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Published on: February 23, 2024
Factors affecting adherence to treatment and follow-up of burns in children: A single centre experience
Mustafa Talip Sener1, Osman Enver Aydın2, Yuksel Ançı1
1Department of Forensic Medicine, Burn Care Unit, Ataturk University, Erzurum, Turkey.
Insights
Physicians must identify non-accidental burn injuries in children. Early discharge against medical advice (DAMA) in pediatric burn patients, often due to socioeconomic factors, warrants careful evaluation for potential abuse.
Area of Science:
- Pediatric Burn Care
- Child Abuse Detection
- Medical Ethics
Background:
- Pediatric burn injuries are a significant concern, with a subset potentially linked to child abuse.
- Understanding factors influencing treatment adherence is crucial for optimal outcomes.
Purpose of the Study:
- To identify factors affecting treatment adherence in pediatric burn patients.
- To highlight the physician's role in recognizing non-accidental burn injuries in children.
Main Methods:
- Retrospective analysis of pediatric patients hospitalized in a burn unit.
- Chi-square test used for statistical significance assessment.
Main Results:
- Out of 189 patients, 52 (27.5%) were discharged against medical advice (DAMA).
- DAMA patients showed no follow-up outpatient clinic contact; two cases were confirmed as abuse.
- Parental reasons for DAMA included family, financial, and accommodation issues.
Conclusions:
- Every pediatric burn case requires assessment for non-accidental etiology, even if accidental causes are common.
- Physicians must remain vigilant for signs of burn-related child abuse.
Aim:
Children are prone to burn injury. Burns can be seen as a part of child abuse. The aim of this study was to investigate the factors affecting adherence to the treatment of burn patients, and to emphasize the role of the physician in identifying children's non-accidental burn injuries.
Materials And Methods:
Children who were hospitalized in the burn unit were analyzed retrospectively. Results were assessed for significance using the Chi-square test.
Results:
A total of 189 patients were included. Some patients (n = 52; 27.5%) were discharged against medical advice (DAMA) before completion of treatment. Although we could not demonstrate a relationship between non-accidental etiology and DAMA group, it was significant that these patients did not contact the outpatient clinic after discharge. It was evident from records that two of these cases were abused. The reasoning of the parents in the DAMA group for the early discharge was siblings at home, financial and accommodation problems.
Conclusion:
Although burns in children commonly occur due to an accident, each burn case should be examined for a non-accidental etiology and findings suggesting abuse should be noted. Physicians should be alert for the detection of signs of burn related child abuse.
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