Perceptions and experiences of female burn survivors with facial disfigurement

The effect of social appearance anxiety and body perception on the quality of life in burn patients

This study was conducted with a descriptive and cross-sectional design to demonstrate the effect of social appearance anxiety and body perception on quality of life in burn patients. The study was conducted in the intensive care units and burn clinic of Elazığ Fırat University Hospital between 17 February 2022 and 30 April 2022. Data were collected from 94 burn patients using the Personal Information Form, Social Appearance Anxiety Scale, Body-Cathexis Scale and Quality of Life Scale-Short Form. Most participants were 30 years old and under, male, married, had no children and had an education level of high school or below. Most had social security and an income equal to their expenses. They were not uncomfortable with coming to the hospital, and 1-3 months had passed since the burn incident. They did not spend time outside, and most had no part of their bodies that they did not like, while 26.1% did not like their feet. A negative relationship was detected between the Social Appearance Anxiety Scale and Body-Cathexis Scale, and a positive relationship between the total and sub-dimensions of the Quality of Life Scale (p > 0.05). There was a negative relationship between the Body-Cathexis Scale and the Quality of Life Scale total and sub-dimensions (p < 0.05), and a positive relationship between the total and sub-dimensions of the Quality of Life Scale (p < 0.05).

Process of Maintaining Self in Individuals Living With Systemic Sclerosis: A Grounded Theory Study of American Women

BACKGROUND

People with chronic illnesses may struggle to adapt psychologically to the illness experience and have feelings of identity loss, self-diminishment, and biographical disruption. This may limit people's ability to engage in optimal self-management. Systemic sclerosis is a debilitating, stigmatizing, and life-limiting progressive chronic illness with significant disfiguring effects. Little is known about the identity management process in people with disfiguring and debilitating conditions such as systemic sclerosis.

PURPOSE

The purpose of this study was to generate a grounded theory explicating the process of maintaining a sense of self in people living with systemic sclerosis.

METHODS

Fifteen women with systemic sclerosis were recruited to ensure representation of a range of illness duration and progression. Semi-structured interviews were conducted, transcribed, and analyzed using open, selective, and theoretical coding.

RESULTS

A basic social process of "maintaining self" was generated from the data that explained the women's experience of living with systemic sclerosis and how they tried to hold on to their identity. Three core categories were identified. Adapting to changes are the behaviors that participants struggled through to carry on with their everyday lives. Dismantling of self was a distressing internal process where participants lost their sense of self and purpose. Restoring self was a transformative process that allowed participants to rewrite and rebuild their biographies.

CONCLUSIONS

Findings suggest that the management of identity was important for understanding how people adapt to life with systemic sclerosis. This study can help nurses better understand how to support patients holistically with the management of systemic sclerosis.

An Overview of Recent Developments in the Management of Burn Injuries

According to the World Health Organization (WHO), around 11 million people suffer from burns every year, and 180,000 die from them. A burn is a condition in which heat, chemical substances, an electrical current or other factors cause tissue damage. Burns mainly affect the skin, but can also affect deeper tissues such as bones or muscles. When burned, the skin loses its main functions, such as protection from the external environment, pathogens, evaporation and heat loss. Depending on the stage of the burn, the patient's condition and the cause of the burn, we need to choose the most appropriate treatment. Personalization and multidisciplinary collaboration are key to the successful management of burn patients. In this comprehensive review, we have collected and discussed the available treatment options, focusing on recent advances in topical treatments, wound cleansing, dressings, skin grafting, nutrition, pain and scar tissue management.

The Impact of Facial Burns on Short- and Long-Term Quality of Life and Psychological Distress-A Prospective Matched Cohort Study

Burn injuries are a major healthcare challenge worldwide, with up to 50% of all minor burns located on the head and neck. With this study, we sought to describe the effect of facial burns (FB) on health-related quality of life through a prospective and matched cohort study design. Patients completed the 36 Item Short Form (SF-36) and the Hospital Anxiety and Depression Scale (HADS). Results were analyzed based on the distribution of datasets. In total, 55 patients with FB and 55 age-and sex-matched candidates were recruited. The most common mechanism of thermal injury was burns from flames. The FB group scored lower in physical and psychological dimensions than the control group, both acutely and one year after injury. An analysis of each domain showed that subjects in the FB group trended toward improvements in their score after one-year post-burn in physical functioning (acute: 71.0 ± 29.2; one-year: 83.7 ± 23.9; p = 0.02) and bodily pain (acute: 58.5 ± 30.3; one-year: 77.9 ± 30.5; p = 0.01) domains. Additionally, the FB group had significanlyt higher scores for anxiety (FB: 4.8 ± 3.2; control: 2.5 ± 2.8; p = <0.002) and depression (FB: 3.9 ± 3.5; control: 2.1 ± 2.7; p = 0.01) compared to the control. In conclusion, facial burns are associated with physical and psychosocial deficits, as well as elevated levels of psychological distress.

The use of inpatient goal planning in a regional burns centre: A thematic analysis of staff and patient experiences

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.

Towards a better understanding of the social stigma of facial difference

Facial difference (FD) is not only an individual experience; it is inherently social, reflecting interactions between social norms and individual attitudes. Often FD is stigmatized. In this paper, we employ a widely used stigma framework, namely the social stigma framework put forth by Pryor and Reeder (2011), to unpack the stigma of FD. This framework posits that there are four forms of stigma: public stigma, self-stigma, stigma by association, and structural stigma. We first discuss the social and psychological literature on FD as it pertains to these various forms of stigma. We then describe coping approaches for FD stigma. Lastly, we delineate evidence-based methods for addressing the various forms of FD stigma, such that future efforts can more effectively tackle the stigma of facial difference.

Inpatient suicide in psychiatric settings: Evaluation of current prevention measures

The risk of suicide in psychiatric hospitals is 50 times higher than in the general population, despite patient safety being a priority for any hospital. However, to date, due to the complexity of assessing suicide risk, there has been no consensus on the suicide prevention measures that should be in place in hospitals. The aim of this work is: To provide an overview of the progress that has been made in the field of inpatient suicide prevention in recent years; discuss the problems that remain; and suggest potential future developments. As new clinical dimensions (notably anhedonia, psychological pain and hopelessness) develop, they should become new therapeutic targets. Team training (like the Gatekeeper Training Program) and the latest advances in suicide risk assessment (such as the Collaborative Assessment and Management of Suicidality) should be implemented in psychiatric wards. Suicide prevention plans (e.g., ASSIP, SAFE-T, etc.) represent easy-to-administer, low-cost interventions. The Mental Health Environment of Care Checklist has been proven effective to reduce suicide risk at hospitals. Furthermore, the types of psychotherapy recommended to reduce suicide risk are cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT). There are several pharmacological treatments for suicide risk, such as lithium and clozapine, which have been shown to be effective in the long term, as well as ketamine and esketamine, which are more effective in the short term. Following some encouraging recent results, buprenorphine may also be proposed to patients with a suicide risk. Triple chronotherapy rapidly improves depressive symptoms over 9 weeks. Regarding brain stimulation techniques, rTMS has proven to be effective in alleviating multiple dimensions of suicidality.

Emotion Regulation Strategies and Sense of Life Meaning: The Chain-Mediating Role of Gratitude and Subjective Wellbeing

This study aimed to explore the mechanism of college students' meaning of life. The Emotion Regulation Questionnaire, the Gratitude Questionnaire Six-Item Form, the General Wellbeing Schedule, the Meaning in Life Questionnaire were used as measurement instruments. In total, 1,312 valid responses were obtained. The results showed that the cognitive reappraisal and expression suppression strategies were significantly positively and negatively correlated with gratitude, subjective wellbeing, and the sense of life meaning, respectively. Further, Emotion regulation strategies can affect college students' sense of life meaning through three paths: the mediating effect of gratitude; the mediating effect of subjective wellbeing; the chain mediating effect of gratitude and subjective wellbeing. This study illuminated the roles of gratitude, and subjective wellbeing in influencing the sense of life meaning among the Chinese college students. Limitations and future research directions are discussed.

The Work Gratitude Scale: Development and Evaluation of a Multidimensional Measure

This study explores gratitude as a multidimensional and work-specific construct. Utilizing a sample of 625 employees from a variety of positions in a medium-sized school district in the United States, we developed and evaluated a new measure, namely the Work Gratitude Scale (WGS), which encompasses recognized conative (intentional), cognitive, affective, and social aspects of gratitude. A systematic, six-phased approach through structural equation modeling (SEM) was used to explore and confirm the factorial structure, internal consistency, measurement invariance, concurrent, convergent, and discriminant validity of the WGS. The results supported a 10-item measure with three dimensions: "grateful appraisals" (three items), "gratitude toward others" (four items), and "intentional attitude of gratitude" (three items). Thereafter, first-order, second-order, and bifactor confirmatory models were estimated and compared. Work gratitude was found to be best described by a second-order construct with three underlying first-order dimensions. Measurement invariance was supported in relation to gender. Concurrent validity was supported in relation to two existing dispositional gratitude scales, namely the Gratitude Questionnaire and the Gratitude, Resentment, and Appreciation Scale (GRAT). Convergent validity was supported in relation to the Core Self-Evaluations Scale (CSES) and the Psychological Capital Questionnaire. Discriminant validity was supported in relation to various demographic factors such as age, gender, occupation, and tenure. The findings support the WGS as a multidimensional measure that can be used in practice to measure overall work-related gratitude and to track the effectiveness of gratitude-related workplace interventions.

Society, family, and individual characteristics as double-edged swords in the social reintegration of Iranian female survivors from unintentional severe burns: a qualitative study of enablers and barriers

Background

Reintegrating to society is a significant challenge during burn survivors’ rehabilitation.

Aim

This study aims to describe what Iranian female survivors from unintentional severe burns experience as enablers and barriers of social reintegration (SR).

Methods

Fourteen adult female burn survivors whose burns were unintentional participated in this qualitative study. Data were gathered through semi-structured face-to-face or telephone interviews and analyzed using inductive content analysis.

Results

Thirteen subcategories and six categories were emerged. Categories and subcategories of enablers content area were as follows: positive impact of society on SR (normal treatment of society, instrumental support), positive impact of family on SR (magnifying personal abilities assets, empathy and emotional support), and positive impact of personal characteristics on SR (coping with others stares, right to have a normal social life). Categories and subcategories of Barriers content area were as follows: negative impact of society on SR (being questioned in public, incorrect judgment about intent of burns, burns as a contagious disease), negative impact of family on SR (embarrassment of appearing in public with the survivor, family mistrust), and negative impact of intra-personal factors on SR (exaggeration of the post-burn changes, being over-sensitive to the others looks). From the deep interpretation of the data two overarching themes were emerged: “acceptance of the new normal by the society and the individual” and “being encompassed by misconceptions and mistreatments”.

Conclusions

Society, family and the individual characteristics have a dual role to play in the success of social reintegration in Iranian female unintentional burn survivors.