Qualitative analysis of a psychological supportive counseling group for burn survivors and families in Malawi

Abstract

Objective While psychological care, including supportive group therapy, is a mainstay of burn treatment in the developed world, few reports of support groups for burn survivors and their caregivers in the developing world exist. This study records the findings of a support group in Malawi and provides a qualitative analysis of thematic content discussed by burn survivors and caregivers. Materials and Methods We established a support group for burn survivors and caregivers from February-May 2012 in the burn unit at Kamuzu Central Hospital in Lilongwe, Malawi. Sessions were held weekly for twelve weeks and led by a Malawian counselor. The group leader compiled transcripts of each session and these transcripts were qualitatively analyzed for thematic information. Results Thematic analysis demonstrated a variety of psychological issues discussed by both survivors and caregivers. Caregivers discussed themes of guilt and self-blame for their children’s injuries, worries about emotional distance now created between caregiver and survivor, fears that hospital admission meant likely patient death and concerns about their child’s future and burn associated stigma. Burn survivors discussed frustration with long hospitalization courses, hope created through interactions with hospital staff, the association between mental and physical health, rumination about their injuries and how this would affect their future, decreased self-value, increased focus on their own mortality and family interpersonal difficulties. Conclusions The establishment of a support group in our burn unit provided a venue for burn survivors and their families to discuss subjective experiences, as well as the dissemination of various coping techniques. Burn survivors and their caregivers in Malawi would benefit from the establishment of similar groups in the future to help address the psychological sequelae of burns.

Experiences of guilt, shame and blame in those affected by burns: A qualitative systematic review

“…The day before, I had burned ants using alcohol, and then, the next day, she did the same This sentiment was also expressed in another study [34] in which a parent expressed guilt and self-blame arising from their child's burn injury, and questions kept repeating in their mind: The guilt, and rumination that was experienced by family with regards to the burn and the healing process resulted in many questioning and doubting their abilities as parents and making relatively minor decisions [42].…”

“…This systematic review incorporated the experiences of guilt, blame and shame across the lifespan for burn survivors (n =187), their families as well as the experiences of the parents of burn injured children (n=154). Studies were conducted across eight countries; Australia [26][27][28][29][30], China [31], Brazil [32,33], Malawi [34], Sweden [35], India [36,37], Canada [38][39][40], United…”

“…Parents with feelings of guilt were identified across several of the included studies [29,[34][35][36][37]42]. Horridge et al [42] who examined the parental processes that influence children returning to school, found that guilt, as well as stress and anxiety experienced by parents concerning the burn and the recovery process led parents to question their own ability to be effective and protect their child against harm and this is reflected in this excerpt from a parent: [36] who reported that family and health professionals reprimanded them for not being responsible parents stating "They are not fit to parent" (p. 790).…”

Long-term medical treatment of patients with severe burns at exposed sites

“…Barnett et al[ 24 ] established a platform for burn survivors and their families to communicate together about daily care, functional exercises, and mental health, which was helpful in dealing with mental problems after an accident. The mental health of patients’ families is also of great importance, and a number of these patients are children, thus, their rehabilitation may be affected by their parents’ psychological status.…”

The Medical Social Worker: A Neglected Ally in the Management of Patients with Burn Injuries

“…Invariably, the MSW were still required to wear the discharge planner hat, but they equally helped the patients join a social support group. Establishing social support groups provides avenues for burn survivors and their families to discuss subjective experiences, as well as receive information on various coping techniques (21).…”