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Wang YQ, Wu ZH, Chen XJ, Ma H. Patient-reported outcomes and their predictors 2 years after burn injury: A cross-sectional study. Int Wound J 2023; 21:e14448. [PMID: 37864399 PMCID: PMC10828125 DOI: 10.1111/iwj.14448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 10/11/2023] [Indexed: 10/22/2023] Open
Abstract
This study aimed to describe patient-reported outcomes 2 years after burn injury and to comprehensively elucidate predictors that may influence these outcomes. This cross-sectional, prospective study included 352 patients who were admitted to the Department of Burn Surgery at a tertiary teaching hospital between January 2017 and December 2020. We collected demographic and disease-related data and instructed participants to complete the Readiness for Hospital Discharge Scale (RHDS) and the Burn Specific Health Scale-Brief (BSHS-B) questionnaire. The overall score of patient-reported outcomes 2 years after burn injury was 126.55 ± 33.32 points, and the dimensions with the lowest scores were "hand function" (13.96 ± 5.75), "heat sensitivity" (14.84 ± 4.90), "treatment regimens" (13.41 ± 6.77) and "work" (11.30 ± 4.97). Multiple linear regression analysis revealed that less postburn pruritus, better readiness for hospital discharge, less total body surface area (TBSA), better social participation, white-collar jobs, older age, better sleep quality and burns not caused by electricity were associated with better outcomes. Patients experienced poor patient-reported outcomes 2 years after burn injury. Integrated rehabilitative care is necessary to address patients' unique needs and improve long-term patient-reported outcomes.
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Affiliation(s)
- Yan qiong Wang
- Department of Burn and Plastic Surgery, West China HospitalSichuan University/West China School of Nursing, Sichuan UniversityChengduChina
| | - Zhi hui Wu
- Department of Burn and Plastic Surgery, West China HospitalSichuan University/West China School of Nursing, Sichuan UniversityChengduChina
| | - Xiao juan Chen
- Department of Burn and Plastic Surgery, West China HospitalSichuan University/West China School of Nursing, Sichuan UniversityChengduChina
| | - Hong Ma
- Department of Burn and Plastic Surgery, West China HospitalSichuan University/West China School of Nursing, Sichuan UniversityChengduChina
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Wang Y, Wong FKY, Bayuo J, Chung LYF, Zhang L, Wang T. Challenges of nurses and family members of burn patients: Integrative review. Nurs Open 2023; 10:3547-3560. [PMID: 36840702 PMCID: PMC10170885 DOI: 10.1002/nop2.1651] [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: 02/22/2022] [Revised: 11/28/2022] [Accepted: 02/05/2023] [Indexed: 02/26/2023] Open
Abstract
AIMS To identify the challenges facing burn care nurses and burn patients' family members and to explore the relationship between the above challenges. DESIGN Whittemore and Knafl's integrative review. METHODS Databases used for this review included Cochrane Library, Web of Science, PubMed and Embase. The original research published from January 2010 to November 2021 was selected. Studies reporting the challenges of family members or nurses of burn patients identified through extensive database search were considered for inclusion. The Mixed-Method Appraisal-Tool was applied for the evaluation of the quality of the literature. The analysis approach used was content analysis. RESULTS Of the 2746 identified studies, 17 studies were included. Key findings related to the challenges facing nurses and family members of burn patients were extracted. The themes relating to burn care nurses included ethical and religious issues, clinical issues, work-life imbalance and limited support. The themes relating to family members included family's different views on prognosis and treatment, work-life imbalance, psychological issues and lack of multifaceted support. The challenges for the formal and informal caregivers are similar and there is existence of some shared concerns. If the above challenges are not resolved, support for the burn patients may be adversely affected. Corresponding measures should be taken to overcome such challenges.
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Affiliation(s)
- Yi Wang
- School of Nursing, Lanzhou University, Lanzhou, China
| | | | - Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | | | - Li Zhang
- Department of Burns, Gansu Provincial People's Hospital, Lanzhou, China
| | - Taotao Wang
- Department of Burns, Gansu Provincial People's Hospital, Lanzhou, China
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The development and validation of the CARe Burn Scale: Child Form: a parent-proxy-reported outcome measure assessing quality of life for children aged 8 years and under living with a burn injury. Qual Life Res 2020; 30:239-250. [PMID: 32902793 PMCID: PMC7847857 DOI: 10.1007/s11136-020-02627-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE Patient-reported outcome measures (PROMs) identify patient needs and therapeutic progress. This paper outlines the development and validation of the CARe Burn Scale: Child Form, a parent-proxy-reported outcome measure that assesses quality of life in children aged 8 and under living with a burn injury. METHODS A literature review and interviews with 12 parents of children with a burn and seven health professionals informed the development of a conceptual framework and draft PROM. Cognitive debriefing interviews with 18 parents and eight health professionals provided feedback to ascertain content validity, and 311 parents took part in field testing. Rasch and traditional psychometric analyses were conducted to create a shortened version. Further psychometric analyses with 133 parents tested the shortened CARe Burn Scale in relation to other parent-proxy measures. RESULTS The final conceptual framework included 5 domains: Social and Emotional Difficulties, Social and Emotional Well-Being, Wound/Scar Discomfort, Wound/Scar Treatment and Physical Abilities. Two scales fulfilled Rasch and traditional psychometric analyses, providing evidence of construct validity, acceptability, and reliability. Three scales did not fulfil the Rasch criteria and were retained as checklists. Compared to other parent-proxy measures, individual CARe Burn Scales correlated moderately with similar constructs and had low correlations with dissimilar constructs, indicating evidence of criterion validity (concurrent and discriminant). CONCLUSIONS The CARe Burn Scale: Child Form can be used to measure children's quality of life after having a burn injury which can inform rehabilitation and surgical decision-making.
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Lotfi M, Zamanzadeh V, Ostadi A, Jalili Fazel M, Nobakht A, Khajehgoodari M. Development of family-based follow-up care system for patients with burn in Iran: Participatory action research. Nurs Open 2020; 7:1101-1109. [PMID: 32587729 PMCID: PMC7308696 DOI: 10.1002/nop2.483] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 10/30/2019] [Accepted: 03/02/2020] [Indexed: 11/10/2022] Open
Abstract
Aim After the discharge of patients with burns, quality of life, psychological and social adjustment, performance and their follow-up are ambiguous. Therefore, we decided to improve the status of family-based care programmes in patients with the burn. Design Participatory action research. Methods The participatory action research was conducted between the Faculty of Nursing, Sina Hospital's managers and multidisciplinary burn teams from 2017-2018. The procedure for data collection included focus group meetings with key informants, interviews, observation, and questionnaire. Qualitative data were analysed using the qualitative content analysis and qualitative data were analysed by SPSSv.24. Results The study, comprised of four phases, started in May 2017 and completed in 9 months. The results of quantitative showed that quality of life has a statistically significant difference before and after the action. The qualitative data resulted were grouped into 3 categories and 28 subcategories and were analysed in the SWOT Matrix. All the multidisciplinary burn teams together with the managers as a team working of the care providers and the academic researcher resulted in enablers the changes in providing health education and services as well as improving the quality of life of patients and their families.
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Affiliation(s)
- Mojgan Lotfi
- Department of Medical Surgical NursingFaculty of Nursing and MidwiferySina HospitalTabriz University of Medical SciencesTabrizIran
| | - Vahid Zamanzadeh
- Department of Medical Surgical NursingFaculty of Nursing and MidwiferyTabriz University of Medical SciencesTabrizIran
| | - Ali Ostadi
- Department of Internal MedicineFaculty of MedicineSina HospitalTabriz University of Medical SciencesTabrizIran
| | - Maryam Jalili Fazel
- Sina Hospital Research CenterTabriz University of Medical SciencesTabrizIran
| | - Afsaneh Nobakht
- Faculty of Nursing and MidwiferySina HospitalTabriz University of Medical SciencesTabrizIran
| | - Mohammad Khajehgoodari
- Department of Medical Surgical NursingFaculty of Nursing and MidwiferySina HospitalTabriz University of Medical SciencesTabrizIran
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Gee C, Maskell J, Newcombe P, Kimble R, Williamson H. Australian health professionals' perspectives of psychosocial adjustment to visible differences: A qualitative analysis of pediatric populations. Body Image 2020; 33:13-26. [PMID: 32086188 DOI: 10.1016/j.bodyim.2020.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 02/07/2020] [Accepted: 02/08/2020] [Indexed: 10/25/2022]
Abstract
Living with a visible difference (e.g., disfigurement) can compromise a child's psychological wellbeing. Although some children can adjust well, others can develop a range of appearance-related issues such as social anxiety, low self-esteem, and body dissatisfaction. However, current research fails to confirm what factors contribute to appearance-related distress, and what factors buffer the consequences of living with a visible difference. Semi-structured qualitative interviews were conducted with 16 Australian specialist health professionals who care for children with visible differences. Interviews explored the type of appearance-related psychosocial concerns presented to a pediatric hospital, perspectives on the impact of appearance-related distress, as well as factors and processes that health professionals perceive influence adjustment. Data were subjected to inductive thematic analysis. Rich evidence was offered by health professionals, which demonstrated deep understanding of the psychological wellbeing of their patients. Three themes were identified: Mind, Body, and Soul; Stages of Life; and Individual Differences. Findings highlighted the complexity of appearance-related distress, with individual differences in adjustment, and the powerful impact it can have on a child's short and long-term psychosocial wellbeing. The importance of reaching consensus in the conceptualisation and measurement of psychological wellbeing is stressed, and key domains associated with adjustment are proposed.
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Affiliation(s)
- Caroline Gee
- Centre for Children's Burns and Trauma Research, Child Health Research Centre, The University of Queensland, Level 7, 62 Graham Street, South Brisbane, Queensland, 4101, Australia.
| | - Jessica Maskell
- Gold Coast University Hospital, Social Work Department, 1 Hospital Boulevard, Southport, Queensland, 4217, Australia.
| | - Peter Newcombe
- Institute for Teaching and Learning Innovation, Level 3, Building 17, Staff House Road, The University of Queensland, St Lucia, Queensland, 4072, Australia.
| | - Roy Kimble
- Centre for Children's Burns and Trauma Research, Child Health Research Centre, The University of Queensland, Level 7, 62 Graham Street, South Brisbane, Queensland, 4101, Australia; Pegg Leditschke Children's Burns Centre, Queensland Children's Hospital, Level 5, 501 Stanley Street, South Brisbane, Queensland, 4101, Australia.
| | - Heidi Williamson
- Centre for Appearance Research, University of the West of England, Frenchay Campus, Bristol, BS16 1QY, United Kingdom.
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Shivanpour M, Firouzkouhi M, Abdollahi Mohammad A, Naderifar M, Mohammadi M. Nurses Experiences in the Burn Unit: A Qualitative Research. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2020; 25:232-236. [PMID: 32724769 PMCID: PMC7299416 DOI: 10.4103/ijnmr.ijnmr_162_19] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 02/02/2020] [Accepted: 02/14/2020] [Indexed: 11/18/2022]
Abstract
Background: Nurses form the largest group of burn care treatment team. They have valuable experiences regarding the care of burned patients that needs to be explored. Therefore, the present study was aimed to explain the experiences of nurses who work in the burn unit. Materials and Methods: This qualitative study was conducted in the burn units of Zabol and Zahedan Hospitals in 2018. Accordingly, the data were collected through a semi-structured deep interview with 16 nurses. Purposeful sampling method was used for data collection. The data were analyzed using a thematic analysis approach. Results: The data analysis ultimately led to the development of 4 themes and 16 sub-themes. The extracted themes included burden of burn unit, toil of burn unit as a deal with God, need for continuing the education program, and work-life imbalance. Conclusions: Nurses in burn unit experience many challenges that can affect their job and life, which require special attention of the authorities, their families, and other colleagues. For better patient care, there is a need for up-to-date facilities and training. The hospital managers should pay more attention to the nursing staff of the burn units through increasing staff number, changing the working units, and offering financial and motivational vacations.
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Affiliation(s)
- Maryam Shivanpour
- Student Research Committee, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran
| | - Mohammadreza Firouzkouhi
- Department of Med Sur, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran
| | | | - Mahin Naderifar
- Department of Pediatric, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran
| | - Mohammad Mohammadi
- Zabol Pre-Hospital Emergency Center, Zabol University of Medical Sciences, Zabol, Iran
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Gee C, Maskell J, Newcombe P, Kimble R, Williamson H. Opening a Pandora's Box that can't be salvaged: Health professionals' perceptions of appearance-related care in an Australian pediatric specialist hospital. Body Image 2019; 31:1-12. [PMID: 31465991 DOI: 10.1016/j.bodyim.2019.07.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 07/09/2019] [Accepted: 07/11/2019] [Indexed: 11/19/2022]
Abstract
Many children and young people struggle adjusting to the psychosocial consequences (e.g., body dissatisfaction, social anxiety, and stigmatisation) of visible differences (or disfigurement). As appearance-affecting conditions often require specialist multidisciplinary team care, health professionals are in a unique position to offer psychosocial support and intervention. However, there is a dearth of literature on how appearance-related concerns are managed in pediatric hospital settings. Sixteen Australian specialist health professionals participated in semi-structured qualitative interviews to address this gap. Interviews explored current appearance-related psychosocial service provision, barriers in accessing appearance-related care, and perceptions of online platforms to deliver specialist support and intervention. Thematic analysis demonstrated four themes: We can do it better, Capability versus availability, Online generation, and Putting appearance on the agenda. This research highlighted the potential value of online platforms to increase accessibility to specialist appearance-related care, the need for more psychosocial resources to be integrated into appearance-related specialities, prioritising the development of low to medium appearance-related support and intervention, increasing the appearance-related knowledge of health professionals and families, and the need for more holistic approaches in routine care.
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Affiliation(s)
- Caroline Gee
- Centre for Children's Burns and Trauma Research, Child Health Research Centre, The University of Queensland, Level 7, 62 Graham Street, South Brisbane, Queensland, 4101, Australia.
| | - Jessica Maskell
- Gold Coast University Hospital, Social Work Department, 1 Hospital Boulevard, Southport, Queensland, 4217, Australia.
| | - Peter Newcombe
- Institute for Teaching and Learning Innovation, Level 3, Building 17, Staff House Road, The University of Queensland, St Lucia, Queensland, 4072, Australia.
| | - Roy Kimble
- Centre for Children's Burns and Trauma Research, Child Health Research Centre, The University of Queensland, Level 7, 62 Graham Street, South Brisbane, Queensland, 4101, Australia; Pegg Leditschke Children's Burns Centre, Queensland Children's Hospital, Level 5, 501 Stanley Street, South Brisbane, Queensland, 4101, Australia.
| | - Heidi Williamson
- Centre for Appearance Research, University of the West of England, Frenchay Campus, Bristol, BS16 1QY, United Kingdom.
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Samoborec S, Ayton D, Ruseckaite R, Evans SM. Biopsychosocial barriers affecting recovery after a minor transport-related injury: A qualitative study from Victoria. Health Expect 2019; 22:1003-1012. [PMID: 31155834 PMCID: PMC6803416 DOI: 10.1111/hex.12907] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 04/17/2019] [Accepted: 04/18/2019] [Indexed: 11/30/2022] Open
Abstract
Objective The aim of the study was to understand the recovery phenomena and to explore participants' perspectives on the biopsychosocial facilitators and barriers affecting their recovery after a minor transport injury. Methods A qualitative method was used involving semi‐structured interviews with 23 participants who sustained a minor transport injury. Interviews and analysis were guided by the biopsychosocial model (BPS) of health. The outcomes were themes capturing biopsychosocial barriers to, and personal experiences of, recovery using a previously defined framework. Results The themes indicate that recovery is a multifaceted phenomenon affected by comorbidities such as chronic pain, depression and anxiety. A range of subsequent complexities such as the inability to self‐care and undertaking daily domestic duties, and incapacity to participate in recreational activities were major barriers to recovery. These barriers were found to be an on‐going source of frustration, dissatisfaction and a perceived cause of depressive symptomatology in many participants. Most participants reported mixed feelings of the care received. Other common issues raised included a lack of understanding of the assessment time, regular follow‐up, guidance and on‐going support. Conclusion This study revealed that recovery after a minor transport‐related injury was a challenging, complex, demanding and a long‐term process for the individuals in this study. Findings from this limited cohort suggested that, for participants to return to their pre‐accident health status, a more coordinated approach to information and care delivery may be required.
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Affiliation(s)
- Stella Samoborec
- Department of Epidemiology and Preventive Medicine (DEPM), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Darshini Ayton
- Department of Epidemiology and Preventive Medicine (DEPM), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine (DEPM), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Susan M Evans
- Department of Epidemiology and Preventive Medicine (DEPM), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Guest E, Griffiths C, Harcourt D. A qualitative exploration of psychosocial specialists' experiences of providing support in UK burn care services. Scars Burn Heal 2018; 4:2059513118764881. [PMID: 29873339 PMCID: PMC5987094 DOI: 10.1177/2059513118764881] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION A burn can have a significant and long-lasting psychosocial impact on a patient and their family. The National Burn Care Standards (2013) recommend psychosocial support should be available in all UK burn services; however, little is known about how it is provided. The current study aimed to explore experiences of psychosocial specialists working in UK burn care, with a focus on the challenges they experience in their role. METHODS Semi-structured telephone interviews with eight psychosocial specialists (two psychotherapists and six clinical psychologists) who worked within UK burn care explored their experiences of providing support to patients and their families. RESULTS AND DISCUSSION Thematic analysis revealed two main themes: burn service-related experiences and challenges reflected health professionals having little time and resources to support all patients; reduced patient attendance due to them living large distances from service; psychosocial appointments being prioritised below wound-related treatments; and difficulties detecting patient needs with current outcome measures. Therapy-related experiences and challenges outlined the sociocultural and familial factors affecting engagement with support, difficulties treating patients with pre-existing mental health conditions within the burn service and individual differences in the stage at which patients are amenable to support. CONCLUSION Findings provide an insight into the experiences of psychosocial specialists working in UK burn care and suggest a number of ways in which psychosocial provision in the NHS burn service could be developed.
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Affiliation(s)
- Ella Guest
- University of the West of England Bristol, Bristol, UK
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Heath J, Shepherd L, Harcourt D. Towards improved psychological outcomes for survivors of burn injuries. Scars Burn Heal 2018; 4:2059513118765371. [PMID: 29873331 PMCID: PMC5987089 DOI: 10.1177/2059513118765371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Jennifer Heath
- Centre for Appearance Research, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
- British Burn Association Psychosocial Special Interest Group
| | - Laura Shepherd
- British Burn Association Psychosocial Special Interest Group
- Department of Clinical Psychology & Neuropsychology, Nottingham University Hospitals NHS Trust, Queens Medical Centre, Nottingham, UK
| | - Diana Harcourt
- Centre for Appearance Research, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
- British Burn Association Psychosocial Special Interest Group
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