Behavioral Aspects of Pediatric Burns

294 Pages·1994·31.097 MB·English

by  Kenneth J. Tarnowski (auth.), Kenneth J. Tarnowski Ph.D. (eds.)

Behavioral Aspects
of Pediatric Burns
Issues in Clinical Child Psychology
Series Editors: Michael C. Roberts, University of Kansas-Lawrence, Kansas
Lizette Peterson, University of Missouri-Columbia, Missouri
BEHAVIORAL ASPECTS OF PEDIATRIC BURNS
Edited by Kenneth J. Tarnowski
CHILDREN AND DISASTERS
Edited by Conway F. Saylor
HANDBOOK OF DEPRESSION IN CHILDREN AND
ADOLESCENTS
Edited by William M. Reynolds and Hugh F. Johnston
INTERNATIONAL HANDBOOK OF PHOBIC AND ANXIETY
DISORDERS IN CHILDREN AND ADOLESCENTS
Edited by Thomas H. Ollendick, Neville J. King, and William Yule
MENTAL HEALTH INTERVENTIONS WITH PRESCHOOL
CHILDREN
Robert D. Lyman and Toni L. Hembree-Kigin
A Continuation Order Plan is available for this series. A continuation order will bring
delivery of each new volume immediately upon publication. Volumes are billed only upon
actual shipment. For further information please contact the publisher.
Behavioral Aspects of
Pediatric Burns
Edited by
J.
KENNETH TARNOWSKI
University of South Florida
Fort Myers, Florida
SPRINGER SCIENCE+BUSINESS MEDIA, LLC
Library of Congress Cataloging-in-Publication Data
Behavioral aspects of pediatr1c burns 1 ed1ted by Kenneth J.
Tarnowski.
p. cm. -- <Issues in cl1nical chlld psychology>
Includes bibliographical references and index.
ISBN 978-1-4757-9391-8 ISBN 978-1-4757-9389-5 (eBook)
DOI 10.1007/978-1-4757-9389-5
1. Burns and scalds 1n chlldren--Psychologlcal aspects.
1. Tarnowski, Kenneth J. II. Series.
[DNLM, 1. Burns--1n infancy & chlldhood. 2. Burns--psychology.
3. Child Behavior. WO 704 8419 1994]
RD96.4.B44 1994
617.1'1'0083--dc20
DNLM/DLC
for L1brary of Congress 94-30884
CIP
ISBN 978-1-4757-9391-8
© 1994 Springer Science+Business Media New York
Originally published by Plenum Press, New York in 1994
Softcover reprint of the hardcover 1st edition 1994
Ali rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or
by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise,
without written permission from the Publisher
To my extraordinary parents, Bill and Ellen
and
wife, Pat, for their support, love, and encouragement
Contributors
F. Daniel Armstrong, Ph.D., Department of Pediatrics, University of
Miami School of Medicine, Miami, Florida
Patricia Blakeney, Ph.D., Shriners Bums Institute, Galveston, Texas
Christopher P. Brandt, M.D., Department of Surgery, Case Western Re
serve University School of Medicine, MetroHealth Medical Center, Cleve
land, Ohio
Ronald T. Brown, Ph. D., Departments of Psychiatry and Behavioral
Sciences and Pediatrics, Emory University School of Medicine, Atlanta,
Georgia
Joseph P. Bush, Ph.D., Graduate School of Psychology, Fielding Institute,
Santa Barbara, California
Arden D. Dingle, M.D., Departments of Psychiatry and Behavioral Sci
ences and Pediatrics, Emory University School of Medicine, Atlanta,
Georgia
Marion Doctor, M.S.W., Children's Hospital Bum Center, University of
Colorado School of Medicine, Denver, Colorado
Richard B. Fratianne, M.D., Department of Surgery, Case Western Re
serve University School of Medicine, MetroHealth Medical Center, Cleve
land, Ohio
Caryl L. Gay, Ph. D., Department of Pediatrics, University of Miami School
of Medicine, Miami, Florida
vii
viii CONTRIBUTORS
Russell T. Jones, Ph.D., Department of Psychology, Virginia Polytechnic
Institute and State University, Blacksburg, Virginia
Nadine J. Kaslow, Ph.D., Department of Psychiatry and Behavioral Sci
ences, Emory University School of Medicine, Grady Memorial Hospital,
Atlanta, Georgia
Kamela Koon-Scott, Ph.D., Department of Psychiatry and Behavioral
Sciences, Emory University School of Medicine, Grady Memorial Hospi
tal, Atlanta, Georgia; present address: Department of Pediatrics, University
of Florida College of Medicine, University Medical Center, Jacksonville,
Florida
Jacqueline D. Levy, Ph.D., Department of Pediatrics, University of Miami
School of Medicine, Miami, Florida
Marlene T. Maron, Ph.D., Otter Creek Associates, Burlington, Vermont
Thomas Pruzinsky, Ph.D., Department of Psychology, Quinnipiac Col
lege, Hampton, Connecticut
L. Kaye Rasnake, Ph.D., Department of Psychology, Denison University,
Granville, Ohio
Kenneth J. Tarnowski, Ph.D., Department of Psychology, University of
South Florida, Fort Meyers, Florida
Vasiliki Zaharopoulos, Department of Psychology, Virginia Polytechnic
Institute and State University, Blacksburg, Virginia
Preface
In recent years, considerable professional attention has centered on the
behavioral aspects of various childhood illnesses and injuries. Indeed,
child health psychology has grown exponentially over the past decade.
One index of this growth is found in the number of texts that have recently
appeared in the area (Gross & Drabman, 1990; Karoly, 1988; Krasnegor,
Arasteh, & Cataldo, 1986; Levine, Carey, Crocker, & Gross, 1982; Routh,
1988; Russo & Varni, 1982; Tuma, 1982; Varni, 1983). In general, these texts
provide summaries of the psychological literature across a variety of
established (e.g., oncology) and emerging (psychoneuroimmunology)
areas of child health.
Until recently, many books on the psychological aspects of pediatric
health provided no or minimal information about the psychosocial plight
of child burn victims. In some instances, pediatric burns might be men
tioned parenthetically as another example of a population for which
behavioral treatment procedures (e. g., pain management) may be of value.
In part, the relative inattention devoted to this population may be related
to the perception that the literature in this area is sketchy and charac
terized by significant methodological and substantive shortcomings. In
many instances, this perception is largely justified. However, it is also the
case that the pediatric burn literature has evolved considerably over the
past decade and that the incidence of, and morbidity associated, with
severe burn injuries mandates immediate and increased attention by
mental health professionals.
Several factors prompted the development of the current volume. In
the process of providing inpatient and outpatient assessment, treatment,
and consultation and liaison services to burned children and their families,
it has been time-consuming and often disappointing to search the litera
ture for materials of potential value in answering specific referral ques-
ix
X PREFACE
tions. Common referral questions often involve issues pertaining to acute
psychological reactions, pain management, and long-term psychosocial
sequelae. A summary of the existing literature that extends well beyond
the scope and detail of a typical book chapter wouk' be of obvious value.
Another impetus for the book involved consideration of the uniqueness of
bum injuries. Severe nonfatal bums by thermal, electrical, chemical, or
radiation causes constitute the most serious form of human injury
(McLoughlin & McGuire, 1990). Bums share characteristics with other
types of acute injuries (e.g., orthopedic), as well as those of chronic illness
(e.g., sickle-cell disease). As such, not only do they pose unique clinical
considerations but also warrant increased attention from a developmental
perspective. These injuries, and the circumstances surrounding their
occurrence, have the potential to seriously disrupt a variety of important
developmental processes. Indeed, the fact that severe pediatric bums do
not invariably cause such devastating or lasting disruption attests to the
impressive resiliency of children and families. Finally, it is important to call
attention to the fact that the vast majority of pediatric bums are entirely
preventable.
The purpose of the book is to survey the literature on the behavioral
aspects of pediatric bums and to consider the implications for prevention,
consultation, treatment, and follow-up. The book is divided into four sec
tions. The goal of the first section is to provide a general introduction to
the topic of pediatric bums including epidemiological, medical, and surgi
cal aspects. The second section of the book considers broadly the acute
reactions and long-term psychosocial sequelae associated with severe
bum injury. In the third section of the book, a variety of behavioral topics
are considered. The goals of the contributions in this section are to build
on the information presented in earlier chapters and to acquaint the reader
with the range of applied considerations that one confronts in the context
of clinical work with this population. Issues relevant to consultation and
liaison, pain management, body image disturbance, school reintegration,
family functioning, and injury prevention are discussed in detail. The final
section highlights and integrates the themes of the previous chapters and
provides a general prospectus to guide future clinical and research efforts.
The book is intended for mental health professionals (psychologists,
psychiatrists, social workers, and counselors), physicians (surgeons, pedi
atricians), nurses, and other specialists (child life workers) who are in
volved in the inpatient/outpatient care of burned children and their fami
lies. Wherever possible, an attempt is made to draw conclusions and
establish recommendations based on review of the pediatric bum litera
ture. For several topics, readers may be surprised at the limitations of and
gaps in the primary literature. In such instances, every effort is made to