Health-Related Quality of Life in adolescent survivors of burns: Agreement on self-reported and mothers' and fathers' perspectives.

AIM: This study examined the agreement on self-reported Health-Related Quality of Life (HRQOL) between adolescents with burns and their mother's and father's observation at 6 and 18 months after the burn. Moreover, factors potentially influencing discrepancies between the adolescent and proxy reports were examined. METHODS: Children with burns (11-18 years old) and their mother and father were invited to participate. A total of 54 adolescents aged 11 years or older filled out the American Burn Association/Shriners Hospitals for Children Burn Outcomes Questionnaire (BOQ). Descriptive and correlational analyses were performed. RESULTS: The physical functioning scores showed to be optimal in almost all participants (99%) and across the three informants. Adolescents reported better functioning than their fathers and mothers on most of the scales. On average the correlations between self-reports and proxy reports were moderate to good. Higher parental traumatic stress scores were linked to less favorable parent-reported burn outcomes. CONCLUSION: Overall, this study showed that a large proportion of the parents had similar views on the adolescents physical functioning, but disparities emerged also, mainly in psychosocial scales. The discrepancies between self- and parent reports should be discussed when they have a role in treatment decisions. Preferably, besides parent-reports, adolescents' self-reports should be included in clinical assessments and treatment decisions, as parental traumatic stress symptoms are a possible factor influencing parental observations.

The relationship between behavioural problems in preschool children and parental distress after a paediatric burn event.

This study examines mother- and father-rated emotional and behaviour problems in and worries about 0- to 5-year-old children at 3 and 12 months after a burn event and the relation with parental distress. Mothers (n = 150) and fathers (n = 125) representing 155 children participated in this study. Child emotional and behaviour problems and parental worries about the child were assessed with the Child Behavior Checklist at both time points. Parents' level of acute subjective distress was assessed within the first month after the burn event with the Impact of Event Scale. Mothers and fathers held comparable views of their child's emotional and behaviour problems, which were generally within the normal limits. Parents' own acute stress reactions were significantly related to parent-rated child behaviour problems at 3 and 12 months postburn. A substantial part of mothers' and fathers' worries about the child concerned physical and emotional aspects of the burn trauma, and potential future social problems. Parents with high acute stress scores more often reported burn-related concerns about their child at 3 and 12 months postburn. Health-care professionals should be informed that parents' distress in the subacute phase of their child's burn event may be related to subsequent worries about their child and to (parent-observed) child emotional and behaviour problems. The authors recommend a family perspective, with particular attention for the interplay between parents' distress and parent-reported child behaviour problems and worries, in each phase of paediatric burn care.