Influential Factors in the Recovery Process of Burn Survivors in a Predominately Rural State: A Qualitative Study

Author(s):  
Kimberly Dukes ◽  
Stephanie Baldwin ◽  
Evangelia Assimacopoulos ◽  
Brian Grieve ◽  
Joshua Hagedorn ◽  
...  

Abstract Navigating the recovery journey following a burn injury can be challenging. Survivor stories can help define recovery constructs that can be incorporated into support programs. We undertook this study to determine themes of recovery in a predominately rural state. Eleven purposefully selected burn survivors were interviewed using a semi-structured format. Consensus coding of verbatim transcriptions was used to determine themes of successful recovery. Four support-specific themes were identified. These included: using active coping strategies, expressing altruism through helping others, finding meaning and acceptance, and the active seeking and use of support. These themes could be incorporated into support programming and would help guide future survivors through the recovery period.

Author(s):  
Kimberly Dukes ◽  
Stephanie Baldwin ◽  
Joshua Hagedorn ◽  
Emily Ruba ◽  
Katherine Christel ◽  
...  

Abstract Sustaining a burn injury often results in a life-long recovery process. Survivors are impacted by changes in their mobility, appearance, and ability to carry out activities of daily living. In this study, we examined survivors’ accounts of their treatment and recovery in order to identify specific factors that have had significant impacts on their well-being. With this knowledge, we may be better equipped to optimize the care of burn patients. We conducted inductive, thematic analysis on transcripts of in-depth, semi-structured interviews with 11 burn survivors. Participants were purposefully selected for variability in age, gender, injury size and mechanism, participation in peer support, and rurality. Survivors reported varied perceptions of care quality and provider relationships. Ongoing issues with skin and mobility continued to impact their activities of daily living. Many survivors reported that they did not have a clear understanding or realistic expectations of the recovery process. Wound care was often described as overwhelming and provoked fear for many. Even years later, trauma from burn injury can continue to evolve, creating fears and impediments to daily living for survivors. To help patients understand the realistic course of recovery, providers should focus on communicating the nature of injury and anticipated recovery, developing protocols to better identify survivors facing barriers to care, and referring survivors for further support.


2019 ◽  
Vol 40 (Supplement_1) ◽  
pp. S114-S114
Author(s):  
K Dukes ◽  
S Baldwin ◽  
E Assimacopoulos ◽  
B Grieve ◽  
L Wibbenmeyer

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S122-S122
Author(s):  
Stephanie Baldwin ◽  
Dukes Kimberly ◽  
Katherine N Christel ◽  
Joshua Hagedorn ◽  
Emily Ruba ◽  
...  

Abstract Introduction The treatment and recovery from a burn injury is a long process that can affect a survivor’s appearance, mobility, daily function, and emotional wellbeing. In this study, we sought to identify various factors in survivors’ treatment and recovery process. Methods We conducted thematic analysis on transcripts of in-depth, semi-structured interviews with 11 burn survivors who had been treated at a Midwest tertiary facility. Survivors were purposefully selected for variability in age, gender, injury size, injury mechanism and quality of life responses. All transcripts were coded by at least two authors. We managed coded results in MAXQda, a qualitative data management software program. Results The mean age of interviewees was 51 years (35–63 years) and time from the injury was 5.4 years (2 months to 26 years). Their burn sizes ranged from < 10% in 4 people to 70–79% in one. Participants reported varied perceptions of care quality and provider relationships from the initial hospital stay. Some recalled communication issues from the hospital throughout the long recovery process. Many used graphic terms for the unfamiliar treatment methods. Survivors reported ongoing issues with their skin and mobility that continued to impact activities of daily living even years later. Many did not have clear or realistic expectations or understanding of the recovery process. Wound care was overwhelming and provoked fear for many survivors even with formal instruction. Most participants developed different ways to treat their injuries at home. Barriers to recovery included finances, comorbidities, and environmental characteristics, including rurality. Conclusions Even years later, the burn injury can continue to evolve, create fears, and affect daily living for survivors. To help patients understand the realistic course of recovery, providers could focus on clear communication about the injury and recovery. Providers should recognize survivors with barriers who may need referrals for further support. Applicability of Research to Practice Reflecting on the subjective accounts of survivors will help identify opportunities to improve patient experiences during treatment and throughout the recovery process.


2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S113-S114
Author(s):  
Marc R Matthews ◽  
Sara Calder ◽  
Areta Kowal-Vern ◽  
Philomene Spadafore ◽  
Karen J Richey ◽  
...  

Abstract Introduction Caloric intake has been a vital component for burn wound healing and recovery. The hypothesis was that caloric requirements are based on injury severity & post-burn week as predicated by indirect calorimetry (IC)/predictive equations. Methods This was a retrospective chart review of 115 burn patients (2012–2017). Caloric requirements were determined by the Curreri equation [which includes % total body surface area (TBSA)] and IC for a 5-week period provided mainly by enteral nutrition. Patients received supplements and total parenteral nutrition as needed. Results The mean ±sd age was 43±18 years, 41±18 % TBSA, Body Mass Index of 28±7 kg/m2, and mortality of 26 (23%). The major mechanisms of injury were flame/flash/explosions. There were 59 (51%) of patients with < 40 % TBSA burns, [median Injury Severity Score (ISS) 9; Apache score 14], and 56 (49%) with ≥40 % TBSA (median ISS 25; Apache score 21), p < .0001. The Respiratory Quotient (RQ) had a median of 0.94 (range 0.79 to 1.02). The median number of surgeries for the < 40 % TBSA group was 5 versus 12 for the ≥40 % TBSA, p < .0001. The Injury Factor did not differ from weeks 1–5 (1.8 for < 40 % TBSA and 2.0 for the ≥ 40 % TBSA). The Curreri equation calculation for this study was a median 3640 (range 2161–5950) calories. The Curreri equation resulted in significantly increased caloric recommendations for the ≥ 40 %TBSA compared to the < 40 %TBSA patients, p < .0001. The < 40 %TBSA group had caloric requirements ranging between 1500- 2700 calories compared to the ≥ 40 %TBSA group, whose calories ranged between 2000–3700. The total daily caloric recommendations were also significantly increased in the ≥40 %TBSA compared to the < 40 %TBSA patients. The maximum levels of resting energy expenditure (REE) from IC, total daily calories recommended by the dietitian and average calories ranged between 3000–4500 in the < 40 %TBSA group and 3600–6700 in the ≥ 40 %TBSA group. The caloric recommendations increased for all patients from week 1 to week 3 and leveled off during weeks 4–5. Conclusions Patient caloric requirements were dependent not only on the severity of the burn injury but also the post-burn hospitalization during which surgeries, debridement/grafting, and infectious complications occurred. They increased until the third week post-burn and leveled off in the recovery period. The study caloric recommendations and requirements were consistent with the REE and Curreri equation assessments.


2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S98-S98
Author(s):  
Jessica Banks ◽  
Matt Ferdock ◽  
Jennifer Nagle

Abstract Introduction Skin is not the only casualty following a burn accident. Many children suffer long term, debilitating emotional effects from their burn injury (Abdullah et al. 1994; Kornhaber et al. 2018). Armstrong-James et al. (2018) and Maslow and Lobato (2010) found that summer camps explicitly designed for burn survivor children can positively impact children’s adaptability to stares and comments and improve their sense of self-esteem. Camp Susquehanna has been a summer camp for burn survivors for the past 25+ years. When the COVID19 pandemic closed many businesses, we decided to transition our in-person camp to 100% online. Researchers demonstrated the positive effects of summer camp for burn survivors (Maslow & Lobato, 2010; Bakker et al. 2011). However, the effects of a 100% online camp are not known. Our concern was, are we able to transition and be as impactful as it is face to face at camp? What will the schedule and activities look like in this new format? How will we ensure all children participating will have access to online and the supplies necessary? Methods We opted to select a three-week format with two sessions a day divided into two age groups. We ensured every child had internet access then mailed out a “camp in the box.” It contained all the things needed for each planned activity. The critical question remained, however, will we be as impactful? The current research looks at quantitative and qualitative measures of self-esteem, happiness, and satisfaction following participation in a three-week summer program held in July 2020. We make comparisons to previous years’ results. The authors expected that self-esteem, happiness, and satisfaction levels matched or exceeded last years’ levels. Results We collected data from 42 campers and 22 volunteer camp counselors. Results show that campers were able to receive the support they needed, not only from the staff but also from their peers. Conclusions The delivery method was indeed different this year, but the positive effect on our campers remained the same.


2016 ◽  
Vol 22 (13) ◽  
pp. 1755-1766 ◽  
Author(s):  
Kirsty Garbett ◽  
Diana Harcourt ◽  
Heather Buchanan

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.


Author(s):  
Olivia R Stockly ◽  
Audrey E Wolfe ◽  
Richard Goldstein ◽  
Kimberly Roaten ◽  
Shelley Wiechman ◽  
...  

Abstract Depression and post-traumatic stress are common psychiatric comorbidities following burn injury. The purpose of this study was to develop an admission scoring system that assesses the risk of development of depression or post-traumatic symptoms in the burn population. This study is a retrospective review of the prospectively collected Burn Model System National Database. Adult burn survivors enrolled from 2014-2018 (n=486) were included. The primary outcome was the presence of depression or post-traumatic stress symptoms at 6, 12, or 24 months post-injury. Logistic regression analysis was used to identify demographic and clinical predictors of depression and post-traumatic stress symptoms. A risk scoring system was then created based on assigning point values to relevant predictor factors. The study population had a mean age of 46.5±15.8 years, mean burn size of 18.3±19.7%, and was 68.3% male. Prior to injury, 71.3% of the population was working, 47.9% were married, and 50.8% had completed more than a high school education. An 8-point risk scoring system was developed using the following predictors of depression or post-traumatic stress symptom development: gender, psychiatric treatment in the past year, graft size, head/neck graft, etiology of injury, and education level. This study is the first to develop a depression and post-traumatic stress symptom risk scoring system for burn injury. This scoring system will aid in identifying burn survivors at high risk of long-term psychiatric symptoms that may be used to improve screening, monitoring, timely diagnosis and interventions.


2017 ◽  
Vol 117 (5) ◽  
pp. 2065-2074 ◽  
Author(s):  
Michael D. Johnson ◽  
Alain Frigon ◽  
Marie-France Hurteau ◽  
Charlette Cain ◽  
C. J. Heckman

In this study we evaluate temporal summation (wind-up) of reflexes in select distal and proximal hindlimb muscles in response to repeated stimuli of the distal tibial or superficial peroneal nerves in cats 1 mo after complete spinal transection. This report is a continuation of our previous paper on reflex wind-up in the intact and acutely spinalized cat. To evaluate reflex wind-up in both studies, we recorded electromyographic signals from the following left hindlimb muscles: lateral gastrocnemius (LG), tibialis anterior (TA), semitendinosus (ST), and sartorius (Srt), in response to 10 electrical pulses to the tibial or superficial peroneal nerves. Two distinct components of the reflex responses were considered, a short-latency compound action potential (CAP) and a longer duration bout of sustained activity (SA). These two response types were shown to be differentially modified by acute spinal injury in our previous work (Frigon A, Johnson MD, Heckman CJ. J Physiol 590: 973-989, 2012). We show that these responses exhibit continued plasticity during the 1-mo recovery period following acute spinalization. During this early chronic phase, wind-up of SA responses returned to preinjury levels in one muscle, the ST, but remained depressed in all other muscles tested. In contrast, CAP response amplitudes, which were initially potentiated following acute transection, returned to preinjury levels in all muscles except for Srt, which continued to show marked increase. These findings illustrate that spinal elements exhibit considerable plasticity during the recovery process following spinal injury and highlight the importance of considering SA and CAP responses as distinct phenomena with unique underlying neural mechanisms. NEW & NOTEWORTHY This research is the first to assess temporal summation, also called wind-up, of muscle reflexes during the 1-mo recovery period following spinal injury. Our results show that two types of muscle reflex activity are differentially modulated 1 mo after spinal cord injury (SCI) and that spinal reflexes are altered in a muscle-specific manner during this critical period. This postinjury plasticity likely plays an important role in spasticity experienced by individuals with SCI.


2000 ◽  
Vol 6 (4) ◽  
pp. 259-a-262 ◽  
Author(s):  
D E Clark
Keyword(s):  

2014 ◽  
Vol 658 ◽  
pp. 471-476
Author(s):  
Mariana Rotariu ◽  
Florin Munteanu ◽  
Marius Turnea ◽  
Dragos Arotaritei

The biomechanics of the stump-prosthesis system and of the biphasic interaction between bone and muscle and also between stump and prosthesis belongs to a new interdisciplinary field in which modeling and numerical simulation research is the best solution to capture and investigate particular biomechanical aspects that have a high degree of intra-and inter-individual variability. By means of the reverse dynamics method, during the foot resting on the floor stages, one may thus define the biomechanical models of the anatomic stump-prosthesis system. The solution suggested relies on a set of methods including techniques specific to medical imaging analysis and processing, graphical 3D representation of the anatomic model developed using experimental data and its manipulation for study-related purposes or for later processing.The CAD modeling of the anatomic structures and prosthesis components was done using a series of conventional techniques available in the CAD SolidWorks 2008 and CosmosWorks2008 programming environment. A prerequisite for a successful recovery process is the patient’s availability to get actively involved in a physical therapy program. The monitoring of patients with amputated limbs that leave the hospital and of the complications developed in time in these patients is difficult since some miss their periodic follow-up examinations or are referred to other specialized departments. Therefore, a prediction of the evolution of the diminished functional capacity of patients with amputated limbs by stump-prosthesis system design using the finite element method is much more efficient.


Sign in / Sign up

Export Citation Format

Share Document