Pediatric Burn Injury: Self- Versus Therapist- Mediated Debridement

We examined the extent to which self-mediated debridement (SMD; provid-ing the child with the opportunity to conduct part of his own medical treat-ment) affected the display of behavioral distress during treatment for burn injury. Distress evidenced during SMD was contrasted with that occurring during therapist-mediated debridement (TMD). A within-subjects repeated reversal design was used to evaluate the effects of SMD on the distress of a J 2-year-old patient. Results indicated that the child exhibited less distress while conducting his own debridement in comparison to pain evidenced during TMD. The study highlights the use of several methodological controls neces-sary in applied burn research. KEY WORDS: burn; pediatric burn; debridement. Children represent a high-risk population for burn injuries (Gordon, 1979). The yearly incidence of pediatric burn injuries is approximately 1 million (Dimick, 1977). The psychological sequelae of burns associated with hospitali-zation, pain, intrusive medical procedures, and disfigurement are numerous and devastating (Clarke, 1980; West & Shuck, 1978)