Parenting burn-injured children in India: a grounded theory study

Abstract

Background: Burn injury is one of the major traumas that a child can experience. Parents of burn-injured children experience anxiety, depression, guilt and post traumatic stress disorders as they care for their burn-injured children. Such empirical evidence related to effects of burns on parents and parenting process is unavailable from low and middle income countries like India.

Objectives: The aim of the study was to discover the process of parenting burn-injured children in India. The objective of this paper is to present one of the substantive processes "Enduring the Blame" that emerged from the data.

Design: Constructivist grounded theory methodology was used to explore the experiences of parenting burn-injured children.

Setting: The study was conducted through a tertiary hospital that provided advanced paediatric burn care in a town in South India.

Participants: Nine mothers, nine fathers, three grandmothers and one aunt from 12 families of children who were 15 years or younger and had sustained greater than 20% total body surface burns were purposively included.

Methods: Twenty-two semi structured individual or family interviews were conducted in Tamil over a period of one year. The interview started with an overview question and then was followed by trigger questions as the participants shared their experiences. Second interviews were conducted with three participants in three families for theoretical saturation purposes.

Results: Mothers and fathers encountered blame from family members, health professionals, strangers, and their burn-injured children along the burn injury trajectory. They suffered double trauma of their child's burn and the blame. Parenting their burn-injured child involved a process of "Enduring the Blame." Enduring the Blame included four stages: internalizing blame, submitting to blame, rising above blame, and avoiding blame.

Conclusions: Encouraging and assisting parents in caring for their children instead of blaming is a vital component of paediatric burn care. Parents will benefit from ongoing assessment and psychological interventions that will provide emotional support. Studying the perceptions of health professionals and the burn-injured children will help in further clarification of blame related issues and developing a parenting theory.