Parents of recovering burn survivors describe their children as very demanding, dependent and unhappy. These parents see their children as overly active and restless. They are disappointed in their children and do not experience them as a source of positive reinforcement.

Family stress is rife, particularly when the mother is not coping due to stress. This affects the children. Family stress increases the risk of burn hospitalization in children. In some studies 74 per cent of mothers were at home when their child was burned but were temporarily distracted. Single mothers living alone were at increased risk of having a child hospitalized for a burn, compared to married couples. There are more childhood bums in families with low maternal education and low family income.

Epidemiological studies reveal that burn injuries and trauma to children occur more often in families that are already more stressed than the general population; particularly single-parent families with little money and lots of children.

Even if stress is not a cause of burn injury, it would increase as a result of the injury. Hospitalization of a child is stressful to any family and distress increases when parents are expected to provide or supervise the daily baths, exercises and wearing of splints.

Psychological distress not only has an emotional impact on the family, but it has also been shown to have a physical reaction on the body. The stress profiles of spouses and parents of patients with bums greater than 20 per cent total body surface area, measuring depression, anxiety and cell-medicated immunity, show that immune function declined as depressive symptoms increased.