Repercussões da queimadura na qualidade de vida e na rotina familiar de crianças e adolescentes.

Abstract

Burn is a serious injury with high prevalence in childhood and adolescence. It is considered a public health problem and it can cause serious aesthetic and functional changes, as well as emotional and social disorders, which compromise the Quality of Life (QOL) and family dynamics. Objective: This thesis aims to analyze the interrelationships between burns, QOL and daily routine of children and teeenagers during the rehabilitation after hospital discharge. Method: The thesis was structured in articles: one is an integrative review of the literature and another one is a result of a field research, which was based on the presupposed of the Bioecological Theory of Human Development (BTHD) and used the Process-Person-Context- Time (PPCT). In field research, a mixed parallel convergent and longitudinal prospective study was developed at the rehabilitation clinic of a public hospital located in the city of Recife, state of Pernambuco, from October 2016 to July 2018. The sample was composed of five youngsters of both genders, with deep burns, having had hospital discharge in a maximum of three months, and six caregivers. Data collection was performed through a socio-demographic and clinical questionnaire, physical exams and consultations to the youngsters’ charts. QOL was evaluated through the Brazilian version of KIDSCREEN-52 (Versions for the young and for parents/caregivers). The daily routines were evaluated from semi-structured interviews that followed a pre-elaborated script, having had audio recorded. The quantitative data were analyzed in a descriptive way, considering averages and percentiles. The responses of the children and teenagers and their caregivers were compared to the KIDSCREEN-52 questionnaire in three moments, along 12 months. The interviews were transcribed and analyzed according to the Thematic Analysis proposed by Minayo. In the end, the data were used through an integrated way and excerpts from the interviews were used to justify (or counterpoise) the quantitative results. Results: The integrative review of the literature showed that burns negatively affected all domains of QoL in children and adolescents; it showed that injuries in specific areas, such as face and hands, further compromise areas related to psychosocial health and also showed that longitudinal studies are more appropriate than cross-sectional studies to identify risk factors caused by burn injury in life and health of this population. Over time, there is a tendency to reduce the negative burn impact on the QoL of these individuals. In the field survey, the sample consisted of five young people (11 to 15 years old) and six caregivers. It was observed that generally the burns caused several negative repercussions in the QoL and in the daily routine of the participating children and teenagers. But in the end of twelve months, overall QoL appeared to be less affected, although the 'Friends and Social Support', 'School Environment' and 'Financial Aspect' remained compromised. The daily routine of the youngsters was very compromised and the presence of scars made it difficult to return to school and to social interactions with peers due to experiences of stigmatization over which they were victims. Final Considerations: Burning caused negative repercussions, especially in the psychosocial dimensions of the QoL of the youngsters from this research. In the daily routine, it was observed social participation difficulties due to bullying and stigmatizing behaviors about the scars.