Coping strategies, social support, and mindfulness improve the psychological well-being of Jordanian burn survivors: A descriptive correlational study

The Impact of Individual Cognitive Stimulation Therapy on Caregivers of Burn Patients

This study aimed to investigate the effects of Individual Cognitive Stimulation Therapy (ICST) on the cognition, quality of life, and family relationships of caregivers of burn patients. A total of 98 caregivers of burn patients were randomly divided into a control group and a study group. The control group received routine interventions, while the study group underwent ICST, focusing on psychological diagnosis, comprehension, communication, and reeducation phases. Burn awareness levels, quality of life, social support utilization, and psychological resilience were assessed before and after the intervention. Before intervention, there were no significant differences in burn awareness levels, quality of life, social support utilization, or psychological resilience between the 2 groups. After the intervention, caregivers in the study group exhibited significantly higher scores in burn awareness levels, quality of life dimensions, social support utilization, and psychological resilience compared to the control group (P < .05). Individual cognitive stimulation therapy can improve the burn awareness level, quality of life, and social support utilization of caregivers of burn patients, highlighting its significant clinical implications in enhancing caregiver well-being and patient care.

The relationship between psychological resilience, perceived social support, acceptance of illness and mindfulness in patients with hepatolenticular degeneration

To investigates the current status of mindfulness in patients with Wilson's disease (WD) and to explore the effects of psychological resilience, perceived social support, and acceptance of illness on their mindfulness. By using the convenient sampling method, 136 patients with WD were selected from May 2019 to January 2023 in 12 tertiary hospitals in Chengdu. General information questionnaire, five facet mindfulness scale, resilience scale, acceptance of illness and perceived social support scale were used to conduct the investigation. Structural equation model was used to analyze the data. The score of mindfulness of patients with WD was (128.63 ± 22.62), and there were statistically significant differences in different courses of disease, clinical classification, and hospitalization times (P < 0.05). Perceived social support (β = 0.18, P < 0.01) and psychological resilience (β = 0.36, P < 0.05) directly affected mindfulness, perceived social support (β = 0.21, P < 0.01), and acceptance of illness (β = 0.11, P < 0.05) indirectly affected mindfulness through psychological resilience. Patients with WD have moderate levels of mindfulness, psychological resilience, perceived social support and acceptance of illness directly or indirectly affect their mindfulness. Nursing staff can help patients improve their mental defense ability, actively seek more social support, dialectical view, and accept the disease to improve their level of mindfulness to promote physical and mental health.

Psychological Distress and Quality of Life Among Military Trauma Patients

INTRODUCTION

Military trauma has a significant impact on soldiers, affecting many aspects of their lives, with the highest impact on their quality of life and psychological wellness. This study aimed to measure psychological distress and its relationship with the quality of life among Jordanian military trauma patients.

MATERIALS AND METHODS

A descriptive cross-sectional study was conducted in The Hashemite Protection Departments for military causalities in Amman, Irbid, and Al-Karuk. The authors used the WHO Quality of Life Scale-Brief and Trauma Symptoms Checklist-40 scales for assessing the quality of life and psychological distress among Jordanian military trauma patients. A total of 145 trauma survivors participated in the study and responded to all questionnaires out of 173 distributed. The study was approved by the institutional review board of Al-Zaytoonah University.

RESULTS

The result of this study revealed that military trauma survivors had high levels of psychological distress with a mean of 85.66 (SD = 19.418). The subscale of "Dissociation symptoms" had the highest rating (M = 19.92, SD = 5.096), while the "sleep disorders" subscale had the lowest rating (M = 10.000, SD = 3.501). On the quality of life scale, a moderate level of quality of life resulted among the participants with a mean of 61.620 (SD = 17.190). The "general health" subscale scored the highest among the other domains (M = 18.241, SD = 5.434), while the "physical health" domain scored the lowest (M = 4.910, SD = 2.078). Furthermore, a statistically significant negative relationship between psychological distress and quality of life was reported (r =-0.178, P < .05).

CONCLUSION

Jordanian injured military persons had a moderate quality of life level and high level of psychological distress. A structured follow-up program is required to be developed to improve those patients' health and quality of life. Furthermore, additional research is needed to investigate the impact of military trauma and services on soldiers in Jordan and the Middle East.

Post-traumatic growth and its explanatory factors in burn patients: A systematic review

A few studies have examined post-traumatic growth (PTG) after burns, a relatively new area of research. To understand how to promote PTG in burn survivors, we need to know how PTG and coping are presented, how they change over time, and the components that influence development. Based on the criteria of the PRISMA statement, we conducted our initial search on 1 February 2023. This study systematically reviewed relevant studies in five PubMed, Web of Science, Google Scholar, Scopus and Science Direct search databases. The search used the following keywords: Post-traumatic Growth, Psychological Growth, Post-traumatic Growth, Psychological, PTG, Burns and Burn. The two researchers evaluated the quality of the included studies using a 20-item tool called the appraisal tool for cross-sectional studies (AXIS tool). A total of 1396 burn patients participated in 12 studies. Among the studies included in this systematic review, seven were cross-sectional, and five were cohort. The average age of the patients in this study was 35.77 (SD = 10.19). Among the participants, 52.4% were men. The total body surface area (TBSA) percentage in these patients was 32.77 (SD = 16.42). The mean of PTG inventory (PTGI) was 54.08 (SD = 20.46) out of 105, which is a moderate level. Factors such as coping strategies, perceived social support, TBSA, religion/spirituality and severity of burn are positive factors for PTG in burn survivors. Also, factors such as depression, post-traumatic stress disorder and physical and mental recovery are negative factors for PTG in burn survivors. These factors can be improved through targeted intervention strategies, including overall function, quality of life, social support, optimism, hope and new opportunities. There is a need for further research in several areas related to growth, intervention and measurement.

Mindfulness, Social Support, and Psychological Distress Among Jordanian Burn Patients

Burn is associated with psychological distress, anxiety, and depression. Social support and mindfulness are considered a strength source for postburn survivors to resume their daily living activities. There is a lack of literature that supported the direct impact of mindfulness on social support and psychological distress among burn survivors. The aim of this study is to examine the impact of mindfulness and social support in enhancing the psychological well-being of burn survivors in Jordan. A cross-sectional descriptive design and convenience sampling technique were utilized to meet the study goal. A self-reported questionnaire was completed by a sample of 212 burn survivors. The questionnaire consists of 3 tools to measure psychological distress, social support, and mindfulness. A significant correlation was found between social support and psychological distress among the Jordanian burn survivors. Mindfulness revealed a distinctive variance in psychological distress among the study participants. In addition, some sociodemographic and clinical data have a relationship with psychological distress. Several factors among burn survivors have influenced their psychological and social support status. Also, mindfulness is important for enhancing psychological well-being and affecting the social support among burn patients.

The long-term intercorrelation between post-burn pain, anxiety, and depression: a post hoc analysis of the "RE-ENERGIZE" double-blind, randomized, multicenter placebo-controlled trial

BACKGROUND

Despite the growing prevalence of burn survivors, a gap persists in our understanding of the correlation between acute burn trauma and the long-term impact on psychosocial health. This study set out to investigate the prevalence of long-term pain and symptoms of anxiety and depression in survivors of extensive burns, comparing this to the general population, and identify injury and demographic-related factors predisposing individuals to psychosocial compromise.

METHODS

RE-ENERGIZE was an international, double-blinded, randomized-controlled trial that enrolled 1200 patients with partial- or full-thickness burns that required surgical treatment. For the post hoc analysis, we excluded participants who did not complete the Short Form Health Survey (SF-36) questionnaire. Normative data were taken from the 2021 National Health Interview Survey dataset. Propensity score matching was performed using the nearest-neighbor 1-to-1 method, and the two cohorts were compared in terms of chronic pain, and symptoms of anxiety and depression. A multivariable analysis was performed on the burns cohort to identify factors predicting post-discharge pain and symptoms of anxiety and depression.

RESULTS

A total of 600 burn patients and 26,666 general population adults were included in this study. Following propensity score matching, both groups comprised 478 participants each, who were predominately male, white, overweight and between 20 and 60 years old. Compared to the general population, burn patients were significantly more likely to report the presence of moderate and a lot of pain (p = 0.002). Symptoms of anxiety were significantly higher in the burn population in two of four levels (most of the time; some of the time; p < 0.0001 for both). Responders in the burn population were significantly less likely to report the absence of depressive symptoms (p < 0.0001). Burn patients were also significantly more likely to report that their mental health affects their social life. TBSA, history of depression, and female sex were identified as independently associated factors for pain, anxiety, and depressive symptoms. The presence of chronic pain and anxiety symptoms independently predicted for symptoms of depression.

CONCLUSIONS

Analyzing the largest multicenter cohort of patients with extensive burns, we find that burn injury is associated with chronic pain, and symptoms of anxiety and depression. In addition, TBSA-burned and history of depression directly correlate with the prevalence of chronic pain, and symptoms of anxiety and depression. Finally, pain, and symptoms of anxiety and depression are interrelated and may have interactive effects on the process of recovery following burn injury. Burn patients would, therefore, benefit from a multidisciplinary team approach with early mobilization of pain and mental health experts, in order to promptly prevent the development of psychosocial challenges and their consequences.

The effectiveness of the psychosocial empowerment program in early adjustment among adult burn survivors

BACKGROUND

Burns constitute a major global health challenge, causing not only physical trauma, but also significant psychosocial and emotional disturbances. The complexity of these injuries requires comprehensive rehabilitation programs that address both the physical and psychosocial aspects of recovery. Despite advances in medical care, there is a lack of standardized, accessible, and sustainable psychosocial interventions for burn survivors, particularly in the transition from hospital to home. This study aimed to develop and evaluate a nurse-led psychosocial empowerment intervention for early adjustment among burn survivors after hospital discharge.

METHODS

The study adopted a quasi-experimental framework. A convenient sample of 80 adult burn survivors was randomly divided into an intervention group, receiving the psychosocial empowerment program, and a control group, continuing standard care from November 2022 to May 2023. The effectiveness of the program was evaluated using various tools that measure satisfaction with appearance, coping abilities, and symptoms of post-traumatic stress disorder (PTSD). The intervention focused on enhancing resilience, self-efficacy, and adaptive coping, through targeted skill building in stress management, adaptability to coping, social reintegration, emotion regulation, and problem-solving.

RESULTS

Participants in the intervention group demonstrated significant improvements in body image satisfaction, coping abilities, and symptoms of PTSD compared to the control group.

CONCLUSIONS

The psychosocial empowerment program effectively addressed the psychosocial needs of burn survivors and enhanced their early adjustment after hospital discharge. The findings highlight the critical role of psychosocial support in the rehabilitation of burn survivors and underscore the need to integrate such interventions into standard post-discharge care. Future research should focus on the long-term effects of these interventions and their applicability in diverse settings.

A systematic review of social support and related factors among burns patients

Burn injuries, as a major public health problem, can lead to high morbidity and mortality. Burns is considered as one of the most devastating injuries globally and the fourth most common injury after traffic accidents, falls and interpersonal violence. Burn injuries can affect human life, such as physical and mental health, functional skills, and performance. Changes in appearance, social isolation, stress, anxiety, depression, low self-esteem, unemployment, financial burden and family problems can occur in these patients. These burn complications can be exacerbated without adequate social support. This systematic review evaluated burn patients' social support and related factors. A systematic search was performed on the international electronic databases such as Scopus, PubMed, Web of Science and Persian electronic databases such as Iranmedex, and Scientific Information Database using keywords extracted from Medical Subject Headings such as 'Burns', 'Social support', 'Perceived social support' and 'Social care' from the earliest to 30 April 2022. The quality of the included studies in this review was assessed using the appraisal tool for cross-sectional studies (AXIS tool). A total of 1677 burn patients were included in this review from 12 studies. Mean score of social support in burn patients based on multidimensional scale of perceived social support, Phillips's social support questionnaire, social support questionnaire, social support scale and Norbeck social support questionnaire were 5.04 (SD = 1.59) of 7, 22.06 (SD = 3.05), 78.20 (SD = 15.00) of 95, 82.24 (SD = 13.70) and 4.14 (SD = 0.99), respectively. Factors such as income, educational attainment, burn surface area, reconstructive surgery, quality of life, self-esteem, socialisation, posttraumatic growth, spirituality, and ego resilience had a significant positive relationship with social support of burns patients. Social support in patients with burn had a significant negative relationship with factors such as psychological distress, having children, life satisfaction, neuroticism and post-traumatic stress disorder. Overall, patients with burns had moderate levels of social support. Therefore, it is recommended that health policymakers and managers make it easier for burn patients to adapt to burns by providing psychological intervention programs and the social support needed by burn patients.

Feasibility of Mindfulness for Burn Survivors and Parents of Children with Burns

Burn survivors, spouses, and parents of children with burns may experience psychological distress for a prolonged period. Mindfulness-Based Stress Reduction (MBSR) is an intervention that can improve psychological well-being. This study aimed to examine the effectiveness of an MBSR group intervention in a convenience sample. An MBSR group intervention was conducted for burn survivors (n = 8) and parents of children with burns (n = 9), each comprising eight sessions. The participants completed the Beck Depression Inventory-II-NL, PTSS Checklist DSM-5, Five Facet Mindfulness Questionnaire-Short Form, Self-Compassion Scale-Short form, and evaluation questions at baseline, immediately after, and three months post-intervention. All participants completed the intervention. The intervention was rated very useful (M = 8.8), and the participants were very satisfied (M = 8.8). The highest effect was observed in the parents' group on mindfulness skills and self-compassion. For both groups, there was an increase in personal goal scores immediately after the intervention. Qualitative data show that the participants in both groups experienced more inner peace, more awareness of thoughts and emotions, and more self-compassion. This exploratory study suggests that a mindfulness intervention is feasible and can be effective in improving mindfulness skills and self-compassion, particularly in parents of children with burns.

Microbial community succession in the intestine of mice with deep partial-thickness burns

Introduction

Burn injury has been shown to lead to changes in the composition of the gut microbiome and cause other damage in patients. However, little is known about how the gut microbial community evolves in individuals who have recovered from burn injury.

Methods

In this study, we established a model of deep partial-thickness burn in mice and collected fecal samples at eight time points (pre-burn, 1, 3, 5, 7, 14, 21, and 28 days post-burn) for 16S rRNA amplification and high-throughput sequencing.

Results

The results of the sequencing were analyzed using measures of alpha diversity, and beta diversity and taxonomy. We observed that the richness of the gut microbiome declined from day 7 post-burn and that the principal component and microbial community structure varied over time. On day 28 after the burn, the microbiome composition largely returned to the pre-burn level, although day 5 was a turning point for change. Some probiotics, such as the Lachnospiraceae_NK4A136_group, decreased in composition after the burn but were restored in the later recovery period. In contrast, Proteobacteria showed an opposite trend, which is known to include potential pathogenic bacteria.

Conclusion

These findings demonstrate gut microbial dysbiosis after burn injury and provide new insights into the burn-related dysbiosis of the gut microbiome and strategies for improving the treatment of burn injury from the perspective of the microbiota.