Patient experiences of burn scars in adults and children and development of a health-related quality of life conceptual model: A qualitative study

Megan Simons; Nathaniel Price; Roy Kimble; Zephanie Tyack

doi:10.1016/j.burns.2015.11.012

Patient experiences of burn scars in adults and children and development of a health-related quality of life conceptual model: A qualitative study

Burns. 2016 May;42(3):620-32. doi: 10.1016/j.burns.2015.11.012. Epub 2016 Jan 20.

Authors

Megan Simons¹, Nathaniel Price², Roy Kimble³, Zephanie Tyack⁴

Affiliations

¹ Department of Occupational Therapy, Lady Cilento Children's Hospital, 501 Stanley St, South Brisbane, South Brisbane 4101, QLD, Australia; Centre for Burns and Trauma Research, Child Health Research Centre, Level 7, 46 Graham Street, South Brisbane 4101, QLD, Australia. Electronic address: Megan.Simons@health.qld.gov.au.
² Department of Occupational Therapy, Lady Cilento Children's Hospital, 501 Stanley St, South Brisbane, South Brisbane 4101, QLD, Australia. Electronic address: Nathaniel.Price@health.qld.gov.au.
³ Centre for Burns and Trauma Research, Child Health Research Centre, Level 7, 46 Graham Street, South Brisbane 4101, QLD, Australia; Department of Paediatric Surgery, Urology, Neonatal Surgery, Burns and Trauma, Lady Cilento Children's Hospital, Brisbane 4101, QLD, Australia; School of Medicine, The University of Queensland, St Lucia 4067, QLD, Australia. Electronic address: royk@uq.edu.au.
⁴ Centre for Burns and Trauma Research, Child Health Research Centre, Level 7, 46 Graham Street, South Brisbane 4101, QLD, Australia. Electronic address: z.tyack@uq.edu.au.

PMID: 26803365
DOI: 10.1016/j.burns.2015.11.012

Abstract

Purpose: The aim of this study was to understand the impact of burn scars on health-related quality of life (HRQOL) from the perspective of adults and children with burn scars, and caregivers to inform the development of a conceptual model of burn scar HRQOL.

Method: Twenty-one participants (adults and children) with burn scars and nine caregivers participated in semi-structured, face-to-face interviews between 2012 and 2013. During the interviews, participants were asked to describe features about their (or their child's) burn scars and its impact on everyday life. Two coders conducted thematic analysis, with consensus achieved through discussion and review with a third coder. The literature on HRQOL models was then reviewed to further inform the development of a conceptual model of burn scar HRQOL.

Results: Five themes emerged from the qualitative data: 'physical and sensory symptoms', 'impact of burn scar interventions', 'impact of burn scar symptoms', 'personal factors' and 'change over time'. Caregivers offered further insights into family functioning after burn, and the impacts of burn scars and burn scar interventions on family life. In the conceptual model, symptoms (sensory and physical) of burn scars are considered proximal to HRQOL, with distal indicators including functioning (physical, emotional, social, cognitive), individual factors and the environment. Overall quality of life was affected by HRQOL.

Conclusion: Understanding the impact of burn scars on HRQOL and the development of a conceptual model will inform future burn scar research and clinical practice.

Keywords: Burns; Cicatrix; Conceptual model; Health-related quality of life; Patient-reported outcomes.

MeSH terms

Activities of Daily Living
Adolescent
Adult
Aged
Burns / complications
Burns / physiopathology
Burns / psychology*
Caregivers
Child
Cicatrix / etiology
Cicatrix / physiopathology
Cicatrix / psychology*
Cross-Sectional Studies
Female
Health Status*
Humans
Male
Middle Aged
Models, Theoretical
Patient Reported Outcome Measures
Qualitative Research
Quality of Life*
Young Adult