‘We wrapped him in cotton wool’: a qualitative study examining the healthcare experience of parents following the burn or scald of their child; and the effect of the injury on the family.

Abstract

Childhood injury affects many families in the United Kingdom. In particular, burn injury can have a devastating effect, and disproportionately affects preschool children. In 2005, 158 children under five in Scotland were burned or scalded severely enough to require treatment as inpatients (ISD Scotland 2006).The aim of this thesis is to examine the impact of childhood burn injury on the family, and the parents’ view of its effect on the long-term parent-child relationship, whilst gaining an understanding of the views, opinions and feelings about the healthcare experience of parents after serious burn injury to their child. From an area in the central belt of Scotland, a group of nine families of children who had been burn injured while less than five years of age were recruited. Thirteen parents were interviewed using a semi-structured interviewing technique. The study utilised a qualitative research method, interpretive description, to obtain and analyse rich descriptions of the reality of caring for a burn injured child. Parents’ feelings and opinions about the impact of the injury on long term family relationships were analysed to reveal that parents go through a process of adjustment and adaptation to parenting a burn injured child. This process has 3 stages, the first, ‘holding’ was recognised when parents described an overwhelming obligation to hold and be close to their child. The second, ‘guarding’ was identified as the parents’ imperative to keep their child away from further danger and to regain their feeling of competence lost when the child was injured. The third stage, ‘defending’ has two elements; parental efforts to defend the child and family from shame at the appearance of the burn injury, and defending the child from becoming a burn injury victim. This study contributes to the research on childhood burn injury by identifying a process for parental adaptation, especially in view of the long term physical and psychological effects of burn injury scarring. The implication of the parental adaptation process is that health professionals need to be able to support and facilitate parents at each stage of adaptation; helping parents to be close to their child in particular at the time of treatment, regain their feelings of lost competence by keeping the child safe, and come to terms with the reality of their child’s burn injury scarring and the effects of this on their future. As the treatment and outcomes for burn injury survivors continues to improve, understanding the needs of the family in adjusting to living with a burn injured child becomes ever more important in the development of effective professional practice.