A., De Young, A., Kimble, R. et al. Impact of Parental Acute Psychological Distress on Young Child Pain-Related Behavior Through Differences in Parenting Behavior During Pediatric Burn Wound Care. J Clin Psychol Med Settings 26, 516–529 (2019). https://doi.org/10.1007/s10880-018-9596-1

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Keywords

  • Accidents and injuries
  • Pain
  • Anxiety
  • Coping
  • Distress