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Posttraumatic Stress in Caregivers of Burn-Injured Children: A Cross-Sectional Study
Manman Sun1, Yuhong Ji, Jing Zhao
1Manman Sun , Yuhong Ji , Jing Zhao , and Yinming Wang are clinical nurses at Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China. Manman Sun, Yuhong Ji, and Jing Zhao contributed equally to this work. Contact author: Yinming Wang, a5c3k5@sina.com . The authors have disclosed no potential conflicts of interest, financial or otherwise.
Background:
Burn injuries have far-reaching physical, psychological, and social consequences for children and their families. The posttraumatic stress experienced by primary caregivers of burn-injured children can significantly influence the child's recovery process and overall prognosis while imposing a psychological toll on the caregiver. Exploring the posttraumatic stress of caregivers is therefore of critical clinical and practical importance.
Purpose:
This study aimed to systematically evaluate the prevalence of posttraumatic stress among primary caregivers of pediatric burn survivors and identify the key factors that contribute to it.
Methods:
We conducted a cross-sectional study of the primary caregivers of children who were hospitalized for burn injuries between January 2024 and June 2025. Caregivers were assessed using the Posttraumatic Stress Disorder (PTSD) Checklist-Civilian Version (PCL-C), which categorizes 17 symptoms of posttraumatic stress within three dimensions. To identify independent risk factors associated with PCL-C scores, we employed both univariate and multiple linear regression analyses.
Results:
A total of 240 primary caregivers were included in the study; these caregivers had a mean (SD) PCL-C score of 41.22 (5.09). Among the three PCL-C dimensions, reexperiencing symptoms was the most prevalent, followed by hyperarousal symptoms and avoidance symptoms. Multiple linear regression analysis revealed the following independent PTSD risk factors: the severity of the child's burn injury (β = 0.122, P = 0.001); the caregiver's place of residence (β = 0.116, P = 0.04), educational level (β = 0.123, P = 0.02), and marital status (β = 0.125, P = 0.02); the monthly per capita household income (β = 0.109, P = 0.02); and witnessing the burn incident (β = 0.127, P = 0.005). The final regression model explained 59.5% of the variance in scores ( F = 27.10, P < 0.001).
Conclusion:
Primary caregivers of children with burn injuries experience a high prevalence of posttraumatic stress, which is influenced by a combination of child-related, caregiver-related, and incident-related factors. Health care providers should develop individualized interventions addressing these specific factors to support caregiver mental health and ultimately improve outcomes for both children and their families.
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