BACKGROUND: To devise and evaluate the retention of a new brief training package for non-psychiatrically trained multidisciplinary staff to assess suicide risk and manage suicidal patients, including referral of patients at significant risk to psychiatric staff. METHOD: 8 h of interview skills training, using role play with modelling and video feedback, was taught to 33 health and voluntary workers. Evaluation used a controlled before and after training design. Performance of the interview skills was assessed blindly by raters using predetermined criteria from videotaped role played interviews with actors. Self-rated questionnaires (SIRI-2 and visual analogue scales) were used to assess the clinical skills and confidence respectively of the front-line workers. RESULTS: Suicide risk assessment and management skills such as problem solving, future coping and provision of immediate support were significantly improved at 1 month after training. Training did not significantly improve general interview skills, combating hopelessness nor the removal of lethal weapons. Performance on the SIRI-2 and confidence significantly improved after training. The assessment procedure itself did not improve clinical skills nor confidence. LIMITATIONS: Performance among individual health disciplines was not assessed. Design was not a randomised controlled trial with short follow up and no patient outcome data. CONCLUSIONS: A brief training package is available which is effective in teaching suicide risk assessment and clinical management skills.

Adult↗

PubMedDate not supplied

Synthetic burn dressings: round table discussion.

Explore the source record for details and available documents.

Bandages↗

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Social competence and behavioral problems of pediatric survivors of burns.

Sixty children (35 boys, 25 girls) with burns were surveyed at least 1 year after burn injury to assess the behavior problems and difficulties with competency that they were having. The Child Behavior Checklist, the Youth Self Report, and the Teacher Report Form developed by Achenbach were administered to obtain standardized measures of behavior and competence. The mean values for these scales were in the normal range for each age and sex. However, the Child Behavior Checklist revealed a statistically significant (p < 0.05) increase in problems and decrease in competency for most age groups and both sexes when compared with the reference population. In contrast, the Teacher Report Form and the Youth Self Report revealed very few differences from the reference population. The burn size (15% to 20% total body surface area, 35% to 50% total body surface area, and > 70% total body surface area) did not account for any of the group differences. Further studies involving detailed clinical interviews and other standardized measures are needed to understand the discrepancies between the Child Behavior Checklist and the other scales.

Adolescent↗

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Parental stress as a cause and effect of pediatric burn injury.

The current study reports assessments of stress for parents of children with acute burns at the time of hospital admission and during the first 5 years after injury. At each assessment, parents of children with burns report neither more nor less stress than a normal population. At the time of admission, parents of children with acute burns do not differ from the normal sample on any of the measures of parenting stress. Parents of recovering children with burns do report significant changes. They report significantly higher depressive symptoms at year 2 after the child's burn injury and lower than normal levels of depression in years 4 and 5 after the child's injury. During the recovery period, these parents also attribute their stress more often to the child with burns, whereas other parents more evenly divide blame among their children and their personal characteristics.

Acute Disease↗

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Psychologic adjustment after childhood burn injuries as predicted by personality traits.

The purpose of this study was to examine the nature of psychologic adjustment in persons who have survived childhood burn injuries. It was hypothesized that survivors who were well-adjusted psychologically would possess specific personality traits that would differentiate them from their poorly adjusted peers. Thirty-two subjects were given a standardized assessment of psychologic adjustment and a standardized personality inventory. The subjects were assigned to either a "poorly adjusted" group or a "well-adjusted" group, on the basis of each subject's score on a standardized measure of adjustment. There were no significant differences between the two groups in variables of gender, age, time since burn, or age at time of burn injury. The results indicate three personality traits that seem to be related to psychologic adjustment after a severe burn injury in pediatric patients.

Adaptation, Psychological↗

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Psychosocial sequelae of pediatric burns involving 80% or greater total body surface area.

Important questions for pediatric burn care specialists relate to the quality of life for those children who survive the most severe burn injuries. This study examines the psychological adjustment of 25 children who survived injuries > or = 80% total body surface area and the impact of such injury on the families. Data were analyzed from the most recent assessment, with the Child Behavior Checklist, Teacher Report Form, Piers-Harris Children's Self-Concept Scale, Parenting Stress Index, and a parental questionnaire designed by the authors. As a group, the children's behavioral problems as reported by both parents and teachers were within normal limits. Measures of parental stress, however, clearly differentiated the burn population. These parents attributed more stress to characteristics of their children. Children with > or = 80% TBSA burns develop positive feelings about themselves and appear no more troubled than a comparable group of nonburned children. The impact on the families is significant, however, and must be considered of consequence in the rehabilitation of the burned child.

Adaptation, Psychological↗

PubMedDate not supplied

Parental well-being and behavioral adjustment of pediatric survivors of burns.

Parents of pediatric patients with burns often perceive their children as troubled and having an increased number of problem behaviors. This study examines the relationship between these problem behaviors and the parent's own emotional well-being. Mothers of 38 burned children completed three standardized questionnaires: Child Behavior Checklist, Parental Stress Index, and the Eight State Questionnaire. The population was further divided into troubled and untroubled by a Child Behavior Checklist total problem T score of 60. Parents were not significantly different from reference populations on most of the scales. However, the Parental Stress Index results revealed that parents who report their children as troubled are themselves stressed, not only by their children's behaviors but in areas unrelated to their children. In addition, these mothers report often feeling depressed and guilty on the Eight State Questionnaire. This study emphasizes the need for psychological assessment of both parents and children.

Adaptation, Psychological↗

PubMedDate not supplied

Efficacy of school reentry programs.

Evaluation of school reentry programs are rarely reported, and statements of the value of reentry programs are usually based on anecdotal information. No known reports of empiric data support claims of positive benefit for burned children. This article reports a multifaceted effort to evaluate the effectiveness of one reentry program involving three approaches: (1) questionnaire answered by the school contact person after reentry program, (2) interviews with a random sample of patients (n = 58) and parents (n = 44) 1 to 5 years after burn, and (3) assessment of patients' behavior problems by teachers on a standardized behavior checklist comparing 10 patients who had a school reentry program involving videos to introduce them to their classmates with 10 patients who were matched for age, sex, and total body surface area burned and had no reentry program beyond phone contact. Results indicate that school reentry programs are popular with teachers and parents. This pilot effort involving empiric data failed to demonstrate a positive effect on the adjustment of the child.

Adaptation, Psychological↗