1
|
Daltveit S, Kleppe L, Petterteig MO, Moi AL. Photographs in burn patient diaries: A qualitative study of patients' and nurses' experiences. Intensive Crit Care Nurs 2024; 82:103619. [PMID: 38185023 DOI: 10.1016/j.iccn.2023.103619] [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: 07/25/2023] [Revised: 12/19/2023] [Accepted: 12/22/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE To explore burn patients' and burn intensive care nurses' experiences of the photos in patient diaries. DESIGN A qualitative inductive study using thematic analysis was performed. We conducted individual interviews with six former burn patients (age range 20-77 years; four women), and two focus groups with 11 burn intensive care nurses (age range 38-61 years; all women). Data from patients and nurses were analysed together, and the findings reported according to the consolidated criteria for reporting qualitative research (COREQ). SETTING A Norwegian burn centre where the writing of diaries including text and photos has been practiced for approximately two decades. FINDINGS Three main themes were derived from the combined analysis of the two data sets: hesitating when facing photos; visualising others care; and visualising the trajectory from burn trauma to recovery. Although the patients worried beforehand about what they would see in the photos and the nurses feared to select frightening photos, the photos were welcome, and several patients said they would have liked even more. The photos filled in gaps of memory, told more than words, and did not lie. Photos of family, friends or staff demonstrated shared actions that supported memories and recovery. CONCLUSION Both the burn patients and the burn intensive care nurses considered photos to be an essential part of the diary that gave context and provided a factual presentation of the patients' pathway of treatment, care and recovery. IMPLICATION FOR CLINICAL PRACTICE Tailored information about photo content should be offered to patients before a diary is handed over to them. Nurses should attempt to include photos covering the patients' entire stay at the burn centre, as well as photos of family, friends and staff. Individual nurses should be supported in their practical selection of photos for the diary.
Collapse
Affiliation(s)
- Siri Daltveit
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, 5063 Bergen, Norway.
| | - Lena Kleppe
- Department of Plastic, Hand and Reconstructive Surgery, National Burn Centre, Haukeland University Hospital, PO Box 1400, 5021 Bergen, Norway
| | - Marie Opsanger Petterteig
- Department of Anaesthesia and Intensive Care, Haukeland University Hospital, PO Box 1400, 5021 Bergen, Norway
| | - Asgjerd Litleré Moi
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, 5063 Bergen, Norway; Department of Plastic, Hand and Reconstructive Surgery, National Burn Centre, Haukeland University Hospital, PO Box 1400, 5021 Bergen, Norway; Faculty of Health Sciences, VID Specialized University, Ulriksdal 10, 5009 Bergen, Norway
| |
Collapse
|
2
|
Murray SJ, Cancio LC. The Phenomenon of Community Reintegration for Veterans with Burn Injury: Supportive Communities and Future-Oriented Thinking. J Burn Care Res 2023; 44:555-562. [PMID: 31808802 DOI: 10.1093/jbcr/irz198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Indexed: 11/14/2022]
Abstract
Combat missions in the Middle East have resulted in approximately 52,000 U.S. veterans who have been wounded in action, with 10% of whom suffered burn injuries. More than 90% of the wounded survived, but many were unable to return to military service. The purpose of this study was to investigate the factors that impacted reintegration of veterans with combat burn injuries. Using a mixed-methods approach and analysis, we asked veterans with combat burns "What was your experience reintegrating into the civilian community?" Additionally, we administered the Community Reintegration of Injured Service Members (CRIS) tool to measure the current level of reintegration. Six veterans with combat burn injury identified two major themes: supportive communities and future-oriented thinking. Supportive communities are defined as communities that are veteran-specific, provide long-term burn/injury care, are financially beneficial, and support hobbies, education, and work opportunities. Future-oriented thinking is defined as thinking in which a veteran experiences a turning point in recovery, has a desire to serve others, develops new meaning in life, and experiences posttraumatic growth. In both themes, peer support was a key component. Community reintegration was enhanced by future-oriented thinking and a supportive community, both of which can be buoyed by peer support. These findings are similar to other studies noting the importance of peer support for veterans. Studies of civilians burn survivors describe similar reintegration issues. These two factors may also be applicable to those survivors. Further qualitative inquiry into peer support in the burn community at large may reveal more actionable evidence which could enable burn survivors to meet the long-term goal of community reintegration.
Collapse
Affiliation(s)
- Sarah J Murray
- US Army Institute of Surgical Research Burn Center, 3698 Chambers Pass, JBSA Fort Sam Houston, TX 78234-6315
| | - Leopoldo C Cancio
- US Army Institute of Surgical Research Burn Center, 3698 Chambers Pass, JBSA Fort Sam Houston, TX 78234-6315
| |
Collapse
|
3
|
Ross EE, Colbath RA, Yu J, Munabi N, Gillenwater TJ, Yenikomshian HA. Peer Support Groups: Identifying Disparities to Improve Participation. J Burn Care Res 2022; 43:1019-1023. [PMID: 35781574 PMCID: PMC9435488 DOI: 10.1093/jbcr/irac086] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Disparities in psychosocial outcomes after burn injury exist in patients from racial or ethnic minority groups in the United States. Peer support groups can help patients with many psychosocial aspects of recovery from burns; however, access to such support among patients of racial and ethnic minority or low socioeconomic groups are unknown. The present study examined participation rates in outpatient peer support within this patient population. Patients attending outpatient clinic at an urban safety-net hospital and regional burn center with a majority minority patient population were asked about participation in burn survivor group, interest in joining a group, and given validated survey questions about managing emotions and social interactions since injury. Current or past participation in peer support was low (4.2%), and 30.3% of patients not already in support group were interested in joining. Interest in future participation in peer support was highest among Hispanic patients (37.0%) and lowest among Black patients (0%). Logistic regression models demonstrated that increased total body surface area burned, hospital length of stay, and need for surgical intervention were associated with interest in joining or having joined a peer support group. Effectiveness of management of emotions and social interactions were not associated with interest in joining peer support in the future. These findings demonstrate a considerable difference between levels of interest and participation in peer support within this population. Improving access to and education about benefits of peer support in underresourced communities may help to address the variation in psychosocial outcomes of patients across racial or ethnic minority groups recovering from burns.
Collapse
Affiliation(s)
- Erin E Ross
- From the Keck School of Medicine, University of SouthernCalifornia, Los Angeles, CA, USA
| | - Rachel A Colbath
- From the Keck School of Medicine, University of SouthernCalifornia, Los Angeles, CA, USA
| | - Jeremy Yu
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of SouthernCalifornia, Los Angeles, CA, USA
| | - Naikhoba Munabi
- Division of Plastic Surgery, Keck School of Medicine, University of SouthernCalifornia, Los Angeles, CA, USA
| | - T Justin Gillenwater
- Division of Plastic Surgery, Keck School of Medicine, University of SouthernCalifornia, Los Angeles, CA, USA
| | - Haig A Yenikomshian
- Division of Plastic Surgery, Keck School of Medicine, University of SouthernCalifornia, Los Angeles, CA, USA
| |
Collapse
|
4
|
Shepherd L, Beveridge A. A tiered approach to inpatient psychosocial screening in an adult UK burns service. Burns 2022; 48:698-702. [PMID: 34120780 DOI: 10.1016/j.burns.2021.05.017] [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: 11/23/2020] [Revised: 05/19/2021] [Accepted: 05/28/2021] [Indexed: 12/15/2022]
Abstract
National guidance in the UK advises that psychosocial screening is completed for all inpatients admitted to burns services for over 24 h. Acceptable methods of psychosocial screening have been nationally agreed. However, little is known about how different services conduct psychosocial screening. Moreover, data related to validity and reliability are lacking. This paper describes a tiered approach to inpatient psychosocial screening in a UK adult burns service and considers implications for services. Data collected over a seven-year period was analysed retrospectively. Of 891 patients, almost half (48%; n = 431) were screened face-to-face by a graduate level assistant psychologist. Almost one quarter (23%, n = 205) were screened face-to-face by a qualified clinical psychologist. Around a fifth (22%, n = 193) were screened indirectly through psychological discussions at multi-disciplinary team meetings with a member of the burns clinical psychology team present. A minority of patients were screened face-to-face by liaison psychiatry, or by both liaison psychiatry and a clinical psychologist. Screening and delivery of low-level psychological interventions by a graduate level assistant psychologist appeared to protect resources of qualified clinical psychologists for the most distressed patients. Results highlight the value and cost-effectiveness of a tiered approach to psychosocial screening and in guiding subsequent intervention. Future study is needed in relation to inpatient psychosocial screening and its validity and reliability. Investigating the predictive value of screening methods in identifying those with longer-term psychological difficulties would also be important clinically.
Collapse
Affiliation(s)
- L Shepherd
- Nottingham University Hospitals NHS Trust, Department of Clinical Psychology & Neuropsychology, Queens Medical Centre Campus, Derby Road, Nottingham NG7 2UH, United Kingdom.
| | - A Beveridge
- Nottingham University Hospitals NHS Trust, Department of Clinical Psychology & Neuropsychology, Queens Medical Centre Campus, Derby Road, Nottingham NG7 2UH, United Kingdom
| |
Collapse
|
5
|
Shorey S, Ng ED. Examining characteristics of descriptive phenomenological nursing studies: A scoping review. J Adv Nurs 2022; 78:1968-1979. [PMID: 35405036 PMCID: PMC9320962 DOI: 10.1111/jan.15244] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/21/2022] [Accepted: 03/23/2022] [Indexed: 12/21/2022]
Abstract
Aim To evaluate the characteristics and methodology consistency in nursing research with descriptive phenomenological design. Design Scoping review methodology. Data sources Three electronic databases (CINAHL, Embase, PubMed) were systematically searched for qualitative studies with a descriptive phenomenological design published in nursing journals between January 2021 and December 2021. Review methods Quality appraisal of each study was conducted using the Critical Appraisal Skills Programme checklist. Data were extracted and presented narratively based on research objective, design justification and consistency, theoretical framework, sampling method and sample size, data collection method, data analysis approach and presentation of findings. Results One hundred and three studies were included in the review. Overall, the characteristics of the studies are mostly consistent with Husserl's phenomenology approach in terms of research objectives, the use of other theoretical frameworks, sampling and data collection methods. However, the findings revealed several inconsistencies between research design and data analysis techniques, the lack of design justification and the lack of mention of bracketing. Conclusions Apart from the need for more research and standardized guidelines to clarify the various qualitative research methods, future nurse researchers are urged to provide more methodological details when publishing a descriptive phenomenological study so that readers can examine the effectiveness and quality of the method.
Collapse
Affiliation(s)
- Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Esperanza Debby Ng
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| |
Collapse
|
6
|
Coping with suicide' burning scar's disfigurement among Kurdish women in Iraq (Kurdistan). Burns 2022; 48:448-455. [PMID: 34116870 DOI: 10.1016/j.burns.2021.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 05/08/2021] [Accepted: 05/10/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Suicide is one of the most important causes of death in the world. A critical problem that Iraqi women in Kurdistan are facing is self-immolation. Deformity caused by burn can have many psychological effects on the individuals, including self-image disorder, loss of quality of life, low self-confidence, and disturbances in social interactions. METHODS A qualitative research method with a grounded theory approach was used to achieve the research objectives. Sampling started purposefully and continued with theoretical sampling until access to sufficient knowledge about the phenomenon under investigation. In this study, 22 in-depth interviews were carried out with 19 women participants who had committed self-immolation. FINDINGS After the data analysis, six main categories were formed, including; 1- Facing the inevitable harsh reality. 2- Experiencing negative reactions from others 3- Drowning in the vicious cycle of hopelessness and regret. 4- A bitter journey into the whirlpool of fear and uncertainty. 5- Germination of the hope buds. 6- Re-building weakened self-esteem. "Stepping on the rugged path of distorted image reconstruction" was the core variable in the study. CONCLUSION Although people take some steps to adapt to the situation and deformity, they do not achieve full acceptance of the present circumstances. In this process, the person hopes to regain the lost beauty and does not effortlessly accept the deformity. Instead, she will try everything to get rid of deformity and restore the lost beauty. During the adaptation process, nurses and health care providers, the family and the community have a unique role in accelerating or slowing the process of adaptation.
Collapse
|
7
|
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.
Collapse
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
| |
Collapse
|
8
|
Su YJ, Chow CC. PTSD, depression and posttraumatic growth in young adult burn survivors: Three-year follow-up of the 2015 Formosa fun coast water park explosion in Taiwan. J Affect Disord 2020; 274:239-246. [PMID: 32469812 DOI: 10.1016/j.jad.2020.05.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 04/02/2020] [Accepted: 05/10/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The 2015 Formosa Fun Coast Water Park explosion was a devastating disaster in Taiwan, leaving 15 dead and 484 burn injured. The present study estimated the prevalence of probable PTSD, major depression (MDD), and significant posttraumatic growth (PTG) in burn survivors three years after the explosion. Potential predictors of PTSD and depressive symptoms and PTG (demographic, burn-related, and psychosocial variables) were examined. METHODS Participants were 125 young adult burn survivors. The mean age at the incident was 22.4 years (SD = 4.1) and 62.4% were female. The average total body surface area burned was 51.6% (SD = 19.2%). RESULTS Three years after the explosion, 16.8% and 8.8% of the burn survivors met DSM-5 criteria of probable PTSD and MDD. Gender differences were observed in the prevalence of MDD but not PTSD. PTG was still highly prevalent, with 47.2%, 78.4%, and 84.0% of participants reporting significant PTG at the total scale, subscale, and item levels, respectively. Using hierarchical regression, psychosocial variables explained large amounts of variance in PTSD and depressive symptoms and PTG post-burn (△R2 = 0.411, 0.377, and 0.523) beyond that explained by demographic and burn-related variables. More avoidance and less approach coping predicted greater PTSD and/or depression symptoms post-burn. More approach coping and greater social support strongly predicted higher PTG post-burn. CONCLUSION Rates of probable PTSD and MDD were relatively high in burn survivors, however, PTG was also highly prevalent. Coping styles and social support may play distinct roles in psychosocial adjustment after burn injury.
Collapse
Affiliation(s)
- Yi-Jen Su
- Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 33302, Taiwan; Department of Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. No.5, Fuxing St., Guishan Dist., Taoyuan City 333, Taiwan.
| | - Chia-Chi Chow
- Research Department of Clinical, Educational, and Health Psychology, University College, London, United Kindom. Gower Street, London, WC1E 6BT, UK
| |
Collapse
|
9
|
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]
|
10
|
Kim KM, Ban MS. Rebuilding Life after Burn Injuries in Korea: Using Photovoice. J Burn Care Res 2019; 40:913-922. [PMID: 31284294 DOI: 10.1093/jbcr/irz119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This study analyzed life after injury for burn survivors using the photovoice research method. Study participants were six burn survivors who lived in the community after being discharged from the hospital. These six participants engaged in a series of photovoice workshops and activities that took place over a period of 4 months. The study results were as follows: burn survivors were able to achieve a positive body image during their physical recovery. They overcame many psychological difficulties that accompanied their burn injuries. Their attitudes toward their lives changed positively. The greatest influence in bringing out these changes was support from family, friends, and other burn survivors. They were better able to fight against social oppression with their recovered self-esteem. The participants had experienced a disconnect from the activities and interpersonal relationships they had prior to their injury owing to long-term hospital stays and time away from work. However, as they began new social activities, they were able to establish new interpersonal relationships. Based on the research results, this study suggests that medical, psychological, and social approaches as well as positive changes in social attitude are necessary to support burn survivors' recovery.
Collapse
Affiliation(s)
- Kyung Mee Kim
- Department of Social Welfare, Soongsil University, Seoul, South Korea
| | - Mi So Ban
- Department of Social Welfare, Soongsil University, Seoul, South Korea
| |
Collapse
|
11
|
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.
Collapse
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
| |
Collapse
|
12
|
Kil M, Lee Y. [A Qualitative Study on Interpersonal Relationships of Patients with Facial Burn Injuries: Phenomenological Study]. J Korean Acad Nurs 2019; 49:263-273. [PMID: 31266923 DOI: 10.4040/jkan.2019.49.3.263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 03/05/2019] [Accepted: 03/06/2019] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of the study was to explore the experience of patients with facial burn injuries regarding their interpersonal relationships. METHODS The phenomenological research method was used. Participants of the study consisted of five males and three females. Data were collected through individual in-depth interviews from November, 2014 to February, 2015 and analyzed using Colaizzi's method. RESULTS Five theme clusters were extracted that described patients' experiences. They are "being a lonely foreigner," "closing my mind toward the world," "hiding hurt feelings," "companion of my face," and "communicating with the world". CONCLUSION The results of this study provide a deep understanding and insight into the experience of interpersonal relationships among facial burn patients. The development of a comprehensive program including physical, psychological, and social aspects is recommended to address the problems facial burn patients encounter in interpersonal relationships and to facilitate interaction.
Collapse
Affiliation(s)
- Myungsook Kil
- Department of Nursing, Gangneung Yeongdong University, Gangneung, Korea
| | - Yongmi Lee
- College of Nursing, Kangwon National University, Chuncheon, Korea.
| |
Collapse
|
13
|
Ajoudani F, Jafarizadeh H, Kazamzadeh J. Social support and posttraumatic growth in Iranian burn survivors: The mediating role of spirituality. Burns 2019; 45:732-740. [DOI: 10.1016/j.burns.2018.10.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 10/09/2018] [Accepted: 10/15/2018] [Indexed: 12/22/2022]
|
14
|
Litchfield I, Jones LL, Moiemen N, Andrews N, Greenfield S, Mathers J. The role of self-management in burns aftercare: a qualitative research study. Burns 2018; 45:825-834. [PMID: 30545694 DOI: 10.1016/j.burns.2018.10.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 10/17/2018] [Accepted: 10/23/2018] [Indexed: 11/15/2022]
Abstract
INTRODUCTION For severe burns patient care presents a considerable challenge, necessitating an integrated multi-disciplinary approach that utilises a range of treatments. The period of care post-discharge can be lengthy and complex, and include scar management, occupational and physiotherapies, psychological support, and further surgery. How successfully the patient negotiates this complex care regimen is critical to their long-term recovery and in doing so they would appear to employ approaches recognised as "self-management" in other chronic conditions. However their exact nature and how they are used has yet to be explicitly explored amongst chronic burn patients. METHODS Semi-structured interviews were conducted with 24 patients to discuss their experiences of long-term burn treatment as part of a broader mixed- methods feasibility study of the use of pressure garment therapy in preventing hypertrophic scarring after burn injury. The topic guide included questions on the patient experience of their care post discharge, including pressure garment therapy and other scar management techniques; and their expectations and experiences of treatment and recovery. The data were analysed using an established framework of self-management processes. RESULTS Burns patients employ many of the same processes of self-management as those experiencing more widely recognised chronic diseases or illnesses. This is despite the prospect of gradual improvement amongst burns patients absent in those with incurable chronic conditions. The key processes of self-management they share are the ability to focus on their illness needs, activate the appropriate resources and coming to terms with the consequences of living with either the physical or psychological consequences of their condition. CONCLUSION Modern burn care is technologically advanced and delivered by a highly trained, multi-disciplinary team, yet the level of its success relies on the ability of the patient to independently fulfil a number of health-related tasks and activities once leaving hospital. Considering the potential cost-savings to health services and the prospect of improved outcomes for patients capable of self-management our work is an important first step in more precisely understanding the use of self-management amongst burns patients, and the level of implicit or explicit support currently offered by their care providers.
Collapse
Affiliation(s)
- Ian Litchfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
| | - Laura L Jones
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
| | - Naiem Moiemen
- The Scar Free Foundation Centre for Burns Research, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
| | - Nicole Andrews
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
| | - Sheila Greenfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
| | - Jonathan Mathers
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
| |
Collapse
|
15
|
Persson M, Anastassov Y, Khater R, Spataru R, Nobile F, Skuladottir H, Nilsen T, Rumsey N. Cutting edge training: upskilling health professionals in psychological care for patients undergoing appearance-altering procedures. ACTA ACUST UNITED AC 2018. [DOI: 10.12968/joan.2018.7.10.522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Martin Persson
- Associate Professor, Faculty of Health Science, Kristianstad University, Kristianstad, Sweden
| | - Youri Anastassov
- Plastic Surgeon and Professor, Associatcia Licevi Anomalii, Plodiv, Bulgaria
| | - Regina Khater
- Plastic Surgeon, Associatcia Licevi Anomalii, Plodiv, Bulgaria
| | - Radu Spataru
- Senior Paediatric Surgeon and Associate Professor, Spitalul Clinic de Urgenta Pentru Copii M.S. Curie, Bucharest, Romania
| | - Francesca Nobile
- Psychotherapist and PhD Candidate, Ars Chirurgica S.R.L, Padova, Italy
| | - Hildur Skuladottir
- Medical Doctor, Department of Plastic Surgery and Burns, Helse Bergen Haukeland University Hospital, Bergen, Norway
| | - Thomas Nilsen
- Director, Triskelion-Forening for anvendt forskning og kunnskapsmobilisering, Hafrsfjord, Norway
| | - Nichola Rumsey
- Professor Emerita, Triskelion-Forening for anvendt forskning og kunnskapsmobilisering, Hafrsfjord, Norway
| |
Collapse
|
16
|
Dekel B, van Niekerk A. Women's recovery, negotiation of appearance, and social reintegration following a burn. Burns 2018; 44:841-849. [PMID: 29395394 DOI: 10.1016/j.burns.2017.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 11/16/2017] [Accepted: 12/12/2017] [Indexed: 11/25/2022]
Abstract
The gendered nature of postburn coping has received scant research attention in South Africa, a country that has a high rate of burns with significant concentrations among women. In this study, narratives that emerged from in-depth interviews with seven women were examined. The narratives emphasized essential needs of these burn survivors for personal support, the complexities of negotiating intimate relationships, struggles with the humiliation from family and friends, in some instances strained relationships with children, the support found through religious beliefs and institutions, and often frustratingly slow psychological acceptance of scars. These difficulties faced by women survivors of burns have highlighted the need to include religion/spirituality, intimate male partners, and women's children into the psychological recovery process, in an attempt to assist women's journey to psychological and emotional healing after burn.
Collapse
Affiliation(s)
- Bianca Dekel
- Violence, Injury and Peace Research Unit, South African Medical Research Council, South Africa.
| | - Ashley van Niekerk
- Violence, Injury and Peace Research Unit, South African Medical Research Council, South Africa; Institute for Social and Health Sciences, University of South Africa, South Africa
| |
Collapse
|
17
|
Williamson H, Antonelli P, Bringsén Å, Davies G, Dèttore D, Harcourt D, Hedin G, Jurgutis A, Stepukonis F, Tural Ü, Yalçın AD, Persson M. Supporting patients with body dissatisfaction: A survey of the experiences and training needs of european multi-disciplinary healthcare professionals. NURSINGPLUS OPEN 2018. [DOI: 10.1016/j.npls.2018.05.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
18
|
Posttraumatic growth after burn in adults: An integrative literature review. Burns 2017; 43:459-470. [DOI: 10.1016/j.burns.2016.09.021] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 08/02/2016] [Accepted: 09/19/2016] [Indexed: 11/20/2022]
|
19
|
|
20
|
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.
Collapse
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
| |
Collapse
|
21
|
Johnson RA, Taggart SB, Gullick JG. Emerging from the trauma bubble: Redefining ‘normal’ after burn injury. Burns 2016; 42:1223-32. [DOI: 10.1016/j.burns.2016.03.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 03/19/2016] [Accepted: 03/23/2016] [Indexed: 10/21/2022]
|
22
|
Jones BA, Buchanan H, Harcourt D. The experiences of older adults living with an appearance altering burn injury: An exploratory qualitative study. J Health Psychol 2016; 22:364-374. [DOI: 10.1177/1359105315603473] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Advances in medical treatment mean more older people are living with burn injuries. However, little is known about experiences and support needs of this group. Interpretative Phenomenological Analysis of semi-structured interviews with 10 burn survivors aged 51–71 years identified four themes: time and adjusting to an altered appearance; living with a visible difference in the eyes of others; me, myself and I; importance of maintaining appearance. Adjusting to burns was a long process. Participants discussed feeling isolated, needing information about how ageing impacts on scars and maintaining a socially acceptable appearance. Implications for care and further research are discussed.
Collapse
|
23
|
Garbett K, Harcourt D, Buchanan H. Using online blogs to explore positive outcomes after burn injuries. J Health Psychol 2016; 22:1755-1766. [PMID: 27020086 DOI: 10.1177/1359105316638549] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study uses blog analysis, a new and novel technique, to explore the positive outcomes experienced by burn survivors. This study examined 10 burn survivor blogs to offer a unique, longitudinal insight into burn survivor recovery. Using thematic analysis, three themes emerged: shift in self-perception, enhanced relationships and a change in life outlook. Many of these themes contained stories and experiences unique to a traumatic burn injury, suggesting that standardised trauma scales are not effectively measuring the impact of a burn in this population. Reflections on blog analysis are discussed, along with a recommendation that health researchers utilise the vast amount of data available from online blogs.
Collapse
Affiliation(s)
| | - Diana Harcourt
- University of the West of England, UK
- Children’s Burns Research Centre, UK
| | | |
Collapse
|
24
|
Dunpath T, Chetty V, Van Der Reyden D. Acute burns of the hands - physiotherapy perspective. Afr Health Sci 2016; 16:266-75. [PMID: 27358641 DOI: 10.4314/ahs.v16i1.35] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Acute burns of the hands are complex and may impact on various aspects of a person's life. Physiotherapy rehabilitation and restoration of hand function is critical for the patient's independence and re-integration into society. PURPOSE This study aimed to explore the perceptions and experiences of physiotherapists in the management of patients with their hand burn injuries. METHOD Five focus groups consisting of physiotherapists and physiotherapy assistants working with burn injured patients from each of the five selected public hospitals in KwaZulu-Natal were recruited. An explorative qualitative approach was adopted. RESULTS Physiotherapists emphasised that the acute management of the hand was trivialised due to a primary focus on the survival of the burn sufferer. Therapists identified several factors that determined the patients' level of participation and motivation in therapy one of which was the procedural pain experienced. The role of the therapists' within the rehabilitation framework was found to be critical to their recovery however there appeared to be a breakdown in the collaboration and communication among health care professionals to the detriment of effective intervention. CONCLUSION A multidisciplinary team approach is the foundation in the management of acute burn injuries and during the trajectory of the trauma care continuum.
Collapse
|
25
|
Abrams TE, Ogletree RJ, Ratnapradipa D, Neumeister MW. Adult survivors’ lived experience of burns and post-burn health: A qualitative analysis. Burns 2016; 42:152-162. [DOI: 10.1016/j.burns.2015.09.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 09/07/2015] [Accepted: 09/14/2015] [Indexed: 10/22/2022]
|
26
|
Ren Z, Chang WC, Zhou Q, Wang Y, Wang H, Hu D. Recovery of lost face of burn patients, perceived changes, and coping strategies in the rehabilitation stage. Burns 2015; 41:1855-1861. [DOI: 10.1016/j.burns.2015.08.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 08/22/2015] [Accepted: 08/26/2015] [Indexed: 10/22/2022]
|
27
|
Zamanzadeh V, Valizadeh L, Lotfi M, Salehi F. Preserving self-concept in the burn survivors: a qualitative study. Indian J Palliat Care 2015; 21:182-91. [PMID: 26009672 PMCID: PMC4441180 DOI: 10.4103/0973-1075.156492] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Burn injury is a devastating experience affecting all aspects of a person's essence, including his/her identity and perception. These patients require complex cognitive efforts to redefine their identity to deal with difficult condition after burn injury and preserve self-concept. The experience of life after burn injury is generally a solitary one, closely related to the patients’ cultural and religious context. Therefore, this study was conducted aiming at investigating burn patients’ experiences regarding how to preserve self-concept in life after burn injury in Iran. Materials and Methods: This qualitative study was carried out using qualitative content analysis and in-depth unstructured interviews with 17 surviving burn subjects. Results: During the qualitative content analysis process, the concept of “locating” as the essence of the participants’ experience was extracted as follows: (A) self-exploration (exploring the changes in one's life), (B) others’ exploration (exploring the changes in the life of family members and the relationship between self and others), (C) position evaluation (self-position analysis), and (D) self-concept preservation. Conclusion: The present study has developed new understandings of mental experiences of burn patients’ self-concept by describing the concept of “self-locating”. It helps us in classifying and understanding the concepts described in comprehensive theories developed in this area. They do this by focusing on what burn patients experience for choosing self-preservation strategies and having a meaningful life. The finding can be used as a conceptual framework for palliative care program in Iran.
Collapse
Affiliation(s)
- Vahid Zamanzadeh
- Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Llila Valizadeh
- Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Lotfi
- Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Feridoon Salehi
- Medical Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
28
|
Post-traumatic growth in adults following a burn. Burns 2014; 40:1089-96. [DOI: 10.1016/j.burns.2014.04.007] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 04/12/2014] [Accepted: 04/16/2014] [Indexed: 11/21/2022]
|
29
|
Dunpath T, Chetty V, Van Der Reyden D. The experience of acute burns of the hand – patients perspectives. Disabil Rehabil 2014; 37:892-8. [PMID: 25109499 DOI: 10.3109/09638288.2014.948129] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
30
|
Coming to terms with it all: Adult burn survivors’ ‘lived experience’ of acknowledgement and acceptance during rehabilitation. Burns 2014; 40:589-97. [DOI: 10.1016/j.burns.2013.08.038] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 08/23/2013] [Accepted: 08/28/2013] [Indexed: 11/24/2022]
|
31
|
Hodder K, Chur-Hansen A, Parker A. A Thematic Study of the Role of Social Support in the Body Image of Burn Survivors. Health Psychol Res 2014; 2:1196. [PMID: 26973929 PMCID: PMC4768557 DOI: 10.4081/hpr.2014.1196] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2013] [Revised: 03/17/2013] [Accepted: 03/17/2013] [Indexed: 11/23/2022] Open
Abstract
There is evidence that social support is important for the development and maintenance of body image satisfaction for people who have sustained burn injuries. This qualitative study explored the specific mechanisms by which social support impacts the body image satisfaction of burn survivors, drawing on nine participants’ in depth accounts. Participants were recruited through a burns unit at a public hospital in South Australia. Interviews were conducted with nine female burn survivors aged between 24 and 65 (mean age 44.6). Participants described their perceptions about their appearance post burn and their social support experiences. Four themes were identified: acceptance, social comparison, talking about appearance concerns, and the gaze of others. Results indicate that for these participants, social support was an important factor in coming to terms with changes in appearance, specifically support that helps to minimise feelings of difference. Unhelpful aspects of social support were also identified included feeling that suffering was being dismissed and resenting the perceived expectation from supports to be positive. Social supports are important to consider in relation to body image for those working with people who have survived burn injuries.
Collapse
Affiliation(s)
- Kellie Hodder
- School of Psychology and School of Medicine, Discipline of Psychiatry, University of Adelaide , Australia
| | | | - Andrea Parker
- Burns Unit, The Royal Adelaide Hospital , Adelaide, Australia
| |
Collapse
|
32
|
Moi AL, Gjengedal E. The lived experience of relationships after major burn injury. J Clin Nurs 2014; 23:2323-31. [PMID: 24393409 DOI: 10.1111/jocn.12514] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2013] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To explore and describe the meaning of relationships after major burn injury. BACKGROUND A major burn injury may represent a threat to preburn appearance and level of functioning. Social resources and interaction are considered important for minimising the negative impacts on life after burn through all phases of care and rehabilitation. Yet, the subjective experiences of relating to others after burns have not been extensively explored. DESIGN The study was performed by using a phenomenological approach. METHODS A purposive sample (n = 14) of patients who had experienced major burns were interviewed in average 14 (5-35) months postinjury. The interviews were analysed by the phenomenological method of Giorgi. RESULTS The essence of the experience of relationships was constituted by other people re-anchoring the burn-injured persons to preburn life, being confirming of the new self, as well as being sensitive, competent and safeguarding with respect to actual and potential problems and harms. New bodily limitations demanded assistive others. Moreover, a worry about the overall burden on close family was typical. The supportive actions from others were mostly described as positive, but could also be experienced as challenging, and sometimes even unwanted and interfering with the struggle for regained freedom. CONCLUSIONS Across variation, an increased awareness of the meaning of mutual interdependence was typical. Supportive relationships with family, friends and health professionals were important for the return to society, preburn activities and a meaningful life. RELEVANCE TO CLINICAL PRACTICE A perspective that values the significance of social support from family, friends, health professionals and others who are important for the burn-injured person, and that does not underestimate challenges that may be involved, is recommended during all phases of burn care. Health professionals should also acknowledge the importance of relationships when developing structured educational programmes and organising peer support.
Collapse
Affiliation(s)
- Asgjerd L Moi
- Department of Nursing, Faculty of Health and Social Sciences, Bergen University College, Bergen, Norway
| | | |
Collapse
|
33
|
|
34
|
Kornhaber R, Wilson A, Abu-Qamar MZ, McLean L. Adult burn survivors' personal experiences of rehabilitation: an integrative review. Burns 2013; 40:17-29. [PMID: 24050979 DOI: 10.1016/j.burns.2013.08.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Revised: 07/12/2013] [Accepted: 08/02/2013] [Indexed: 11/29/2022]
Abstract
Burn rehabilitation is a lengthy process associated with physical and psychosocial problems. As a critical area in burn care, the aim was to systematically synthesise the literature focussing on personal perceptions and experiences of adult burn survivors' rehabilitation and to identify factors that influence their rehabilitation. Studies were identified through an electronic search using the databases: PubMed, CINAHL, EMBASE, Scopus, PsycINFO and Trove of peer reviewed research published between 2002 and 2012 limited to English-language research with search terms developed to reflect burn rehabilitation. From the 378 papers identified, 14 research papers met the inclusion criteria. Across all studies, there were 184 participants conducted in eight different countries. The reported mean age was 41 years with a mean total body surface area (TBSA) burn of 34% and the length of stay ranging from one day to 68 months. Significant factors identified as influential in burn rehabilitation were the impact of support, coping and acceptance, the importance of work, physical changes and limitations. This review suggests there is a necessity for appropriate knowledge and education based programmes for burn survivors with consideration given to the timing and delivery of education to facilitate the rehabilitation journey.
Collapse
Affiliation(s)
- R Kornhaber
- Severe Burns Injury Unit, Royal North Shore Hospital, Sydney, NSW, Australia; The University of Adelaide, School of Nursing, South Australia, Australia.
| | - A Wilson
- School of Medicine, Flinders University, Bedford Park, South Australia, Australia; Prince of Wales Clinical School, The University of New South Wales, Sydney, NSW, Australia
| | - M Z Abu-Qamar
- Department of Adult Health Nursing, Faculty of Nursing, Mútah University, Mútah, Jordan
| | - L McLean
- Westmead Psychotherapy Program, Discipline of Psychiatry, Sydney Medical School, University of Sydney, Australia; Consultation-Liaison Psychiatry, Royal North Shore Hospital, Sydney, NSW, Australia; Sydney West and Greater Southern Psychiatry Training Network, WSLHD, Sydney, NSW, Australia
| |
Collapse
|
35
|
Ogilvie R, McCloughen A, Curtis K, Foster K. The experience of surviving life-threatening injury: a qualitative synthesis. Int Nurs Rev 2012; 59:312-20. [DOI: 10.1111/j.1466-7657.2012.00993.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
36
|
Tufanaru C, Attard M. The Quality of Husserlian Phenomenological Research in the Health Sciences: A Methodological Systematic Review. JBI LIBRARY OF SYSTEMATIC REVIEWS 2012; 10:1-16. [PMID: 27820405 DOI: 10.11124/jbisrir-2012-329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Catalin Tufanaru
- 1 Master of Clinical Science (MClinSc) in Evidence-Based Health Care (EBHC) Student, Joanna Briggs Institute, Faculty of Health Sciences, University of Adelaide, Australia; Research Associate, Joanna Briggs Institute, Faculty of Health Sciences, University of Adelaide, Australia, Synthesis Science Unit (SSU) The Joanna Briggs Institute Faculty of Health Sciences The University of Adelaide SA 5005 AUSTRALIA p: +61 8 831 4769 f: +61 8 831 34881 2 Postdoctoral Research Fellow, Synthesis Science Unit (SSU), Joanna Briggs Institute, The University of Adelaide, SA 5005 AUSTRALIA
| | | |
Collapse
|
37
|
|
38
|
Lau U, van Niekerk A. Restorying the self: an exploration of young burn survivors' narratives of resilience. QUALITATIVE HEALTH RESEARCH 2011; 21:1165-1181. [PMID: 21490293 DOI: 10.1177/1049732311405686] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The results of this exploratory study reflect a shift from public health studies that aim to examine the risk and prevalence of burn injury, toward eliciting survivors' subjective meaning-making processes beyond the injury event. We drew on a narrative framework to explore how young survivors' experiences of burn injury led to reconstructions of self and shifts in thinking about others and the world. Although participants' narratives revealed elements of heightened self-awareness, need for acceptance, and desire for recognition, these stood alongside counter narratives denoting positive, transformative, and resilient aspects of healing that reflected a rebirth of the self, life having purpose, and psychospiritual growth. A multidimensional and relational framework for resilience acknowledges the "deficient," but also recognizes the pathways to growth, healing, meaning, and purpose. This shift toward person-centered meanings has value in informing interventions beyond the immediate "wound care," toward the survivors' lifelong (re)negotiation of identity, appearance, psychological adjustment, and social reintegration.
Collapse
Affiliation(s)
- Ursula Lau
- Institute for Social & Health Sciences, University of South Africa, Johannesburg, Gauteng, South Africa.
| | | |
Collapse
|
39
|
Mirivel JC. Communicative conduct in commercial medicine: initial consultations between plastic surgeons and prospective clients. QUALITATIVE HEALTH RESEARCH 2010; 20:788-804. [PMID: 20207955 DOI: 10.1177/1049732310362986] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
In this study, I investigated naturally occurring medical interaction in commercial medicine. Drawing on 30+ hours of videotaped data and 9 months of fieldwork in a cosmetic surgery clinic, this analysis focuses on how plastic surgeons interact with patients who seek to alter their bodily appearance. The ethnographically informed discourse analysis reveals how plastic surgeons manage multiple and competing interactive demands. Specifically, I describe plastic surgeons' key strategies for meeting both health-related and institutional goals. In the conclusion, I reflect on the communication challenges that medical professionals and patients face when consumerism and medicine meet.
Collapse
Affiliation(s)
- Julien C Mirivel
- Department of Speech Communication, University of Arkansas at Little Rock, Little Rock, AR 72204-1099, USA.
| |
Collapse
|
40
|
Norlyk A, Harder I. What makes a phenomenological study phenomenological? An analysis of peer-reviewed empirical nursing studies. QUALITATIVE HEALTH RESEARCH 2010; 20:420-31. [PMID: 20068190 DOI: 10.1177/1049732309357435] [Citation(s) in RCA: 133] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
This article contributes to the debate about phenomenology as a research approach in nursing by providing a systematic review of what nurse researchers hold as phenomenology in published empirical studies. Based on the assumption that presentations of phenomenological approaches in peer-reviewed journals have consequences for the quality of future research, the aim was to analyze articles presenting phenomenological studies and, in light of the findings, raise a discussion about addressing scientific criteria. The analysis revealed considerable variations, ranging from brief to detailed descriptions of the stated phenomenological approach, and from inconsistencies to methodological clarity and rigor. Variations, apparent inconsistencies, and omissions made it unclear what makes a phenomenological study phenomenological. There is a need for clarifying how the principles of the phenomenological philosophy are implemented in a particular study before publishing. This should include an articulation of methodological keywords of the investigated phenomenon, and how an open attitude was adopted.
Collapse
|
41
|
|
42
|
Briscoe WP, Woodgate RL. Sustaining self: the lived experience of transition to long-term ventilation. QUALITATIVE HEALTH RESEARCH 2010; 20:57-67. [PMID: 20019349 DOI: 10.1177/1049732309356096] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Long-term mechanical ventilation (LTMV) is used to support growing numbers of children and adults who develop chronic respiratory failure. The purpose of this hermeneutic phenomenological study was to explore the subjective meaning of the experience of transition from spontaneous breathing to reliance on LTMV. In-depth, audiorecorded interviews of 11 ventilated individuals living in a western Canadian province were transcribed and analyzed. The transition journey was revealed to be a time of psychological, physical, and spiritual challenge. "Sustaining self " was revealed as the essence of ventilator users' transition experience. Findings underscore the complex nature of transition to technological reliance, illuminating the need for increased health professional knowledge and understanding of the symptom experience and management options for individuals living with chronic respiratory failure. Strategies to support individuals' sense of self as they journey to a life reliant on LTMV are required.
Collapse
Affiliation(s)
- Winnifred P Briscoe
- Red River College of Applied Arts, Science and Technology, Winnipeg, Manitoba, Canada.
| | | |
Collapse
|
43
|
Bell NJ, Schuurman N, Morad Hameed S. A small-area population analysis of socioeconomic status and incidence of severe burn/fire-related injury in British Columbia, Canada. Burns 2009; 35:1133-41. [PMID: 19553025 DOI: 10.1016/j.burns.2009.04.028] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2009] [Revised: 04/27/2009] [Accepted: 04/28/2009] [Indexed: 11/27/2022]
Abstract
Socioeconomic determinants of injury have been associated with risk of burn in the UK and USA, but the relative significance of this impact is largely unknown across Canadian populations. The purpose of this study is to determine the extent to which socioeconomic status (SES) is linked to risk of burn in the province of British Columbia (BC) and identify the extent to which these findings are generalizable across both urban and rural population groups. Measures of SES were based on province-wide comparisons using data obtained from the Canada Census using the Vancouver Area Neighbourhood Deprivation Index (VANDIX). Results illustrate that the effects of SES and increased injury risk are substantial, though the most pronounced variations were exhibited across each SES stratum for urban areas and with less demonstrable effect when itemized by injury type within rural areas. Although conservative, the results from this study illustrate that burns disproportionately affect populations of greater relative socioeconomic disadvantage and continued efforts to also address social inequities and their link to injury incidence is likely to be more effective than targeting individual behavior alone when trying to reduce and eliminate their occurrence.
Collapse
Affiliation(s)
- Nathaniel J Bell
- Department of Geography, Simon Fraser University, 8888 University Dr., Burnaby, British Columbia, Canada V5A 1S6.
| | | | | |
Collapse
|
44
|
Moi AL, Vindenes HA, Gjengedal E. The experience of life after burn injury: a new bodily awareness. J Adv Nurs 2008; 64:278-86. [DOI: 10.1111/j.1365-2648.2008.04807.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|