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Burn patients, parents and doctors; are we in agreement?
Alexander J T Wood1, Stephanie C Clugston, Jeremy M Rawlins
1University of Western Australia, Faculty of Medicine, Dentistry and Health Sciences, Australia.
Insights
Paediatric patients desire burn reconstruction less than parents and surgeons. Factors like gender, age, scar visibility, and severity influence decisions, highlighting a need for better agreement among all parties.
Area of Science:
- Pediatric Surgery
- Burn Reconstruction
- Patient-Reported Outcomes
Background:
- Pediatric burns pose significant challenges for patients, families, and healthcare providers.
- Understanding the differing perspectives on burn reconstruction is crucial for effective treatment planning.
Purpose of the Study:
- To investigate and compare the desire for burn reconstruction among pediatric patients, their parents, and surgeons.
- To identify factors influencing these differing desires.
Main Methods:
- A case series of 21 pediatric burn patients.
- Data collection through patient, parent, and surgeon questionnaires, supplemented by medical record reviews.
- Analysis of factors affecting the desire for reconstruction across the three groups.
Main Results:
- Surgeons (76.2%) and parents (61.9%) showed a higher desire for surgery than pediatric patients (52.4%).
- Desire for surgery was influenced by patient gender (higher for females), scar location (higher for hidden scars), and burn severity (higher VSS scores).
- Patient-parent agreement was high (Kappa=0.81), while agreement with surgeons was moderate to poor (Kappa=0.12-0.24).
Conclusions:
- Pediatric patients are less inclined towards burn reconstruction compared to parents and surgeons.
- Age and gender are potential factors influencing the desire for surgical intervention.
- Improving consensus among patients, parents, and surgeons regarding burn reconstruction is an area for future development and research.
Background:
Burns in children present a serious challenge for patients, parents and doctors. This study aimed to investigate differences in desire for burn reconstruction in paediatric patient, parent and surgeon groups.
Methods:
This study is a case series (n=21). Questionnaires were administered to patients, their parents and surgeons. Medical records were also reviewed. Data were analysed to ascertain how different factors affected desire for reconstruction between parents, patients and surgeons.
Results:
Surgeons and parents were more likely to desire surgery than paediatric patients (76.2 vs 61.9 vs 52.4% respectively). Surgeons were more likely to recommend surgery for pre-pubescent patients (81.8 vs 70%). All groups were more likely to desire surgery for female patients. Patients and parents desired surgery more for hidden scars. Higher VSS scores were associated with a higher desire for surgery in all groups. Agreement between patients and parents was highest (Kappa=0.81) with poor-moderate agreement between surgeons, patients and parents (Kappa=0.12-0.24).
Conclusions:
This study suggests that paediatric patients are less likely to want burn reconstruction compared to parents and surgeons. Gender and age may impact on desire for surgery. Opportunities for improving patient, parent and surgeon agreement may exist. Further research is warranted to validate these results.
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