The patient–body relationship and the "lived experience" of a facial burn injury: a phenomenological inquiry of early psychosocial adjustment

Abstract

BackgroundThroughout development and into adulthood, a person’s face is the central focus for interpersonal communication, providing an important insight into one’s identity, age, sociocultural background, and emotional state. The face facilitates important social, including nonverbal, communication. Therefore, sustaining a severe burn, and in particular a facial burn, is a devastating and traumatizing injury. Burn survivors may encounter unique psychosocial problems and experience higher rates of psychosocial maladjustment, although there may be a number of potentially mediating factors.ObjectivesThe purpose of this phenomenological study was to examine the early recovery experience of patients with a facial burn. In particular, this study focused on how the injury impacted on the participants’ relationship with their own body and the challenges of early psychosocial adjustment within the first 4 months of sustaining the injury.MethodsIn 2011, six adult participants encompassing two females and four males ranging from 29 to 55 years of age with superficial to deep dermal facial burns (with background burns of 0.8%–55% total body surface area) were recruited from a severe burn injury unit in Australia for participation in a Burns Modified Adult Attachment Interview. Narrative data were analyzed thematically and informed by Colaizzi’s method of data analysis.ResultsThree overarching themes emerged: relationship to self/other, coping, and meaning-making. Themes identified related to how the experience affected the participants’ sense of relationship with their own bodies and with others, as well as other challenges of early psychosocial adjustment. All participants indicated that they had experienced some early changes in their relationship with their body following their burn injury.ConclusionThese findings highlight the struggle burn survivors experienced with postburn adjustment, but expressed altruism and optimism around their recovery. Past trauma was observed to be a significant finding in this sample. Understanding the “lived experience” supports the way clinical and family systems can foster positive adjustment and coping. Consequently, multidisciplinary burn teams and health care professionals need to understand the principles of trauma-informed care and translate these into practice in the treatment of this group of patients.

Nursing Student Experiences of Caring for Burned Patient: From Fearfulness to Normalization

“…This has been pointed out in other studies as well. ( 12 , 19 ) Consistent with the findings of the present study, and according to other research, nurses working in burn units benefit from different strategies for mitigating their stress and dealing with the challenges they encounter in taking care of burned patients, namely maintaining a positive attitude and getting involved in the care process, (20, 21) being a pragmatic and committed nurse in the burn unit,( 13 ) putting himself/herself in the place of patient and their family, showing empathy and compassion,( 13 , 21 ) and supporting the leadership. ( 22 , 23 ) It seems that adaptation to the stress management challenges of burned patients is a prerequisite for the basic learning of burn care and participation in the care process of these patients.…”

“…However, in order to increase the tendency of students to take care of burned patients and improve their learning, there is a need to reduce students' stress by removing their concerns and also preparing them for pre-internship. In the study by Kornhaber,( 13 ) it was shown that emotional strength and feeling detachment are basic elements in facilitating the process of accepting the patient’s condition and following the procedures of giving care services to burned patients.…”

“…Before they started their internship and burn care course, students had a kind of fear about providing care services in the burn unit because of what they had heard from other students; yet, by getting involved in care services in the burn unit, their attitude changed considerably and they came to a sense of normalization. In the study conducted by Kornhaber,( 13 ) all the participants experienced apprehension in taking care of burned patients. Apparently, some part of the students’ first apprehension was due to their partial knowledge of burn care and of what they would be expected to do in the burn units.…”

Evaluating the Effects of a Trauma Recovery Program for Korean Burn Patients

“…This finding indicated that participants in the intervention group were more likely to have a facial burn. Several studies reported that patients with a facial burn had the highest emotional distress and experienced psychological and social challenges of living with "disfigurement" (Gullick et al, 2014;McLean et al, 2015;Rahzani et al, 2009). As a result, the significant difference in facial burns between the two groups may influence study outcomes; thus, the current study statistically controlled this variable in all analyses.…”

Challenges of nurses and family members of burn patients: Integrative review

“…For the BICU nurses, their challenges may be higher than nurses in the general wards since patients in the ICU may have higher acuities and more needs. In addition, critically ill patient's care demands are generally higher, thus further aggravating the physical and emotional exhaustion of BICU nurses (Carlson, 2013 ; Rachel Anne Kornhaber, 2009 ). On that basis, mutual peer supports and relevant education and training are required (Bayuo, 2018 ).…”