ReviewAdult burn survivors’ personal experiences of rehabilitation: An integrative review
Introduction
Since antiquity, the trauma of a severe burn has beset humankind with poor outcomes and survival rates. The loss of both function and independence, can be physically limiting, requiring aggressive rehabilitation to improve functionality and quality of life. Accordingly, rehabilitation is a critical element in the recovery of those who sustain severe burn injuries. Primarily, the importance of an early and rigorous focus on regaining physical and emotional independence remains critical. Consequently, identification of specific rehabilitation needs is a key priority for those with severe burns to facilitate the restoration of their independence. However, the progression to a rehabilitation facility is often delayed due to the rehabilitation facility's inability to manage burn wounds [1]. Moreover, there are increasing concerns related to complications with burn wound care requiring unplanned readmissions to burn units [2], [3]. Despite the extent of both the physical and psychological trauma endured, the growing body of literature concerning burn rehabilitation is based mainly on research relating to complications of severe burns and largely of a quantitative nature. However, there is dearth of literature that explores the personal perceptions and experiences of adults’ rehabilitation after a severe burn. Therefore this integrative review aims to illuminate the personal perceptions and experiences of rehabilitation as experienced by adult burn survivors through voice and narrative and to understand the factors that influence burn rehabilitation. The integration of burn survivors’ perspectives offers a means of reaffirming burn rehabilitation.
Section snippets
Review process
The framework guiding this integrative review is based on Whittemore and Knafl's [4] five stages: problem identification, literature search, data evaluation, data analysis and presentation (Fig. 1).
Literature search
A systematic search was conducted of PubMed, EMBASE, CINAHL, PsychINFO, Scopus and grey literature using the Trove database. Boolean connectors AND, OR and NOT were used to combine search terms as burn, rehabilitation, perception and experiences. In addition, the references of potential papers
Study characteristics
The review incorporated a broad perspective on adults’ perceptions and experiences of burn rehabilitation addressing peer support [7], [8], [9], adherence to therapy [10], the return to work [8], [11], psychosocial implications [12], quality of life [13], [14], adaption and coping [15], [16], [17] and regaining independence and the reintegration into society [9], [18], [19], [20]. Of the included 14 papers, there were 184 participants involved in studies conducted across eight different
Limitations and strength of evidence
This integrative review is limited by the small number of original papers that were identified for evaluation. Two studies used the same cohort of participants further limiting the pool of research that is incorporated into the integrative review [14], [15], [18], [13]. The incorporation of primarily qualitative studies may be viewed as a limitation. However, the importance of methodological congruence within the review requires consideration. The participants incorporated into the integrative
Conclusion
Ongoing educative support to the health professionals, burn survivors and their families remains an important element in burn rehabilitation. There is a necessity for appropriate knowledge and education based programmes for burn survivors with consideration given to the timing and delivery of education to facilitate the rehabilitation journey. Research that explores the broad understanding of burn survivors’ experiences and perceptions of both the physical and psychosocial rehabilitation
Conflict of interest
The authors declare that they have no conflicts of interest; such as employment, consultancies, stock ownership, honoraria, paid expert testimony, patent applications/registrations, grants or other funding.
References (29)
- et al.
Adherence to pressure garment therapy in adult burn patients
Burns
(2009) - et al.
Return to work after burns: a qualitative research study
Burns
(2009) - et al.
The epidemiology of burn injuries in an Australian setting, 2000–2006
Burns
(2009) - et al.
Development of a burn rehabilitation unit: impact on burn center length of stay and functional outcome
J Burn Care Rehabil
(1998) - et al.
The impact of a burn wound education program and implementation of a clinical pathway on patient outcomes
J Burn Care Rehabil
(2000) - et al.
Predictors of transfer from rehabilitation to acute care in burn injuries
J Trauma Acute Care Surg
(2012) - et al.
The integrative review: updated methodology
J Adv Nurs
(2005) - et al.
Outcomes and predictors in burn rehabilitation
J Burn Care Res
(2012) Suicide by self-immolation: comprehensive overview, experiences and suggestions
J Burn Care Res
(2007)- et al.
Adult burn survivors’ views of peer support: a qualitative study
Soc Work Health Care
(2010)
Return to work after burn injury: burn-injured individuals’ perception of barriers and facilitators
J Burn Care Res
Rising from the ashes: stories of recovery, adaptation and resiliency in burn survivors
Soc Work Health Care
Biopsychosocial factors that interfere in the rehabilitation of burn victims: integrative literature review
Fatores biopsicossociais que interferem na reabilitação de vítimas de queimaduras: Revisão integrativa da literatura
The meanings of quality of life: Interpretative analysis based on experiences of people in burns rehabilitation
Rev Lat Am Enfermagem
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