Challenges of home care in patients with burn: Experiences of patients, family caregivers and healthcare providers

Document Type : Original Article

Authors

1 Nursing and Midwifery Care Research Center, Department of Adult Health Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

2 Imam Musakazem Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

10.48307/nms.2023.403106.1181

Abstract

Background: Burns are a major health challenge in developing countries. Post-discharge problems of patients with burn are complex and require home care and educational interventions. However, few studies are available in this area.
Objectives: This study explored challenges of home care in burn patients from the perspective of patients, family caregivers, and health care providers.
Methods: This qualitative study was conducted during 2022 and 2023. Participants were purposively recruited from Imam Musakazem Hospital in Isfahan, Iran. Data were collected using semi-structured interviews. The qualitative content analysis approach proposed by Graneheim and Lundman was used for data analysis. The trustworthiness of the data was ensured using the criteria of confirmability, credibility, dependability, and transferability proposed by Lincoln and Guba.
Results: The study comprised 24 participants, including seven patients, four family caregivers, two physicians, two managers, and nine nurses. Three main categories were extracted including “the vague structure of home care,” “inefficient home care” and “informal home care.” Each category included 2-3 subcategories.
Conclusion: The home care program for burn patients requires reforms, such as changes in the administrative structure of home care, increasing the quality of home care centers, interdisciplinary collaboration between health team members, and boosting patients and their families’ awareness about the goals and application of the home care program.

Highlights

Sedigheh Farzi [Pubmed] [Google Scholar]

 

Keywords

Main Subjects


  1. Tian H, Wang L, Xie W, Shen C, Guo G, Liu J, et al . Epidemiologic and clinical characteristics of severe burn patients: results of a retrospective multicenter study in China, 2011-2015. Burns Trauma 2018;6:14. doi: 10.1186/s41038-018-0118-z  PMID: 29850643 PMCID: PMC5964711
  2. Smolle C, Cambiaso-Daniel J, Forbes AA, Wurzer P, Hundeshagen G, Branski LK, et al. Recent trends in burn epidemiology worldwide: a systematic review. Burns 2017;43(2):249-57. org/10.1016/j.burns.2016.08.013 PMid: 27600982 PMCid: PMC5616188
  3. World Health Organization. Burns. Available from: https://www.who.int/news-room/fact-sheets/detail/burns. [Last access date: 4 November 2023].
  4. The head of the support association for burn patients. Burned patients do not have a "stand". 30,000 people suffer serious burns every year. Available from: https://www.isna.ir/news/1401100100144/ [Last access date: 5 August 2023].
  5. Parachute, the Canada's national charity dedicated to injury prevention. Costs by Cause of Injury. Available from: https://parachute.ca/en/ professional-resource/cost-of-injury-in-canada/costs-by-cause-of-injury. 2018. [Last access date: 4 November 2023].
  6. Jeschke MG, van Baar ME, Choudhry MA, Chung KK, Gibran NS, Logsetty S. Burn injury. Nat Rev Dis Primers 2020;6(1):11. doi: 10.1038/s41572-020-0145-5 PMID: 32054846 PMCID: PMC7224101
  7. Rencken CA, Allorto N, Harrison AD, McGarvey ST, Aluisio AR. Factors associated with adherence to follow-up care after burn injuries. Burns 2021;47(1):240–8. doi: 10.1016/j.burns.2020.06.029 PMid: 32718731
  8. Du Y, Lv GZ, Yu S, Wang D, Tan Q. Long-term medical treatment of patients with severe burns at exposed sites. World J Clin Cases 2020;8(16):3515–26. doi:10.12998/wjcc.v8.i16.3515 PMid: 32913858 PMCid: PMC7457097
  9. Thompson DM, Thomas C, Hyde L, Wilson Y, Moiemen N, Mathers J. At home parent-administered dressing changes in paediatric burns aftercare: Interviews on parents’ experiences of treatment. Burns 2022;48(2):355–64. org/10.1016/j.burns.2021.06.005 PMid: 34844814
  10. Stanojcic M, Abdullahi A, Rehou S, Parousis A, Jeschke MG. Pathophysiological Response to Burn Injury in Adults. Ann Surg 2018;267(3):576–84. doi:10.1097/SLA.0000000000002097  PMid: 29408836 PMCid: PMC8966302
  11. Naylor MD, Toles M. The Challenge of Providing Evidence-based Transitional Care. Investig en Enfermería Imagen y Desarro 2021; 23:1-2. doi:10.11144/Javeriana.ie23.cpet
  12. Godleski M, Yelvington ML. Rehabilitation and therapy of the burn patient. Burn Care and Treatment: A Practical Guide 2021: 137-45. doi:10.1007/978-3-030-39193-5_10
  13. Parry I. Introduction to innovative solutions in burn rehabilitation from around the world. Burn Open 2021;5(4):52. doi:10.1016/j.burnso.2021.08.002   
  14. Toles M, Colón-emeric C, Naylor MD, Barroso J, Anderson RA. Transitional care in skilled nursing facilities : a multiple case study. BMC Health Serv Res 2016;16(186):1–14. doi:10.1186/s12913-016-1427-1 PMid: 27184902 PMCid: PMC4869313
  15. Jagnoor J, Lukaszyk C, Fraser S, Chamania S, Harvey LA, Potokar T, et al. Rehabilitation practices for burn survivors in low and middle income countries: A literature review. Burns 2018;44(5): 1052–64. doi:10.1016/j.burns.2017.10.007 PMid: 29290511
  16. HeydariKhayat N, Ashktorab T, Rohani C. Home care for burn survivors: A phenomenological study of lived experiences. Home Health Care Serv Q 2021;40(3):204–17. doi:10.1080/01621424.2020.1749206 PMid: 32264786
  17. Rencken CA, Harrison AD, Aluisio AR, Allorto N. A Qualitative Analysis of Burn Injury Patient and Caregiver Experiences in Kwazulu-Natal, South Africa: Enduring the Transition to a Post-Burn Life. Eur Burn J 2021;2(3):75–87. doi:10.3390/ebj2030007
  18. Jafarian AA, Farhoodi A, Jafarian Z, Emami A, Jafarian M, Salehi R. Investigating the possibility of using noninvasive basic monitoring in patients with acute burns undergoing general anesthesia. Arch Trauma Res 2020; 9(4): 173-175.
  19. Speziale HS, Streubert HJ, Carpenter DR. Qualitative research in nursing: Advancing the humanistic imperative. Lippincott Williams & Wilkins; 2011.
  20. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 2004;24(2):105-12.
  21. Guba EG. Criteria for assessing the trustworthiness of naturalistic inquiries. Educ Technol Res Dev 1981;29(2):75-91.
  22. Heydarikhayat N, Ashktorab T, Rohani C. Lived experiences of burn survivors regarding the challenges of home care follow-ups: a phenomenological study. Home Health Care Serv Q 2020;39(1): 33-49. doi:10.1080/01621424.2019.1671932 PMid: 31594490
  23. Moradian ST, Nourozi K, Ebadi A, Khankeh HR. Barriers against providing home health care delivery to ventilator-dependent patients: a qualitative content analysis. Trauma Mon 2017;22(3):1-7. doi: 10.5812/traumamon.31100
  24. Bäckström J, Willebrand M, Sjöberg F, Haglund K. Being a family member of a burn survivor–Experiences and needs. Burns Open 2018;2(4):193-8.  doi:10.1016/j.burnso.2018.07.001
  25. Bayuo J, Wong FKY. Issues and concerns of family members of burn patients: a scoping review. Burns 2021;47(3):503-24. org/10.1016/j.burns.2020.04.023 PMid: 32534893
  26. Hesselink G, Flink M, Olsson M, Barach P, Dudzik-Urbaniak E, Orrego C, et al. Are patients discharged with care? A qualitative study of perceptions and experiences of patients, family members and care providers. BMJ Qual Saf 2012;21:i39-i49. Doi:10.1136/bmjqs-2012-001165 PMid: 23118410
  27. Jones TM, Bhanji A, Ahuja G, Bakhtari R, Cai XC, Garfinkel S, et al. Examination of Health Information Needs of Caregivers of and Individuals with Burn Injuries. J Burn Care Res 2022;43(4):846-51. doi:10.1093/jbcr/irab211 PMid: 34718614 PMCid: PMC9249141
  28. Farzi S, Taleghani F, Yazdannik A, Esfahani MS. Communication culture in cancer nursing care: An ethnographic study. Support Care Cancer 2022;30(1):615-23. doi:10.1007/s00520-021-06388-2 PMid: 34357456
  29. Wu Y-H, Hsieh H-Y, Kuo Y-L, Wu C-Y. The experiences and needs of nurses providing home-based palliative care: A qualitative meta-synthesis. J Palliat Care 2022: 08258597221105167. doi:10.1177/08258597221105167 PMid: 35642265
  30. Wu C-Y, Wu Y-H, Chang Y-H, Tsay M-S, Chen H-C, Hsieh H-Y. Community Nurses’ preparations for and challenges in providing palliative home care: a qualitative study. Int J Environ Res Public Health 2021;18(22):11838. doi:10.3390/ijerph182211838 PMid: 34831593 PMCid: PMC8624655
  31. Fahimi S, Hajimehdipoor H, Abdollahi M, Mortazavi S. Burn healing plants in Iranian traditional medicine. Res J Pharmacognosy 2015;2(1):53-68
  32. Valizadeh L, Zamanzadeh V, Saber S, Kianian T. Challenges and barriers faced by home care centers: An integrative review. Med Surg Nurs J 2018;7(4): e83486. doi: 10.5812/msnj.83486
  33. Jeschke MG, van Baar ME, Choudhry MA, Chung KK, Gibran NS, Logsetty S. Burn injury. Nat Rev Dis Primers 2020;6(1):1-25. doi:10.1038/s41572-020-0145-5 PMid: 32054846 PMCid: PMC7224101
  34. Taleghani F, Farzi S, Yazdannik A, Esfahani MS. The shadow of paternalism on patient-centeredness in oncology nursing care: A barrier of health-care promotion. J Educ Health Promot 2022;11 (126):1-7. doi: 10.4103/jehp.jehp_793_21 PMid: 35677286  PMCid: PMC9170218