What's in a story? A text analysis of burn survivors' web-posted narratives

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

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.

Narrative discourse of burn injury and recovery on peer support websites: A qualitative analysis

Although advances have been made in burn care and recovery, less is known about the experience of living with severe burn injury. Like other patient groups, burn survivors are now turning to social media and shared web-based peer support resources during recovery and continuing long after discharge. Ongoing peer support is often part of the reclamation process after-burn injury. Peer support and event sharing helps foster hope, motivation and reassurance.

OBJECTIVES

To: 1) Examine and further understand the narrative discourse of burn survivorship in peer support social media content, 2) establish commonalities in the sharing community and key themes related to recovery and adaptation.

METHODS

This qualitative enquiry began with a comprehensive overview of burn narratives on survivor peer generated websites. We conducted a purposeful sampling of 21 biographies posted on burn survivor peer and patient support websites. Participants with greater than 30% burn injury were included that provided narrative and discourse regarding burn recovery and survivorship. Underlying story arcs, meaning behind sentences and shared language of the experience were investigated using thematic analysis.

RESULTS

Four themes were identified: retelling of the traumatic event; social support; body image, the new normal; and rebirth and transformation. Accounts reflected the traumatic nature of the event with slowed downtime, attention to details and heightened recall. The value of peer and family support was a common theme. There was attention to the challenges related to changed body image and regaining confidence in body appearance. Most stories also documented transitioning and rebirth and other more positive aspects of trauma recovery.

CONCLUSIONS

Accounting the burn experience and recovery is part of the reclamation process. Biographies document the trauma recovery process. Storying the event is an integral component of burn survivor community content. These online communities have become a mainstream resource and part of the reclamation process.

Context- and Subgroup-Specific Language Changes in Individuals Who Develop PTSD After Trauma

Post-traumatic stress disorder (PTSD) is a very common condition with more than 3 million new cases per year in the US alone. The right diagnosis in a timely manner is key to ensuring a prompt treatment that could lead to a full recovery. Unfortunately, avoidance of trauma reminders, social stigma, self-presentation, and self-assessment biases often prevent individuals from seeking timely evaluation, leading to delays in treatment and suboptimal outcomes. Previous studies show that various mental health conditions are associated with distinct patterns of language use. Analyzing language use may also help to avoid response bias in self-reports. In this study, we analyze text data from online forum users, showing that language use differences between PTSD sufferers and controls. In all groups of PTSD sufferers, the usage of singular first-person pronouns was higher and that of plural first-person pronouns was lower than in control groups. However, the analysis of other word categories suggests that subgroups of people with the same mental health disorder (here PTSD) may have salient differences in their language use, particularly in word usage frequencies. Additionally, we show that word usage patterns may vary depending on the type of the text analyzed. Nevertheless, more studies will be needed to increase precision by further examine a variety of text types and different comorbidities. If properly developed, such tools may facilitate earlier PTSD diagnosis, leading to timely support and treatment, which are associated with better outcomes.

Barriers and facilitators of implementing a collaborative HPV vaccine program in an incarcerated population: A case study

BACKGROUND

Men and women in county jails make up a population that is difficult to reach with traditional preventive health interventions. Collaborations between local health departments and county jails represent an opportunity to enhance public health by reaching a vulnerable population with services like vaccinations. The objective of this study was to coordinate planning and implementation of a collaborative program between a local health department (HD) and a county jail to offer human papillomavirus (HPV) vaccinations to adolescents (ages 10-17) and young adults (ages 18-26) in the jail and to identify facilitators and barriers to inform future program development.

METHODS

A county-municipal jail and a local HD in Kansas participated. A case study method was employed based on data collected from a focus group, telephone interviews, and site observations, September 2016 to December 2017. Data were coded using codes roughly drawn from the consolidated framework for implementation research (CFIR). Codes were then consolidated into themes related to barriers and facilitators.

RESULTS

No adults were vaccinated; two juveniles were vaccinated. Barriers to a collaborative program to offer HPV vaccine to young adults arose in two areas: constrained resources and divergent organizational cultures and priorities. Barriers to offering HPV vaccinations to juveniles in the jail included parental consent and the unpredictable, often brief duration of juvenile detentions. A shared commitment to offering HPV vaccination services by leaders and staff in the two agencies was a key facilitator.

CONCLUSION

Finding ways to leverage leadership and staff buy-in and address specific barriers of constrained resources and divergent culture and priorities merits close attention, since partnerships between jails and local HD have potential to increase HPV vaccination rates in an overlooked population and advance public health.

The lived experience of relationships after major burn injury

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.