Burn Survivors' Experience of Core Outcomes during Return to Life: a Qualitative Study

[Systematic evaluation of qualitative research on the real experience of burn patients during rehabilitation]

Objective: To systematically evaluate and integrate the real experience of burn patients during rehabilitation, and to provide theoretical guidance for the continual nursing care for burn patients. Methods: The systematic evaluation method was adopted. Databases including the China National Knowledge Internet, Wanfang Database, China Biology Medicine disc were retrieved with the search terms in Chinese version of "/, //, ////", and PubMed, Embase, CINAHL, PsycINFO, Cochrane Library were retrieved with the search terms of "burn/burns, rehabilitation/recovery/survivor/survive, experience/views/perceptions/, qualitative/phenomenon/interview/grounded theory". The qualitative studies on the real experience of burn patients during rehabilitation published from the establishment of each database to June 2020 were searched. The quality of the included studies was evaluated according to the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center. The research country, research method, research object, research content, and main research result were summarized, and meta-synthesis of the research results was conducted with the aggregative integration method. Results: A total of 12 studies were included, and the quality of all the studies was grade B. The studies were conducted in 8 countries including Australia, Canada, Norway, etc., the research method mainly was phenomenological research method, and all the studies were focused on adult burn patients. A total of 46 specific themes were extracted with totally 10 new categories formed after summarization, and 3 integrated results were obtained as follows: burn patients suffered from both physical and psychological burdens, and their normal life was broken; burn patients gained post-traumatic growth and could actively adjust to cope with life difficulties; burn patients had multiple needs. Conclusions: Burn patients experience both physical and psychological pains during rehabilitation, so they long for multiple support from family and society. Medical staff, social groups, and family members should pay attention to the psychological experience and needs of burn patients with different characteristics during rehabilitation, and build a multi-directional social support system to help patients return to the society and rebuild their lives.

Nursing process from theory to practice: Evidence from the implementation of "Coming back to existence caring model" in burn wards

Aim

To develop the caring model and utilize and evaluate the effect of the model in the nursing student's learning process in burn wards.

Design

A longitudinal multiphase study.

Methods

In the first phase, "Coming back to existence caring model" was developed, in the second phase, to evaluate the program, 35 students in the first semester and 31 students in the second semester of the 2017–2018 academic year were selected randomly, and their logbooks were analysed.

Results

Components of the nursing process, based on the model, were wound management, care and documentation, early mobilization, discharge planning and patient education. The lowest nursing process utilization in both semesters was in the sexuality domain. The most nursing diagnosis was a risk for infection. In the discharge plan, education about how the patient communicates with others in the second semester was less than other educational content (61/3%). However, empowering students was remarkable.

Pay-for-performance challenges in family physician program

OBJECTIVE

This study was conducted to investigate the challenges faced in the implementation of the pay-for-performance system in Iran's family physician program.

STUDY DESIGN

Qualitative.

PLACE AND DURATION OF STUDY

The study was conducted with 32 key informants at the family physician program at the Tabriz University of Medical Sciences between May 2018 and June 2018. Method: This is a qualitative study. A purposeful sampling method was used with only one inclusion criterion for participants: five years of experience in the family physician program. The researchers conducted 17 individual and group non-structured interviews and examined participants' perspectives on the challenges faced in the implementation of the pay-for-performance system in the family physician program. Content analysis was conducted on the obtained data.

RESULTS

This study identified 7 themes, 14 sub-themes, and 46 items related to the challenges in the implementation of pay-for-performance systems in Iran's family physician program. The main themes are: workload, training, program cultivation, payment, assessment and monitoring, information management, and level of authority. Other sub-challenges were also identified.

CONCLUSION

The study results demonstrate some notable challenges faced in the implementation of the pay-for-performance system. This information can be helpful to managers and policymakers.

Lived experiences of burn survivors regarding the challenges of home care follow-ups: a phenomenological study

Burn victims often require long-term treatments. Patients prefer to be at home while receiving care services but there are some deficiencies in conducting home care. To explore the challenges of nurse-led follow-up, 16 burn survivors who received home care for 6 months were interviewed. The theme, "barriers of care," was extracted. It included two subthemes entitled "Barriers related to implementation of home care and "Barriers of ideality." Providing home care for burn survivors encounters several barriers that were classified into two categories including modifiable and nonmodifiable barriers. Suitable infrastructure and policies are necessary to conduct home care for burn survivors.

The main concern of burn survivors in Iran

Background:

The present work was conducted to study the burn patients’ experiences to get an insight into their main concerns when they suffer the tragic event, recover from it, and adjust back in the society, so that better rehabilitation programs can be planned corresponding to their needs as well as to the needs of the society and the existing situations.

Materials and Methods:

In this qualitative study, 17 burn survivors were enrolled. Unstructured interviews were used for data collection. All the interviews were recorded, transcribed, and analyzed using qualitative content analysis method.

Results:

Based on the existing elements of the explicit textual meanings, two categories of threat and disturbance were formed. The category of threat was extracted from the following five subcategories: (a) Threat to physical life; (b) threat to the process of living; (c) psychological threat; (d) spiritual threat; and (e) social threat. The category of disturbance was extracted from the following three subcategories: (a) Sensory disturbance: Suffering pain; (b) self-concept disturbance; and (c) behavioral disturbance.

Conclusions:

Burn survivors experience severe pain, enduring and suffering in their daily activities after burn. Passing through these difficult trajectories is perceived as a threat and disturbance in self-integrity.

Road Traffic Accident Victims' Experiences of Return to Normal Life: A Qualitative Study

Background

Road traffic accident (RTA) victims also suffer from different types of injuries and disabilities, which can affect their quality of life. They usually face with various physical, mental, and social problems. Most traffic accident victims had difficulty to return to normal life.

Objectives

This study aimed to understand the experiences of return to normal life in RTA victims.

Patients and Methods

This qualitative study with content analysis approach was conducted on 18 Iranian patients with disability in the upper or lower limbs caused by traffic accidents, who had passed a time between 3 months till 2 years. A purposeful sampling method was applied until reaching data saturation. Data were collected using semi-structured interviews. Afterwards, the gathered data were analyzed through conventional content analysis.

Results

By analyzing 498 primary codes, four main categories, including supportive needs, adaptation to the new situation, seeking information, and transition from functional limitation, were extracted from traffic accident victims’ experiences of reintegration to normal life.

Conclusions

The results of this study may help policy-makers to take steps toward health promotion and recovery of RTA victims. Considering the results of this study, it is a need for further research to investigate RTAs victims’ needs for reintegration to home and community. Access to training and supportive facilities like strong therapeutic, nursing and social support, and the possibility to participate in self-care activities is essential for reintegration to community in RTA victims.