Sibling adjustment to burn trauma.

摘要

The present study examined the psychosocial adjustment of the siblings of children suffering from burn trauma. In addition, the study investigated the impact of illness factor variables, family adaptation variables, and sibling constellation variables to identify risk factors impacting their level of adjustment.;Seventy-nine parents or legal guardians of the sibling closest in age to the pediatric burn patient meeting specified inclusion criteria participated in this study in addition to fourteen non-injured siblings from ages 11--18. Levels of psychological adjustment were obtained using the Child Behavioral Checklist (CBCL) (Achenbach, 1991). Family factors predicting psychosocial adjustment were assessed utilizing the Family Environment Scale (FES) (Moos and Moos, 1981). Two instruments were developed for the present project: one to identify factors indicated by well siblings as being relevant to their adjustment; the other to identify changes in the non-injured sibling's behavior since the burn injury.;Using a nonparametric Mann Whitney U statistic, a marginally significant difference was found (MW-U: 2df z = -1.676, p < 0.0938) on the Total Problems Scale, suggesting that the study group was better adjusted than the age and gender matched normative group on psychological dimensions. Analysis of the Competency Dimension of the CBCL resulted in significant differences (MW-U: 2df z = -2.357, p < 0.0184) indicating that the children of siblings with burn injuries faired worse than the normative group on overall Competence, particularly Social Competence.;Further nonparametric analyses compared the study sample to the normative group as clustered by severity of injury. Analysis indicated that the minimal and the moderate burn study group did significantly better on the CBCL Syndrome dimensions. However, analysis of the CBCL Competency scales found that the moderate (MW-U: 2df z = -2.314, p < 0.0206) and severe injury groups (MW-U: 2df z = -1.663, p < 0.0962) were lower than the normative sample, particularly in social competence.;Analysis of family adaptation factors as a predictor of psychosocial adjustment of the study group could not be carried out. A Cronbach's Alpha Statistic indicated poor internal consistency on the FES scales and therefore deemed inappropriate with this population.