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Burn injuries in Zimbabwe: development of guidelines for physiotherapy rehabilitation of musculoskeletal impairments and functional limitationsMudawarima, Tapfuma 18 August 2022 (has links) (PDF)
Background and need: Burn injuries are a major cause of hospital admission in low-income countries such as Zimbabwe and often lead to secondary complications such as disfigurements, contractures, and scar formations. The study aimed to establish “Guidelines for Rehabilitation of Musculoskeletal Impairments and Functional Limitations for Zimbabwe for Patients with Burns” based on the best evidence available. There were three good candidates for use as the source guideline, but ultimately, the Agency for Clinical Innovation (ACI) of New South Wales in Australia guidelines1 was chosen. The contextualisation of these guidelines for the Zimbabwean situation was informed by the outcomes of five sub-studies. A summary of the methodologies applied and the key results follow. Methods and Results: The Epidemiology of Burns in Zimbabwe: The characteristics of patients with burns in Zimbabwe was established through a retrospective record review (descriptive review) to characterise patients admitted with burns to the two central hospitals in Harare over fifteen months. The sample consisted of 926 admission records and 435 full patient folders were retrieved and analysed. Unfortunately, 425 full folders of children were missing and 85 folders of adults. There was a clear difference in presentation between children and adults, with children constituting over threequarters of all admissions, but with less severe injuries. Post-discharge follow-up: Access to rehabilitation and impact on Health-Related Quality of Life (HRQoL): The second study investigated the utilisation of post-discharge care, regarding referral after discharge and home programme. This was a study with a small sample, 14 adult and 23 child respondents. Despite referrals having been made to local rehabilitation departments, there was practically no further post-discharge contact with rehabilitation and only a single person received post-discharge rehabilitation. Both Health-Related Quality of Life (HRQoL) instruments used by the adult respondents indicated less impact on physical domains of functioning with the greatest impact in pain and emotional well-being. In the absence of trained counsellors, rehabilitation therapists might need to step into this role. Systematic review: The broad objective of this review was to systematically evaluate the effectiveness, safety and applicability to low-income countries of therapeutic exercises utilised by physiotherapists to improve function in patients with burns. The review, which included 19 papers, established that exercises (either resistance or aerobic), are effective and generally have a positive effect on muscle strength and aerobic capacity. However, there was a risk of bias in many of the papers and the evidence is not of high quality. As most of the research enrolled paediatric patients older than seven years and no adverse effects were reported, it can be concluded that resistance exercise is safe for this group of patients. However, as most children admitted with burns are younger than seven years, exercise needs to be carefully monitored in this group as safety and efficacy have not been proven for younger children. The results from this support the use of aerobic and resistance as an important component of a burn rehabilitation program as they have shown to improve muscle strength aerobic capacity and functional status even after hospital discharge, especially in patients with severe burns. Documentation of the current rehabilitation practice: This phase documented clinical interventions used to treat musculoskeletal problems by observation of seven rehabilitation workers (not only physiotherapists), based in the five central hospitals, one provincial and one district hospital. The treatments of five adults and five paediatric patients were observed at each hospital, a total of 70 treatments in all. The most significant finding was that the management of patients with burns was offered by a single rehabilitation worker a Physiotherapists (PT), Occupational Therapists (OT) or Rehabilitation Technician (RT), working in Burns' Units without any specialised training or additional courses. The management of burns across all hospitals was similar, and information saturation was reached with the planned number of observations. Passive and active movements were used almost universally, and the patients received a ward programme, which included positioning. Sitting and standing were included in some patients and patients were monitored for any adverse effects. A major weakness observed was the lack of baseline assessment or treatment progress during treatment. No compression bandages were applied and no scar tissue massage was done. Identification and adaptation of the suitable guidelines: Following a literature search and examination of different guidelines by two independent reviewers, the Agency for Clinical Innovation of New South Wales, Australia1 was chosen as a candidate for amendment. The guidelines were amended based on the results of the previous studies and subjected to a Delphi process with four to six Zimbabwean rehabilitation therapists who were experienced in the field of burn management. A credible set of guidelines for Zimbabwe for the rehabilitation of musculoskeletal impairments and functional limitations was thus produced. Conclusion: The current study adds to the body of knowledge through the development of guidelines for the physiotherapy rehabilitation of musculoskeletal impairments and functional limitations for patients with burns in low- and middle-income countries. The thesis has provided an evidence-based framework for patients, rehabilitation workers and policymakers to inform the provision of effective management of patients with burns. The Zimbabwe Guidelines should be regarded as a first attempt rather than the final version and hopefully will be subjected to further review as they are tried out in practice.
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Examination of burn patients' pain experience during resting conditions and proceduresBridges, Sharon 01 January 1999 (has links)
Pain is a major problem for bum patients, particularly during dressing changes and wound debridement. The bum patients' pain experience, related to resting conditions and procedural dressing changes, was studied. The purpose of this descriptive study was to describe bum patients' pain experience as related to resting and procedural pain and anxiety. Specifically, the research was designed to describe bum patients' pain and anxiety during resting conditions and dressing changes and describe bum patients' responses of their acceptable level of pain.
A convenience sample of 23 acutely burned adults over the age of 18 undergoing bum wound care without previous surgical intervention in a southeastern bum unit was recruited to participate in this study. Data were collected using the short-form McGill pain questionnaire, the Visual Analogue Scale-anxiety and the Visual Analogue Scale-pain. Demographics of the sample were collected. The Baseline Assessment Form and the Procedural Assessment Form were used to collect data regarding the setting and medications used prior to each measurement. Descriptive statistics, the Wilcoxon signed-ranks test, and the Friedman test were used to analyze data, describe the sample and report baseline and procedural responses of pain and anxiety.
The analysis of data revealed that there was a significant difference found between pain responses during resting conditions and procedures (z = -2.34, p = .02), with procedural pain being greater. There were no significant differences in anxiety between resting conditions and procedures (z = -1.41, p = .16). There was a significant difference between bum patients' acceptable level of pain, resting pain, and procedural pain (x2 = 9.2, p = .01). Resting pain was significantly lower than patients' acceptable level of pain (z = -2.97, p = < .01). Procedural pain was slightly lower than patients' acceptable level of pain but these results were not statistically significant (z = - .90, p = .37).
This study demonstrated that there are differences between bum patients' pain at rest and pain during procedures, specifically dressing changes. There are many implications for clinical practice. First, pain assessment must be based on the use of a valid and reliable patient self-report tool. Second, the pain management regimen must be highly individualized and should take into considerations the differences between resting and procedural pain. Third, pain and anxiety management should be studied utilizing multiple methods of pain and anxiety management techniques (i.e. medication, music, humor, and wound care teaching). Fourth, bum patients' acceptable level of pain should be assessed to provide adequate pain management. Lastly, further research is needed in the area of bum pain management. The area of bum pain management requires additional research to develop guidelines encompassing patients' bum experiences and effective outcomes focusing on the utilization of valid and reliable assessment tools.
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Difference between calorie requirements of enterally fed trauma and burn patients and actual calories suppliedRaven, Donna I. January 1998 (has links)
This study compared calorie needs, prescription and intake in enterally fed trauma and burn patients. Calorie needs of twenty-eight sequentially admitted patients were assessed by indirect calorimetry or by the Fick method. Caloric prescriptions were calculated from physicians orders. Following attainment of ordered goal rate, three day caloric intake was averaged. Caloric needs were not statistically different from caloric prescription. Caloric intake was significantly lower than caloric needs (p= 0.001). Intolerance and procedures were frequently cited reasons for withholding feedings. Results of this study suggest that trauma and burn patients may not receive the prescribed level of calories during the initial stage of enteral nutrition support. / Department of Family and Consumer Sciences
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Photoacoustic discrimination of viable and thermally coagulated blood for burn injury imagingTalbert, Robert John, January 2007 (has links)
Thesis (M.S.)--University of Missouri-Columbia, 2007. / The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file (viewed on January 11, 2008) Includes bibliographical references.
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Functional, psychological and community integration changes over time in persons with major burn injuryGrace, Sheila Ann Isom. January 2006 (has links) (PDF)
Thesis (M.S.) -- University of Texas Southwestern Medical Center at Dallas, 2006. / Not embargoed. Vita. Bibliography: 92-100.
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The nutritional management of adult burn wound patients in South AfricaEllmer, Marlene 12 1900 (has links)
Thesis (MNutr (Human Nutrition))--University of Stellenbosch, 2007. / OBJECTIVE: The objectives of this study were to determine the nutritional practices used in burns units in South Africa and to compare them with the latest available literature in order to make appropriate recommendations for possible implementation.
METHODS: Validated questionnaires were sent out to surgeons, dietitians and professional nurses working in burns units that complied with the inclusion criteria. Information on the units was obtained from an advertisement placed via email through ADSA. Non-random sampling was done and all the burns units were included in the study. Descriptive cross-sectional statistics were used to analyze the data.
RESULTS: Twelve burns units were identified. Ten of the burns units’ health professionals (surgeons, dietitians and professional nurses) participated in the study. All the health professionals had experience in burned patients’ management judging by the average number of year’s experience. The average number of adult burned patients treated was 188 (58-350) and the mortality per year was 16% [Standard Deviation (SD) 6.4%] About half of the professionals indicated they used a protocol for the implementation of nutrition support. A degree of miscommunication was noted between the health professionals working in the units. Very few units (n=2) were able to perform wound excisions within 72 hours post-burn. All the dietitians used predictive equations when estimating energy requirements and the most popular formula remained the Curreri formula. Various different predictive equations were used. Even though most institutions indicated that micronutrient supplementation was routine practice, no standard regimen existed and supplementation varied significantly between units. The oral route, enteral route or a combination were used to feed patients with different degrees of burns, and the majority (60%) of the health professionals stated that they waited until oral diets were tolerated before enteral nutrition was stopped. The nasogastric enteral route remained the most popular route. Very few units used other feeding routes, and they would rather opt for TPN if nasogastric feeding should fail. The estimated nutritional requirements were met in 90% of patients in whom the feeding tube was successfully placed. From the results it appeared that dietitians were less confident regarding the use of immunonutrition in burned patients, in spite of the available literature. Anabolic agents were not very commonly used in South Africa, probably due to the high cost. Patients were not followed-up regularly by dietitians.
CONCLUSION The results of this study indicated that despite the use of correct recommendations in certain instances there remained a definite degree of variation and uncertainty amongst health professionals. There also appeared to be poor communication between health professionals. The burns units in South Africa should use set standards for nutritional managements, obtain and implement strict feeding protocols and improve communication amongst the health professionals.
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Estudo da desacetilação da quitosana e obtenção de suas nanopartículas para aplicação em Engenharia de tecidos. / Study of the deacetylation of chitosan and the obtaining of its nanoparticles for application in Tissue Engineering.Souza, Juliana Rodrigues de 07 August 2017 (has links)
Estima-se, que, no Brasil, ocorram cerca de um milhão de vítimas de queimaduras por ano, e mesmo com a dinâmica de inovações na área da saúde, a reparação deste tipo de lesão tecidual, permanece um grande desafio. Os queimados tendem a contrair infecções sistêmicas, as quais poderão levar a óbito, se não houver o tratamento adequado ao paciente. Desta forma, são necessários cuidados extremos nas etapas que envolvem este complexo reparo tissular. Diante das dificuldades na substituição ou regeneração de órgãos ou tecidos lesionados, surgiu um campo interdisciplinar chamado de engenharia de tecidos, com foco no estudo para o desenvolvimento de suportes tridimensionais, constituídos de materiais sintéticos ou naturais, onde são cultivadas células do próprio paciente, para posteriormente serem reinseridas reparando tecidos ou substituindo órgãos por inteiro. A quitosana é um dos biopolímeros mais utilizados hoje na área de engenharia de tecidos, devido a sua capacidade de agir de forma significativa nas três fases que envolvem a cicatrização de queimaduras, sendo elas: a fase inflamatória, a fase proliferativa e a fase reparadora, e por sua alta ação bacteriostática e fungistática. Diante das propriedades já existentes da quitosana, o objetivo desta pesquisa foi o estudo para intensificá-las, através do aumento do seu grau de desacetilação e modificando-a para uma escala nanométrica aumentando assim sua área superficial. Para isso, a quitosana foi submetida a meio altamente alcalino com variação de temperatura e variação do tempo de reação, utilizando a ferramenta estatística fatorial completo 23. Após a obtenção das amostras desacetiladas, foi verificado, através dos espectros obtidos por espectroscopia na região do infravermelho, que os maiores valores de grau de desacetilação ocorreram utilizando os níveis máximos em todos os fatores envolvidos na reação. Para analisar a cinética da reação e confirmar as informações obtidas do fatorial 23, foi feito um novo planejamento fatorial 22, fixando o tempo de seis horas de reação, e no decorrer deste tempo foram retiradas onze alíquotas, para análise de seus graus de desacetilação (GD). O padrão de resultados dos experimentos permitiu a aplicação de um modelo matemático que representou a realidade do que ocorreu durante a reação, sendo este o modelo do núcleo não reagido. Posteriormente, a quitosana com alto grau de desacetilação foi submetida ao método de ultrassom e pelas análises do diâmetro das partículas, potencial zeta e índice de polidispersão, foi possível verificar que a quitosana após ser submetida ao ultrassom e no pH adequado, foi possível atingir partículas em escala nanométrica. / It is estimated that in Brazil about one million burn victims occur per year, and even with the dynamics of innovations in the health area, the repair of this type of tissue injury, remains a great challenge. Burns tend to contract systemic infections, which can lead to death if the patient is not adequately treated. In this way, extreme care is required in the steps involved in this complex tissue repair. Faced with difficulties in the replacement or regeneration of injured organs or tissues, an interdisciplinary field called tissue engineering has emerged, focusing on the study for the development of three-dimensional supports, consisting of synthetic or natural materials, where the patient\'s own cells are cultured, subsequently reinserted by repairing tissues or replacing whole organs. Chitosan is one of the most widely used biopolymers nowadays in the field of tissue engineering, due to its capacity to act in a significant way in the three phases that involve the healing of burns, namely: inflammatory phase, proliferative phase and repair phase, and for its high bacteriostatic and fungiostatic action. In view of the existing properties of chitosan, the objective of this research was to intensify them by increasing its degree of deacetylation and modifying it to a gauge scale, thus increasing its surface area. For this, chitosan was submitted to a highly alkaline medium with temperature variation and reaction time variation, using the complete factorial statistical tool 23. After obtaining the deacetylated samples, it was verified by spectroscopy in the infrared region, that the highest values of deacetylation degree occurred after using the maximum levels in all factors involved in the reaction. In order to analyze the kinetics of the reaction and to confirm the information obtained from factorial 23, a new 22 factorial design was made, fixing the time of six hours of reaction, during which eleven aliquots were taken for analysis of their degree of desacetylation (GD). The pattern of results of the experiments allowed the application of a mathematical model that represented the reality of what occurred during the reaction, being this the model of the shrinking core model. Subsequently, the chitosan with a high degree of deacetylation was subjected to the ultrasound method and the analysis of particle diameter, zeta potential and polydispersion index allowed to verify that chitosan after being submitted to ultrasound at the appropriate pH achieved particles in nanometer scale.
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Body Image Quality of Life Inventory - BIQLI: Adaptação para o português e validação para pacientes brasileiros, vítimas de queimaduras / Body Image Quality of Life Inventory- BIQLI: Adaptation to Portuguese and validation for Brazilian burn-victim patientsAssunção, Flávia Fernanda de Oliveira 19 September 2011 (has links)
O Body Image Quality of Life Inventory (BIQLI) é um instrumento composto por 19 itens e avalia o impacto positivo ou negativo da imagem corporal sobre alguns aspectos da vida: emoções, convívio social, alimentação, sexualidade, bem-estar emocional, exercícios, relacionamentos entre amigos, família e trabalho/escola. Originalmente proposto no idioma inglês, esse instrumento apresenta uma escala bipolar de resposta com sete opções. Os objetivos deste estudo metodológico foram adaptar o BIQLI para o português-Brasil e avaliar confiabilidade e validade da versão adaptada do instrumento, em uma amostra de pacientes brasileiros, vítimas de queimaduras. O processo de adaptação seguiu as seguintes etapas: tradução do BIQLI para o português por dois tradutores, obtenção da versão consensual em português, avaliação pelo Comitê de Juízes para análise das equivalências semântica, idiomática, conceitual e cultural, back-translation por dois tradutores americanos, obtenção da versão consensual em inglês, comparação da versão consensual em inglês com a versão original do BIQLI, envio da versão consensual em inglês a um dos autores do instrumento original, análise semântica dos itens e pré-teste da versão adaptada do BIQLI em pacientes brasileiros que sofreram queimaduras. A validade de construto foi avaliada pelo teste de correlação de Pearson entre os resultados obtidos pela aplicação do BIQLI e os resultados da avaliação de construtos correlatos - autoestima (com aplicação da Escala de Autoestima de Rosenberg) e qualidade de vida (com a aplicação da Burns Specific Health Scale- Revised). Para verificar o número de componentes do BIQLI e visando à comparação com outros estudos, foram realizados a análise dos componentes principais e o teste para comparação de grupos distintos. A confiabilidade foi avaliada pela consistência interna de seus itens (Alfa de Cronbach). O nível de significância adotado foi de 0,05. Participaram da etapa de validação 77 pacientes, com idades entre 18 e 62 anos, em atendimento no ambulatório da Unidade de Queimados do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto. A média dos valores obtidos para cada um dos 19 itens do BIQLI foi de 0,62 (Desviopadrão - D.P. = 1,1) e para o escore total do BIQLI foi de 11,8 (D.P. = 20,9). Com relação à validade de construto, obtiveram-se correlações moderadas entre as medidas de imagem corporal e autoestima (r= 0,30 e p= 0,008) e correlações moderadas entre as medidas de imagem corporal e as obtidas nos domínios afeto e imagem corporal (r= 0,45 e p= 0,000) e relações interpessoais ( r= 0,33 e p= 0,003) da BSHS-R. Com relação à confiabilidade, obtivemos um alto valor para a consistência interna da versão adaptada do BIQLI (Alfa = 0,90). A análise fatorial realizada com um único fator previamente determinado explicou 37,30% da variância de resposta, de forma que a menor carga encontrada foi 0,395. Concluímos que a versão adaptada do BIQLI atendeu aos critérios de validade e confiabilidade, mantendo as propriedades da versão original. / The Body Image Quality of Life Inventory (BIQLI) is an instrument composed of 19 items and assesses the negative or positive body-image impact over a few aspects of life: emotions, social life, diet, sexuality, emotional well-being, exercise, relationship with friends, family and work/school. Originally proposed in the English language, this instrument presents a bipolar response scale with seven options. The objective of this methodological study was to adapt the BIQLI to Brazilian Portuguese and assess the reliability and validity of the instrument\'s adapted version, in a sample of Brazilian patients victims of burns. The adaptation process followed the following steps: translation of the BIQLI into Portuguese by two translators, obtainment of the consensual Portuguese version, assessment by the Judging Committee to analyze the semantic, idiomatic, conceptual and cultural equivalence, back-translation by two American translators, obtainment of the consensual English version, comparison of the consensual English version with the original BIQLI version, forwarding of the consensual English version to one of the authors of the original instrument, semantic analysis of the adapted BIQLI version items and pre-testing on Brazilian patients that suffered burns. The validity of the construct was assessed through the Pearson correlation test between the results obtained through applying the BIQLI and the results of the correlate construct assessments - self-esteem (applying the Rosenberg Self-Esteem Scale) and quality of life (applying the Burns Specific Health Scale- Revised). To check the number of components in the BIQLI and aiming at the comparison to other studies, the main components were analyzed and the test to compare different groups was performed. The reliability was assessed through the internal consistency of its items (Cronbach Alpha). The significance level adopted was of 0.05. Seventy-seven patients, aged between 18 and 62 being treated at the outpatient clinic of the Ribeirão Preto Medical School Clinical Hospital Burn Unit participated in the validation phase. The mean of the values obtained for each one of the 19 items in the BIQLI was of 0.62 (Standard Deviation - S.D. = 1.,1) and for the total BIQLI score 11.8 (S.D. = 20.9). With regards to the construct validity, moderate correlations were obtained between the body-image and self-esteem measurements (r= 0.30 and p= 0.008) and moderate correlations between the body-image measurements and those obtained from the affection and body-image (r= 0.45 and p= 0.000) and interpersonal-relations ( r= 0.33 and p= 0.003) domains of the BSHSR. As to the reliability, we obtained a high value for the internal consistency of the adapted BIQLI version (Alpha = 0.90). The factorial analysis performed with a single predetermined factor explained 37.30% of the response variance, in such a way that the lowest load found was of 0.395. We concluded that the adapted BIQLI version met the validity and reliability criteria, maintaining the properties of the original version.
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Queimaduras com álcool em crianças: realidade brasileira e vulnerabilidades / Alcohol burns in children: Brazilian reality and vulnerabilitiesGino Cesar Cunha Arrunátegui 04 May 2011 (has links)
Grande número de casos de queimaduras com álcool entre adultos e crianças é frequentemente apontado nas casuísticas nacionais. A Resolução da ANVISA (Agência Nacional de Vigilância Sanitária) de 2002, que restringia a comercialização de álcool em grandes concentrações para uso doméstico, foi o reconhecimento oficial da existência deste tipo de queimadura como um problema social e de saúde pública. Dias antes de findar o prazo de adequação à medida, os maiores fabricantes do produto foram liberados de a acatarem. Passados alguns anos, buscou-se, na presente tese de doutorado, apreciar quesitos surgidos no debate de então, os quais ainda permanecem, dada sua relevância. Para melhor evidenciar os contornos e as implicações da questão abordada pela iniciativa governamental, este trabalho teve como objetivos: caracterizar a magnitude do problema das queimaduras no Brasil através da análise crítica das informações disponíveis e reconhecer os tipos mais frequentes da lesão; descrever a casuística de um centro brasileiro de referência no tratamento de queimaduras e situá-la em relação ao contexto nacional e internacional; caracterizar cenários e circunstâncias em que crianças foram vítimas de queimaduras com álcool, dentro de uma população delimitada; interpretar, instruídos pelo conceito de vulnerabilidade, as relações dinâmicas e as combinações existentes entre as condições individuais e sociais presentes nos contextos em que crianças sofrem queimaduras com álcool. A investigação empírica aliou ao método epidemiológico descritivo o enfoque qualitativo, apoiado em entrevistas em profundidade a partir de roteiro temático. Os dados permitiram sustentar que o Brasil exibe em seu perfil epidemiológico características que não são encontradas na literatura produzida em outras partes do mundo: alta proporção de queimaduras com álcool entre pacientes hospitalizados, sejam adultos ou crianças. Nas histórias relatadas pelos pais entrevistados foram reconhecidos elementos do universo simbólico das camadas populares, assim como dinâmicas sociais e culturais subjacentes aos comportamentos aparentemente inadequados (ou vulneráveis, pela perspectiva adotada na pesquisa) na utilização do álcool, que resultaram na queimadura de seus filhos / Large numbers of burn cases with alcohol among adults and children are often pointed out in the national case series. A resolution from ANVISA (Agência Nacional de Vigilância Sanitária) in 2002, which restricted the sales of alcohol in high concentrations for home use, was the official recognition of the existence of this type of burn as a social and public health problem. Days before the expiration of the period of adjustment, the major product manufacturers were released from the heeding. After a few years, we sought to consider questions arose in the debate at that time in this thesis, questions which still remain due to their importance. To better highlight the contours and implications of the issue addressed by government initiative, this study aimed to: characterize the magnitude of the problem of burns in Brazil through critical analysis of available information and recognize the most frequent types of injury; describe the series of a Brazilian reference center for treatment of burns and situate it in relation to national and international context; characterize scenarios and the circumstances in which children were victims of burns with alcohol within a defined population; interpret, instructed by the concept of vulnerability, the dynamic relationships and the combinations between the individual and social conditions present in the contexts in which children suffer burns with alcohol. The empirical investigation allied the qualitative approach to the descriptive epidemiological method, supported with in-depth interviews from thematic guide. The data allowed the claim that Brazil exhibits in its epidemiological profile characteristics that are not found in the literature produced in other parts of the world: a high proportion of burns with alcohol among hospitalized patients, whether adults or children. In stories reported by the surveyed families, elements of the symbolic universe of the popular classes were recognized, as well as social and cultural dynamics underlying the apparently \"inadequate\" behavior (or vulnerable, by the perspective adopted in the research) in the use of alcohol, which resulted in the burning of their children.
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A Família da Criança Vítima de Queimaduras: Vivência dos pais frente à Hospitalização. / The Parents experience towards Hospitalization.Viana, Joelma de Matos 08 March 2013 (has links)
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Previous issue date: 2013-03-08 / Significant advances in knowledge about burn trauma impacts on the victim and
their families have been achieved in recent decades. In order to contribute with
these results, this paper aimed to investigate the experience of parents facing
the hospitalization and the physical and emotional rehabilitation of child burn
victim. Furthermore, as specific goals: Identify how and under what conditions
the burns occurred; know the adopted procedure to cope with burn accidents
and the feelings experienced due to the process that culminated in the accident
and subsequent hospitalization; verify the adoption of preventive measures after
the accident. The paper adopted qualitative and interpretative characters
following the methodological framework of Grounded Theory. The study was
conducted at the Center of Burn Victims Protection, an NGO linked to Burns
Hospital in Goiás, with nine mothers and one father who have had their children
victimized by burns. Data were collected between June and October 2012 using
a semi-structured interview and subsequently analyzed following the initial and
focused coding proposed by Charmaz. Four central categories emerged from
the analysis, some with subcategories, which are presented as follows: The
History of Accident (with the subcategories: Condition and Scene of the
Accident and Trauma on the Family); Impacts of the Burn on the Family;
Implications of Burn on a Child s Life; course (with the subcategories:
Experiences, Coping, Resources and Reinterpretation). The results lead to
realize the importance of ensuring the permanence of the family with the child
during hospitalization as a key element in the process of recovery of the victim.
The painful episodes experienced lead to a reflection and a production of
meanings to the illness experience, rearranging the family s life, that learns and
reframes their concepts and values from the trauma because it receives
unconditional support of professionals during the initial hospitalization and then
on the phase of physical and social rehabilitation. / Significativos avanços no conhecimento acerca dos impactos do trauma da
queimadura sobre a vítima e seus familiares têm sido alcançados nas últimas
décadas. Visando contribuir com tais resultados este estudo teve objetivo geral
investigar a vivência de pais frente à situação de hospitalização e reabilitação
física e emocional da criança queimada. Para o alcance dos resultados foi
adotado o estudo qualitativo de caráter interpretativo seguindo o referencial
metodológico da Teoria Fundamentada em Dados. O estudo foi realizado no
Núcleo de Proteção aos Queimados, uma ONG vinculada ao Hospital de
Queimaduras do estado de Goiás, e contou com a participação de nove mães e
um pai de crianças que foram vitimadas pela queimadura. Os dados foram
coletados entre os meses de junho e outubro de 2012 por meio de um roteiro
de entrevista semi-estruturado e posteriormente analisados seguindo a
codificação inicial e focalizada proposta por Charmaz. Da análise emergiram
quatro categorias centrais, algumas com subcategorias, que estão assim
apresentadas: A História do Acidente (com as subcategorias Condição e Cena
do Acidente e A Família diante do Trauma); Impactos da Queimadura sobre a
Família; Implicações da Queimadura Sobre a Vida da Criança; Percurso (com
as subcategorias: Vivências, Enfrentamento, Recursos e Ressignificação). Os
resultados encontrados levam a perceber a importância da garantia de
permanência do familiar junto à criança durante a hospitalização como um
elemento fundamental no processo de recuperação da vítima. Os episódios
dolorosos vivenciados levam a uma reflexão e produção de sentidos para a
experiência da doença, reordenando a vida da família, que aprende e
ressignifica os seus conceitos e valores a partir do trauma, pois recebe apoio
incondicional de profissionais especializados durante a hospitalização inicial e,
posteriormente, na fase de reabilitação física e social.
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