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Katsu A, Mackenzie L, Elliott JM, Mackey M, Tyack Z. Return-to-employment for working-aged adults after burn injury: A mixed methods scoping review. Work 2024:WOR230148. [PMID: 38578910 DOI: 10.3233/wor-230148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND This scoping review aimed to identify the barriers, facilitators and benefits of returning to work following burn injury, outcome measures used, management strategies, and models of care. OBJECTIVE To provide a comprehensive overview about working-aged adults returning to their preinjury employment after burn injury. METHODS We followed a pre-determined scoping review protocol to search MEDLINE, CINAHL, Embase, PsycINFO, PubMed, Scopus, CCRCT and CDSR databases between 2000 to December 2023. Papers reporting primary data from previously employed adults with cutaneous burn injuries were included. RESULTS In all, 90 articles met the review criteria. Return-to-work was both an outcome goal and process of recovery from burn injury. Physical and psychological impairments were identified barriers. Job accommodations and modifications were important for supporting the transition from hospital to workplace. Employment status and quality of life sub-scales were used to measure return-to-work. CONCLUSIONS Consistent definitions of work and measurements of return-to-employment after burn injury are priorities for future research. Longitudinal studies are more likely to capture the complexity of the return-to-employment process, its impact on work participation and changes in employment over time. The social context of work may assist or hinder return-to-work more than physical environmental constraints. Equitable vocational support systems would help address disparities in vocational rehabilitation services available after burn injury.
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Affiliation(s)
- Akane Katsu
- Discipline of Occupational Therapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - James M Elliott
- The Kolling Institute, Northern Sydney Local Health District, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Martin Mackey
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Zephanie Tyack
- Australian Centre for Health Services Innovation (AusHSI), Centre for Healthcare Transformation and School of Public Health and Social Work, Queensland University of Technology, Australia
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Burry E, Collins J, Devey-Burry R. E-learning course for burn care: A proposal. Nursing 2024; 54:18-20. [PMID: 38386445 DOI: 10.1097/01.nurse.0001008484.30360.8d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Affiliation(s)
- Elizabeth Burry
- Elizabeth Burry is an RN on the Medical Surgical Intensive Care Unit at Health Sciences Centre in St. John's, Newfoundland and Labrador, Canada, and both Jennifer Collins and Robin Devey-Burry are assistant professors at Memorial University in Newfoundland and Labrador, Canada
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Katsu A, Mackenzie L, Tyack Z, Mackey M. Understanding return-to-employment experiences after burns: Qualitative scoping review findings. Aust Occup Ther J 2024; 71:113-131. [PMID: 37990624 DOI: 10.1111/1440-1630.12915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/21/2023] [Accepted: 10/25/2023] [Indexed: 11/23/2023]
Abstract
INTRODUCTION Participation in work and employment is a milestone of adulthood. People returning to work after burn injury may have physical, psychological, social, and environmental barriers to overcome in order to resume their pre-injury employment. The aim of this paper is to evaluate qualitative findings regarding return-to-employment after burn injury. METHODS A qualitative synthesis was conducted based on the qualitative findings of an earlier mixed methods review. A pre-determined scoping review protocol was used in the earlier review to search MEDLINE, CINAHL, Embase, PsycINFO, PubMed, Scopus, CCRCT, and CDSR databases between 2000 and Aug 2021. Any papers presenting qualitative data from previously employed adults with cutaneous burn injuries were included. FINDINGS A total of 20 papers with qualitative data on return-to-employment after burn injury were found. Only six included studies focused on return-to-employment outcomes and the remaining studies reporting on quality of life and life experiences after burn injury. Common themes included impairments that develop and change over time; occupational identity and meaning; temporal aspects of burn recovery; burn rehabilitation services and interventions; attitudes, knowledge and support of service providers; workplace environments supporting work re-engagement after burn injury; usefulness of work accommodations; family and social supports, individuals attributes that influence re-engaging in employment; and accepting and rebuilding. CONCLUSION Resumption of work after burn injury is regarded as a key marker of recovery for working-aged adults by burn survivors and burn care professionals. Support at transition points during the burn recovery process and peer-led programmes were important. However, limited information currently exists regarding clinical practices, service gaps, and understanding of return-to-employment outcomes after burn injury.
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Affiliation(s)
- Akane Katsu
- Discipline of Occupational Therapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Zephanie Tyack
- Australian Centre for Health Services Research, Faculty of Health, Queensland University of Technology, QLD, Australia
| | - Martin Mackey
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Mc Kittrick A, Gustafsson L, Hodson T, Di Tommaso A. Exploration of individuals perspectives of recovery following severe hand burn injuries. Burns 2023; 49:467-475. [PMID: 35570111 DOI: 10.1016/j.burns.2022.04.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/21/2022] [Accepted: 04/26/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Burns to one or both hands can impact how a person interacts with the world around them. Research regarding the specific impact of hand burn injuries and the experiences of individuals who have sustained hand burn injuries remains limited. OBJECTIVE The aim of this study was to explore the lived experiences of people with severe hand burn injuries, including their return to daily activities. METHODS This study used an interpretive description approach, incorporating 23 semi-structured interviews with people who had sustained severe hand burn injuries. RESULTS A major theme, "changes over time ", was identified and reflected the progressive nature of the experience over time. This was present in all three sub-themes: physical recovery, activities of daily living recovery, and psychosocial impact. Participants described a dual process of managing the recovery of the burn injury and burn rehabilitation interventions, whilst simultaneously learning to live with their injury and finding ways to engage in their occupations to the best of their abilities. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS The findings of the study suggest that burns recovery could be described in terms of performance rather than impairment and needs to be continuously monitored overtime.
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Affiliation(s)
- Andrea Mc Kittrick
- Department of Occupational Therapy, Royal Brisbane and Women's Hospital, Herston, 4029 QLD, Australia; Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, QLD 4111, Australia.
| | - Louise Gustafsson
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, QLD 4111, Australia; Honorary Associate Professor School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, 4072 QLD Australia
| | - Tenelle Hodson
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, QLD 4111, Australia
| | - Amelia Di Tommaso
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, QLD 4111, Australia
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Watkins H, Hughes O, Jones L, Tate L, Khela MM, Hurrell C. The use of inpatient goal planning in a regional burns centre: A thematic analysis of staff and patient experiences. Burns 2023; 49:100-109. [PMID: 35272925 DOI: 10.1016/j.burns.2022.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 01/25/2022] [Accepted: 02/17/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Rehabilitation from a burn or related injury can be a lengthy and painful process. OBJECTIVES The present study explored the experiences of staff and patients of inpatient goal planning used on a rehabilitation ward within a regional burns centre. DESIGN A qualitative study using semi-structured interviews. SETTING Patients and staff were recruited from The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, South Wales, UK. PARTICIPANTS Twelve participants were recruited and interviewed in two phases. Phase one included six staff members who had been involved in delivering goal planning sessions and phase two included six former inpatients who had participated in goal planning during their rehabilitation in hospital. RESULTS Three main themes were identified for staff: benefits for patients and families, process and structure and challenges of the process. For patients, the three main themes identified were: role of goal planning in rehabilitation, tailoring the programme around the patient and encountering challenges. CONCLUSIONS Findings from the narratives of staff and patients suggest the use of goal planning in inpatient recovery and rehabilitation in a burns centre is very beneficial. Although challenges were reported, this investigation yields potential for goal planning to be a successful rehabilitation strategy.
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Affiliation(s)
- Helen Watkins
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea SA6 6NL, UK.
| | - Olivia Hughes
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea SA6 6NL, UK
| | - Lowri Jones
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea SA6 6NL, UK
| | - Laurie Tate
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea SA6 6NL, UK
| | - Mariam Mouris Khela
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea SA6 6NL, UK
| | - Chloe Hurrell
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea SA6 6NL, UK
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Impact of severe necrotizing fasciitis on quality of life in the Netherlands. Eur J Trauma Emerg Surg 2022; 48:4805-4811. [PMID: 35678866 DOI: 10.1007/s00068-022-02011-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 05/15/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Necrotizing fasciitis (NF) is a severe soft-tissue infection which can leave survivors with big and multiple disfiguring alterations to their bodies, which can negatively affect the lives of patients by causing functional limitations and altered self-perception. In this study we aim to find if NF affect (self-reported) quality of life (QoL) in patients surviving NF. METHODS All patients with (histopathological or surgical confirmed) NF who were admitted to the intensive care unit for 24 h or more between January 2003 and December 2017 in five hospitals from the Nijmegen teaching region were included. Quality of life was measured with the SF-36 and WHOQol-BREF. These results were compared to reference populations from the Netherlands and a Australian reference population. RESULTS 44 out of 60 patients (73.3%) who were contacted returned the surveys and were eligible for analysis. These patients showed lowered levels of quality of life on multiple domains of the SF-36: physical functioning, role limitations due to physical health, vitality and general health. The physical domain of the WHOQol-BREF showed also significant lowered levels of quality of life. CONCLUSION NF is a severe illness with a high morbidity and mortality rate. This study shows that patients who do survive NF have decreased (self-reported) quality of life in multiple domains with a focus on decreased physical functioning. During and after admission realistic expectations should be discussed and there should be more attention to signs of permanent disability. That way extra support by a physiotherapist or social worker can be provided.
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Hammer R, Molembi B, Morgenegg M, Mottet L. [Management of patients with facial burns]. SOINS; LA REVUE DE REFERENCE INFIRMIERE 2021; 66:52-54. [PMID: 34654517 DOI: 10.1016/j.soin.2021.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
People with severe facial burns face a long process of readjustment to social life. Altered body image challenges their identity and daily interactions. The mirror test, in which nurses help patients to look at their wounds, is a key step in the care given by carers, but also in the transition from the hospital world to the social world.
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Affiliation(s)
- Raphaël Hammer
- Haute École de santé Vaud, avenue de Beaumont 21, 1011 Lausanne, Suisse; Haute École spécialisée de Suisse occidentale, rue de la Jeunesse 1, 2800 Delémont, Suisse.
| | - Brandi Molembi
- Centre hospitalier universitaire vaudois, rue du Bugnon 46, 1011 Lausanne, Suisse
| | - Marie Morgenegg
- Centre hospitalier universitaire vaudois, rue du Bugnon 46, 1011 Lausanne, Suisse
| | - Louise Mottet
- Centre hospitalier universitaire vaudois, rue du Bugnon 46, 1011 Lausanne, Suisse
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Bayuo J, Wong FKY. Intervention Content and Outcomes of Postdischarge Rehabilitation Programs for Adults Surviving Major Burns: A Systematic Scoping Review. J Burn Care Res 2021; 42:651-710. [PMID: 32608488 DOI: 10.1093/jbcr/iraa110] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Improvement in burn care has led to more patients surviving the injury but has also led to more burn survivors requiring rehabilitation for a protracted period after discharge. Thus, this review sought to map the intervention content and outcomes associated with existing postdischarge rehabilitation programs for adults surviving major burns. A systematic scoping review approach was utilized. The Template for Intervention Description and Replication (TIDieR) and core outcome set for adult burn survivors were used to guide data extraction following which a narrative synthesis was undertaken. In all, 23 papers were retained in the review. Following discharge and up to 1 year postburn, the components of the rehabilitation programs comprised of physical, psychological, and social components. Beyond 1 year postburn, the rehabilitation programs demonstrated a preponderance of physical therapies. Support for family members was not highlighted in the included studies. Outcomes of rehabilitation programs up to 1 year postburn covered the seven core outcome domains. Outcomes associated with rehabilitation programs beyond 1 year postburn were, however, limited to the perceived quality of life, neuromuscular, and physical role functioning domains. Although most studies reported statistically significant findings, the outcome measures varied across studies which makes it difficult to draw overarching conclusions. The findings suggest that long-term rehabilitation programs for adult burn survivors are lacking. More robust studies are also needed to examine community participation outcomes associated with burns rehabilitation programs. The nature of burns and its far-reaching consequences suggest a patient- and family-centered approach to rehabilitation.
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Affiliation(s)
- Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong
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Dukes K, Baldwin S, Hagedorn J, Ruba E, Christel K, Assimacopoulos E, Grieve B, Wibbenmeyer LA. "More than Scabs and Stitches": An Interview Study of Burn Survivors' Perspectives on Treatment and Recovery. J Burn Care Res 2021; 43:214-218. [PMID: 33895838 DOI: 10.1093/jbcr/irab062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Sustaining a burn injury often results in a life-long recovery process. Survivors are impacted by changes in their mobility, appearance, and ability to carry out activities of daily living. In this study, we examined survivors' accounts of their treatment and recovery in order to identify specific factors that have had significant impacts on their well-being. With this knowledge, we may be better equipped to optimize the care of burn patients. We conducted inductive, thematic analysis on transcripts of in-depth, semi-structured interviews with 11 burn survivors. Participants were purposefully selected for variability in age, gender, injury size and mechanism, participation in peer support, and rurality. Survivors reported varied perceptions of care quality and provider relationships. Ongoing issues with skin and mobility continued to impact their activities of daily living. Many survivors reported that they did not have a clear understanding or realistic expectations of the recovery process. Wound care was often described as overwhelming and provoked fear for many. Even years later, trauma from burn injury can continue to evolve, creating fears and impediments to daily living for survivors. To help patients understand the realistic course of recovery, providers should focus on communicating the nature of injury and anticipated recovery, developing protocols to better identify survivors facing barriers to care, and referring survivors for further support.
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Affiliation(s)
- Kimberly Dukes
- University of Iowa Carver College of Medicine, Hawkins Dr, Iowa City, IA, USA.,Iowa City Veterans Affairs Health Care System, W Suite, VAMC, Iowa City, IA, USA
| | - Stephanie Baldwin
- University of Iowa Carver College of Medicine, Hawkins Dr, Iowa City, IA, USA.,MercyOne Medical Center - North Iowa, Mason City, IA
| | - Joshua Hagedorn
- University of Iowa Carver College of Medicine, Hawkins Dr, Iowa City, IA, USA
| | - Emily Ruba
- University of Iowa Carver College of Medicine, Hawkins Dr, Iowa City, IA, USA
| | - Katherine Christel
- University of Iowa Carver College of Medicine, Hawkins Dr, Iowa City, IA, USA
| | - Evangelia Assimacopoulos
- University of Iowa Carver College of Medicine, Hawkins Dr, Iowa City, IA, USA.,Department of Emergency Medicine, University of Iowa Hospitals and Clinics, Hawkins Dr, Iowa City, IA, USA
| | - Brian Grieve
- University of Iowa Carver College of Medicine, Hawkins Dr, Iowa City, IA, USA
| | - Lucy A Wibbenmeyer
- University of Iowa Carver College of Medicine, Hawkins Dr, Iowa City, IA, USA.,Department of Surgery, University of Iowa Hospitals and Clinics, Hawkins Dr, Iowa City, IA, USA
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Bayuo J, Bristowe K, Harding R, Agbeko AE, Baffour PK, Agyei FB, Wong FKY, Allotey G, Agbenorku P, Hoyte-Williams PE. "Managing uncertainty": Experiences of family members of burn patients from injury occurrence to the end-of-life period. Burns 2021; 47:1647-1655. [PMID: 33832797 DOI: 10.1016/j.burns.2021.02.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 01/14/2021] [Accepted: 02/03/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although mortality rates associated with burns have decreased, there is still a significant number of persons who may not survive severe forms of the injury and thus, undergo comfort/end of life care. The experiences of family members of persons whose injuries are deemed unsurvivable remain minimally explored and there is a general lack of practice guidelines and recommendations to support them at the end-of-life period. AIM To explore the experiences of family members whose relatives died in the burn unit to inform the development of practice recommendations. METHODS Qualitative description was employed for this study. Convenience sampling was used to recruit 23 family members of injured persons who died in the burn unit. Face to face semi-structured interviews were conducted and followed up with telephone interviews. The interviews were audio-recorded, transcribed verbatim and thematic analysis performed inductively. RESULTS Three themes emerged: reactions following injury occurrence, navigating through the experience, and managing uncertainties about survival. The sudden nature of the injury led to feelings of self-blame, guilt, helplessness, and grief and these escalated at the end of life. As the family members journeyed through their uncertainties regarding the outcomes of care, they had a feeling of being a part of the patient's suffering. Family members received little professional support in coming to terms with their loss in the post-bereavement period. CONCLUSIONS Family members experience distress following the occurrence of burns and at the endof-life period. Practice recommendations should focus on communication, bereavement, and post-bereavement support.
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Affiliation(s)
- Jonathan Bayuo
- Department of Nursing, Faculty of Health and Medical Sciences, Presbyterian University College, Ghana; School of Nursing, The Hong Kong Polytechnic University, Hong Kong, PR China.
| | - Katherine Bristowe
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, Kings College, London, United Kingdom
| | - Richard Harding
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, Kings College, London, United Kingdom
| | | | - Prince Kyei Baffour
- Burns Intensive Care Unit, Plastics and Reconstructive Surgical Unit, Directorate of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Frank Bediako Agyei
- Department of Nursing, Faculty of Health and Medical Sciences, Presbyterian University College, Ghana
| | | | - Gabriel Allotey
- Burns Intensive Care Unit, Plastics and Reconstructive Surgical Unit, Directorate of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Pius Agbenorku
- Plastics, Burns and Reconstructive Surgical Division, Directorate of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana; School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Paa Ekow Hoyte-Williams
- Plastics, Burns and Reconstructive Surgical Division, Directorate of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana
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Mathers J, Moiemen N, Bamford A, Gardiner F, Tarver J. Ensuring that the outcome domains proposed for use in burns research are relevant to adult burn patients: a systematic review of qualitative research evidence. BURNS & TRAUMA 2020; 8:tkaa030. [PMID: 33163540 PMCID: PMC7603423 DOI: 10.1093/burnst/tkaa030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 12/31/2019] [Indexed: 11/13/2022]
Abstract
Background There have been several attempts to define core outcome domains for use in research focused on adult burns. Some have been based in expert opinion, whilst others have used primary qualitative research to understand patients' perspectives on outcomes. To date there has not been a systematic review of qualitative research in burns to identify a comprehensive list of patient-centred outcome domains. We therefore conducted a systematic review of qualitative research studies in adult burns. Methods We searched multiple databases for English-language, peer-reviewed, qualitative research papers. We used search strategies devised using the SPIDER tool for qualitative synthesis. Our review utilized an iterative three-step approach: (1) outcome-focused coding; (2) development of descriptive accounts of outcome-relevant issues; and (3) revisiting studies and the broader theoretical literature in order to frame the review findings. Results Forty-one articles were included. We categorized papers according to their primary focus. The category with the most papers was adaptation to life following burn injury (n = 13). We defined 19 outcome domains across the 41 articles: (1) sense of self; (2) emotional and psychological morbidity; (3) sensory; (4) scarring and scar characteristics; (5) impact on relationships; (6) mobility and range of joint motion; (7) work; (8) activities of daily living and self-care; (9) treatment burden; (10) engagement in activities; (11) wound healing and infection; (12) other physical manifestations; (13) financial impact; (14) impact on spouses and family members; (15) analgesia and side effects; (16) cognitive skills; (17) length of hospital stay; (18) access to healthcare; and (19) speech and communication. We suggest that sense of self is a core concern for patients that, to date, has not been clearly conceptualized in the burns outcome domain literature. Conclusions This outcome domain framework identifies domains that are not covered in previous attempts to outline core outcome domains for adult burn research. It does so with reference to existing theoretical perspectives from the sociology and psychology of medicine. We propose that this framework can be used as a basis to ensure that outcome assessment is patient-centred. Sense of self requires further consideration as a core outcome domain.
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Affiliation(s)
- Jonathan Mathers
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - Naiem Moiemen
- The Scar Free Foundation Centre for Burns Research, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK
| | - Amy Bamford
- The Scar Free Foundation Centre for Burns Research, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK
| | - Fay Gardiner
- The Scar Free Foundation Centre for Burns Research, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK
| | - Joanne Tarver
- School of Life & Health Sciences, Aston University, Aston Triangle, Birmingham, B4 7ET, UK
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Wang Y, Ke Z, He Z, Chen X, Zhang Y, Xie P, Li T, Zhou J, Li F, Yang C, Zhang P, Huang C, Kai L. Real-time burn depth assessment using artificial networks: a large-scale, multicentre study. Burns 2020; 46:1829-1838. [PMID: 32826097 DOI: 10.1016/j.burns.2020.07.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 07/15/2020] [Accepted: 07/15/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Early judgment of the depth of burns is very important for the accurate formulation of treatment plans. In medical imaging the application of Artificial Intelligence has the potential for serving as a very experienced assistant to improve early clinical diagnosis. Due to lack of large volume of a particular feature, there has been almost no progress in burn field. METHODS 484 early wound images are collected on patients who discharged home after a burn injury in 48 h, from five different levels of hospitals in Hunan Province China. According to actual healing time, all images are manually annotated by five professional burn surgeons and divided into three sets which are shallow(0-10 days), moderate(11-20 days) and deep(more than 21 days or skin graft healing). These ROIs were further divided into 5637 patches sizes 224 × 224 pixels, of which 1733 shallow, 1804 moderate, and 2100 deep. We used transfer learning suing a Pre-trained ResNet50 model and the ratio of all images is 7:1.5:1.5 for training:validation:test. RESULTS A novel artificial burn depth recognition model based on convolutional neural network was established and the diagnostic accuracy of the three types of burns is about 80%. DISCUSSION The actual healing time can be used to deduce the depth of burn involvement. The artificial burn depth recognition model can accurately infer healing time and burn depth of the patient, which is expected to be used for auxiliary diagnosis improvement.
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Affiliation(s)
- Yuan Wang
- College of Computer Science and Technology, National Defense University of Science and Technology, Changsha, Hunan, China
| | - Zuo Ke
- College of Computer Science and Technology, National Defense University of Science and Technology, Changsha, Hunan, China
| | - Zhiyou He
- Department of Burns and Reconstructive Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Xiang Chen
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Human Engineering Research Center of Skin Health and Disease, Changsha, Hunan, China; Department of Dermatology Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Yu Zhang
- Department of Dermatology Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Peizhen Xie
- College of Computer Science and Technology, National Defense University of Science and Technology, Changsha, Hunan, China
| | - Tao Li
- College of Computer Science and Technology, National Defense University of Science and Technology, Changsha, Hunan, China
| | - Jiao Zhou
- College of Computer Science and Technology, National Defense University of Science and Technology, Changsha, Hunan, China
| | - Fangfang Li
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Human Engineering Research Center of Skin Health and Disease, Changsha, Hunan, China; Department of Dermatology Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Canqun Yang
- College of Computer Science and Technology, National Defense University of Science and Technology, Changsha, Hunan, China
| | - Pihong Zhang
- Department of Burns and Reconstructive Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Chun Huang
- College of Computer Science and Technology, National Defense University of Science and Technology, Changsha, Hunan, China
| | - Lu Kai
- College of Computer Science and Technology, National Defense University of Science and Technology, Changsha, Hunan, China
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Bayuo J, Wong FKY, Agyei FB. "On the Recovery Journey:" An Integrative Review of the Needs of Burn Patients From Immediate Pre-Discharge to Post-Discharge Period Using the Omaha System. J Nurs Scholarsh 2020; 52:360-368. [PMID: 32445507 DOI: 10.1111/jnu.12563] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND To establish a conceptual understanding of the needs of burn patients, the specific research question asked is: "What are the needs of burn patients from 1-week pre-discharge to the post-discharge period?" METHODS Whittemore and Knafl's integrative review approach was used to answer the review question. The databases searched were the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, Embase, and Scopus. Thirty-two primary studies were retained at the end of the screening process. Directed content analysis was undertaken, with the Omaha system as an organizing framework. RESULTS Recovery after burns is not a linear process, but an intricate one filled with varied needs in the physiological (pain, skin, neuro-musculo-skeletal, and infection), psychosocial (social contact, role changes, spirituality, grief, mental health, and sexuality), health-related behavior (nutrition, sleep and rest patterns, and physical activity), and environmental (income) domains of the Omaha system. The nature and intensity of these needs change over time, suggesting that recovery for the burn patient is an ongoing process. CONCLUSIONS Several needs exist from 1 week before discharge to the post-discharge period. The mutual relationship and evolving nature of these needs create an avenue for a flexible, regular, holistic transitional program, similar to the support offered to persons living with chronic conditions. CLINICAL RELEVANCE Hospital discharge does not imply an end to the recovery of burn patients, and burn survivors still require holistic care even after discharge. The review shows the applicability of the Omaha system in exploring and classifying the needs of burn survivors and situates nursing at the core of such a program. It is possible that a nurse-led program of care needs to be considered.
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Affiliation(s)
- Jonathan Bayuo
- PhD Candidate, School of Nursing, The Hong Kong Polytechnic University, Hong Kong
| | | | - Frank Bediako Agyei
- Lecturer, Department of Nursing, Faculty of Health and Medical Sciences, Presbyterian University College, Agogo, Ghana
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Bayuo J, Wong FKY. Issues and concerns of family members of burn patients: A scoping review. Burns 2020; 47:503-524. [PMID: 32534893 DOI: 10.1016/j.burns.2020.04.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 02/24/2020] [Accepted: 04/23/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The issues and concerns that emerge in the families of burn patients have received minimal attention. OBJECTIVE To map out what is known about the challenges facing the family members of burn patients. METHODS The review followed the PRISMA Extension guidelines for scoping reviews and the review approach by Arksey and O'Malley to synthesize the available evidence. Twenty-six (26) papers from various database searches were identified and included in the review. The citation retrieval and retention methods are reported in a PRISMA statement. RESULTS Although most of the studies included parents (n=21), the evidence suggests that the shared concerns of family members include taking on new roles, and psychosocial and financial issues. Uniquely, parents had to endure blame, shame and guilt; partners/spouses were faced with difficulties in re-establishing an emotional connection with the patient; siblings simultaneously expressed jealousy and feelings of being outsiders; and children with a burn parent had to deal with feelings of exclusion from the care delivery process. Aside from these individuals, friends, neighbours and in-laws may also assume a caregiving role, with grandparents playing a supporting role. Family members are unprepared for their roles, as they are forced into them suddenly. Although distress may occur among family members, its determinants, severity, pattern and recovery process remain unclear. CONCLUSION A burn is a family injury that creates the need for family-centred care. Future studies need to explore the nature of psychological distress, family members' recovery pathways, and how family members can prepare for their roles in the period after discharge.
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Affiliation(s)
- Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong
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15
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Bayuo J, Bristowe K, Harding R, Agyei FB, Agbeko AE, Agbenorku P, Baffour PK, Allotey G, Hoyte-Williams PE. The Role of Palliative Care in Burns: A Scoping Review. J Pain Symptom Manage 2020; 59:1089-1108. [PMID: 31733355 DOI: 10.1016/j.jpainsymman.2019.11.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 11/06/2019] [Accepted: 11/06/2019] [Indexed: 12/25/2022]
Abstract
CONTEXT Patients with severe burns may face distressing symptoms with a high risk of mortality as a result of their injury. The role of palliative care in burns management remains unclear. OBJECTIVE To appraise the literature on the role of palliative care in burns management. METHODS We used scoping review with searches in 12 databases from their inception to August 2019. The citation retrieval and retention are reported in a PRISMA statement. FINDINGS 39 papers comprising of 30 primary studies (26 from high-income and four from middle-income countries), four reviews, two editorials, two guidelines, and one expert board review document were retained in the review. Palliative care is used synonymously with comfort and end-of-life care in burns literature. Comfort care is mostly initiated when active treatment is withheld (early deaths) or withdrawn (late deaths), limiting its overall benefits to burn patients, their families, and health care professionals. Futility decisions are usually complex and challenging, particularly for patients in the late death category, and it is unclear if these decisions result in timely commencement of comfort care measures. Three comfort care pathways were identified, but it remained unclear how these pathways evaluated "good death" or supported the family which creates the need for the development of other evidence-based guidelines. CONCLUSION Palliative care is applicable in burns management, but its current role is mostly confined to the end-of-life period, suggesting that it is not been fully integrated in the management process. Evidence-based guidelines are needed to support the integration and delivery of palliative care in the burn patient population.
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Affiliation(s)
- Jonathan Bayuo
- Department of Nursing, Faculty of Health and Medical Sciences, Presbyterian University College, Agogo, Ghana; School of Nursing, The Hong Kong Polytechnic University, Hong Kong.
| | - Katherine Bristowe
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, Kings College, London, United Kingdom
| | - Richard Harding
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, Kings College, London, United Kingdom
| | - Frank Bediako Agyei
- Department of Nursing, Faculty of Health and Medical Sciences, Presbyterian University College, Agogo, Ghana
| | | | - Pius Agbenorku
- School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Plastics, Burns and Reconstructive Surgical Division, Directorate of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Prince Kyei Baffour
- Burns Intensive Care Unit, Plastics and Reconstructive Surgical Unit, Directorate of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Gabriel Allotey
- Burns Intensive Care Unit, Plastics and Reconstructive Surgical Unit, Directorate of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Paa Ekow Hoyte-Williams
- Plastics, Burns and Reconstructive Surgical Division, Directorate of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana
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Rivas E, Tran J, Gutierrez IL, Chapa M, Herndon DN, Suman OE. Rehabilitation Exercise Increases Physical Activity Levels in Severely Burned Children While Improving Aerobic Exercise Capacity and Strength. J Burn Care Res 2020; 39:881-886. [PMID: 29596597 DOI: 10.1093/jbcr/irx045] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
This study tested the hypothesis that participation in a rehabilitation exercise program following hospital discharge would increase the level of physical activity in burned children than that seen in free-living nonburned children. Thirty-one severely burned children (12 ± 3 years, 144 ± 18 cm, 42 ± 17 kg, 48 ± 12% TBSA burns) were matched to 31 nonburned children (12 ± 3 y, 147 ± 17 cm, 45 ± 15 kg) based on age and sex. Pedometers were used to track minutes and steps in burned children during their exercise rehabilitation and nonburned children under free-living conditions (healthy control). We found that the average minutes of activity per day was lower in burned children (56 ± 25minutes) than in nonburned children (74 ± 28 minutes, P < .05). However, no difference was detected for average steps per day or week or maximal minutes in 1 day or week. At discharge, burn children had peak torque and mean power values that were 61% of nonburned values, and exercise training improved these by 27 and 28%, respectively (88 and 89% of nonburned values; each P ≤ .0001). Likewise, cardiorespiratory fitness at discharge was 72% of nonburned values, and exercise training improved fitness by 10% (82% of nonburned values, P < .05). Percentage TBSA burned was inversely associated with steps (r = -0.54, P = .001) and minutes of activity (r = -0.53, P = .002), accounting for 28-29% of the variability in burned children. These results show that, at discharge, burned children are capable of matching steps of physical activity levels seen in nonburned healthy children. Physical activity monitoring may be a viable option for continued improvement of physical exercise capacity when burned children are under free-living conditions.
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Affiliation(s)
- Eric Rivas
- Shriners Hospitals for Children, Galveston, TX.,Department of Surgery, University of Texas Medical Branch, Galveston.,Department of Kinesiology and Sport Management, Texas Tech University, Lubbock
| | - Joan Tran
- Shriners Hospitals for Children, Galveston, TX.,Department of Surgery, University of Texas Medical Branch, Galveston
| | | | - Martha Chapa
- Shriners Hospitals for Children, Galveston, TX.,Department of Surgery, University of Texas Medical Branch, Galveston
| | - David N Herndon
- Shriners Hospitals for Children, Galveston, TX.,Department of Surgery, University of Texas Medical Branch, Galveston
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Hsu KC, Chen YC, Chen LF, Lu HF. The Formosa Fun Coast water park dust explosion accident: Three-year cohort study to track changes and analyze the influencing factors of burn survivors’ quality of life. Burns 2019; 45:1923-1933. [DOI: 10.1016/j.burns.2019.07.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 05/29/2019] [Accepted: 07/10/2019] [Indexed: 10/26/2022]
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18
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Gauffin E, Öster C. Patient perception of long-term burn-specific health and congruence with the Burn Specific Health Scale-Brief. Burns 2019; 45:1833-1840. [DOI: 10.1016/j.burns.2018.12.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 12/19/2018] [Accepted: 12/22/2018] [Indexed: 12/24/2022]
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19
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Cimino SR, Rios JN, Godleski M, Hitzig SL. A Scoping Review on the Long-Term Outcomes in Persons with Adult-Acquired Burn Injuries. J Burn Care Res 2019; 41:472-502. [DOI: 10.1093/jbcr/irz146] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Abstract
Adult-acquired burn injuries are a life-altering event that can lead to debilitating functional or psychological impairments. With advancements in health care resulting in decreased mortality rates, survivors of burn injuries can expect to live longer. This warrants a shift in focus to better understand what happens to adults once they are discharged from the hospital into the community. Therefore, the purpose of this scoping review was to map the literature regarding the long-term outcomes of community-dwelling adult-acquired burn survivors. A computer-assisted literature search was conducted on literature from January 1, 2000 to August 31, 2018 utilizing four large databases (MEDLINE, EMBASE, CINHAL, and PsycINFO). Articles were included if they had a minimum of five individuals with a burn injury as a result of an accidental injury who were at least 18 years of age at the time of injury. Fifty-four articles were found suitable for inclusion in this review. The majority of studies were conducted in the United States and were longitudinal in design. Four themes were apparent from the articles: postburn complications, psychosocial outcomes, quality of life, and community participation. Data are lacking with respect to outcomes more than 5 years postburn as well as qualitative research. Furthermore, more literature is needed to understand the impact of postburn complications, coping strategies, and posttraumatic growth as well as barriers to community participation. Overall, there is an emerging body of literature that describes the long-term outcomes of adult-acquired burn survivors up to 5 years postburn.
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Affiliation(s)
- Stephanie R Cimino
- St. John’s Rehab, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Jorge N Rios
- St. John’s Rehab, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Matthew Godleski
- St. John’s Rehab, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sander L Hitzig
- St. John’s Rehab, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Dai A, Moore M, Polyakovsky A, Gooding T, Lerew T, Carrougher GJ, Gibran NS, Pham TN. Burn Patients' Perceptions of Their Care: What Can We Learn From Postdischarge Satisfaction Surveys? J Burn Care Res 2019; 40:202-210. [PMID: 30239737 DOI: 10.1093/jbcr/iry018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Little is understood about the inpatient experience from the burn patients' perspectives. Rather, hospitals emphasize quantitative feedback as part of the ongoing process improvement. Comments returned with the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) administrative survey may provide important patient perspectives. They analyzed quantitative and qualitative HCAHPS data to identify areas for care improvement. They reviewed our burn center HCAHPS results over 2 years. They analyzed "top-box" result in each defined HCAHPS category, which is the most frequently reported best result in each composite, including survey scores ≥9 (out of 10). They performed qualitative content analysis of open-text responses via a HIPAA-compliant analysis software. They developed a hierarchy of major expressed themes and organized them using HCAHPS-validated satisfaction domains. A total of 610 inpatient HCAHPS surveys (21% response rate) were returned. Seventy-five percent of respondents ranked their burn center as ≥9 (out of 10) in care scores. Content analysis identified three main components of the inpatient experience: 1) provider/nurse communication, 2) hospital environment, and 3) the discharge experience. Caring, respect, handoff coordination, explanations, listening, and confidence in provider constituted the six key communication themes. Patients generally reported that burn providers listened to their concerns, but others requested clearer explanations of their condition and care. Responses about hospital environment highlighted excessive noise and disrupted sleep, and variable responses related to cleanliness. Challenges in the discharge experience included difficulties procuring wound care supplies and discharge medications. Qualitative data from HCAHPS helped identify major target areas for burn center performance improvement. Analysis of HCAHPS direct patient feedback is useful in process improvement, whereas numerical data alone do not provide sufficient actionable information.
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Affiliation(s)
- Andrea Dai
- Department of Surgery, University of Washington Medicine, UW Medicine Regional Burn Center, Seattle, Washington
| | - Megan Moore
- Department of Surgery, University of Washington Medicine, UW Medicine Regional Burn Center, Seattle, Washington
| | - Anna Polyakovsky
- Department of Surgery, University of Washington Medicine, UW Medicine Regional Burn Center, Seattle, Washington
| | - Tracy Gooding
- Department of Surgery, University of Washington Medicine, UW Medicine Regional Burn Center, Seattle, Washington
| | - Tara Lerew
- Department of Surgery, University of Washington Medicine, UW Medicine Regional Burn Center, Seattle, Washington
| | - Gretchen J Carrougher
- Department of Surgery, University of Washington Medicine, UW Medicine Regional Burn Center, Seattle, Washington
| | - Nicole S Gibran
- Department of Surgery, University of Washington Medicine, UW Medicine Regional Burn Center, Seattle, Washington
| | - Tam N Pham
- Department of Surgery, University of Washington Medicine, UW Medicine Regional Burn Center, Seattle, Washington
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21
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Cleary M, Visentin DC, West S, Andrews S, McLean L, Kornhaber R. Bringing research to the bedside: Knowledge translation in the mental health care of burns patients. Int J Ment Health Nurs 2018; 27:1869-1876. [PMID: 29799653 DOI: 10.1111/inm.12491] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/05/2018] [Indexed: 11/26/2022]
Abstract
Advances in surgical techniques and wound management have improved outcomes for burn patients; however, the psychological impacts on burn survivors have had less attention. There is a higher rate of mental health disorders amongst burns victims, with those with pre-existing mental health conditions likely to have worse outcomes. To implement effective burns care and rehabilitation, knowledge and understanding of mental health issues is required. This position paper discusses the extent to which clinicians currently translate knowledge around mental health and burns into practice to identify enables and inhibitors. Successful knowledge translation requires dissemination and accessibility of information with the capacity and readiness for change. Clinicians and researchers need to identify how translating research to practice can meet the needs of burn survivors. There is a gap in the utilization of evidence concerning mental health and the needs of burns survivors, and we need to understand what we know as compared to what we do. Clinicians are well placed to determine how and why knowledge does not necessarily translate to practice and how they can better accommodate the needs of burn survivors.
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Affiliation(s)
- Michelle Cleary
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Sydney, New South Wales, Australia
| | - Denis C Visentin
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Sydney, New South Wales, Australia
| | - Sancia West
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Sydney, New South Wales, Australia
| | - Sharon Andrews
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Sydney, New South Wales, Australia
| | - Loyola McLean
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Westmead Psychotherapy Program, Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Sydney West and Greater Southern Psychiatry Training Network, Cumberland Hospital, Western Sydney Local Health District, Sydney, New South Wales, Australia.,Consultation-Liaison Psychiatry, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Rachel Kornhaber
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Sydney, New South Wales, Australia
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Kool MB, Geenen R, Egberts MR, Wanders H, Van Loey NE. Patients' perspectives on quality of life after burn. Burns 2017; 43:747-756. [PMID: 28069345 DOI: 10.1016/j.burns.2016.11.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 11/21/2016] [Accepted: 11/29/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND The concept quality of life (QOL) refers to both health-related outcomes and one's skills to reach these outcomes, which is not yet incorporated in the burn-related QOL conceptualisation. The aim of this study was to obtain a comprehensive overview of relevant burn-specific domains of QOL from the patient's perspective and to determine its hierarchical structure. METHODS Concept mapping was used comprising a focus group (n=6), interviews (n=25), and a card-sorting task (n=24) in burn survivors. Participants sorted aspects of QOL based on content similarity after which hierarchical cluster analysis was used to determine the hierarchical structure of burn-related QOL. RESULTS Ninety-nine aspects of burn-related QOL were selected from the interviews, written on cards, and sorted. The hierarchical structure of burn-related QOL showed a core distinction between resilience and vulnerability. Resilience comprised the domains positive coping and social sharing. Vulnerability included 5 domains subdivided in 13 subdomains: the psychological domain included trauma-related symptoms, cognitive symptoms, negative emotions, body perception and depressive mood; the economical domain comprised finance and work; the social domain included stigmatisation/invalidation; the physical domain comprised somatic symptoms, scars, and functional limitations; and the intimate/sexual domain comprised the relationship with partner, and anxiety/avoidance in sexual life. CONCLUSION From the patient's perspective, QOL following burns includes a variety of vulnerability and resilience factors, which forms a fresh basis for the development of a screening instrument. Whereas some factors are well known, this study also revealed overlooked problem and resilience areas that could be considered in client-centred clinical practice in order to customize self-management support.
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Affiliation(s)
- Marianne B Kool
- Association of Dutch Burn Centres, Postbus 1015, 1940 EA Beverwijk, The Netherlands; Utrecht University, Department of Psychology, Heidelberglaan 1, 3508 TC Utrecht, The Netherlands.
| | - Rinie Geenen
- Utrecht University, Department of Psychology, Heidelberglaan 1, 3508 TC Utrecht, The Netherlands
| | - Marthe R Egberts
- Association of Dutch Burn Centres, Postbus 1015, 1940 EA Beverwijk, The Netherlands; Utrecht University, Department of Psychology, Heidelberglaan 1, 3508 TC Utrecht, The Netherlands
| | - Hendriët Wanders
- Dutch Association of Burn Survivors, Postbus 1015, 1940 EA Beverwijk, The Netherlands
| | - Nancy E Van Loey
- Association of Dutch Burn Centres, Postbus 1015, 1940 EA Beverwijk, The Netherlands; Utrecht University, Department of Psychology, Heidelberglaan 1, 3508 TC Utrecht, The Netherlands
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