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Prediction of psychological symptoms in family members of patients with burns 1 year after injury
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
2013 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 69, no 2, 384-393 p.Article in journal (Refereed) Published
Abstract [en]

Aim

To report a study of predictors of psychological symptoms in family members of patients with burns.

Background

Family members are important as a source of social support for patients undergoing prolonged rehabilitation. Little is known about psychological symptoms of family members of patients with burns, especially in the long term.

Design

The design of the study was prospective and longitudinal.

Methods

Forty-four family members of adult patients treated in a burn centre between 2000-2007 completed questionnaires during care and at 3, 6, and 12 months after injury. Psychological symptoms were assessed with the Hospital Anxiety and Depression Scale. Predictors for anxiety and depression were explored in regression analyses.

Results

The mean scores indicated normal to mild symptoms in general. Moderate and severe symptom levels during care and at 12 months were demonstrated on the anxiety subscale by 15/44 and 5/39, respectively, and on the depression subscale by 5/44 and 0/39 of the family members, respectively. In the final regression models, the primary predictor was psychological symptoms at the previous assessment. Other predictors were previous life events, age, and the coping strategy avoidance.

Conclusion

Family members of patients with burns demonstrate normal to mild levels of psychological symptoms that decrease over time. One-third show moderate to severe anxiety symptoms during care and may benefit from counselling. Previous symptoms predict later symptoms, indicating that screening with a validated instrument is useful. The results provide guidance for nurses in assessing and planning adequate interventions for family members.

Place, publisher, year, edition, pages
2013. Vol. 69, no 2, 384-393 p.
Keyword [en]
burns, family members, injury, nursing, psychological symptoms, rehabilitation
National Category
Psychiatry Nursing Surgery
Research subject
Psychiatry; Caring Sciences in Medical Sciences
Identifiers
URN: urn:nbn:se:uu:diva-190020DOI: 10.1111/j.1365-2648.2012.06017.xISI: 000313722600014PubMedID: 22509932OAI: oai:DiVA.org:uu-190020DiVA: diva2:582828
Available from: 2013-01-07 Created: 2013-01-07 Last updated: 2017-12-06Bibliographically approved
In thesis
1. Family Members of Patients with Burns: Experiences of a Distressful Episode
Open this publication in new window or tab >>Family Members of Patients with Burns: Experiences of a Distressful Episode
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

A severe burn is a trauma associated with long lasting consequences, not only for the survivor but also for the family. Although it is recognized that family members are central in providing social support for the patients, previous research has not focused extensively on this group. The aims of this thesis were to increase knowledge about psychological symptoms and health-related quality of life (HRQoL) in family members of patients with burns, as well as to explore their experiences of burn care and rehabilitation. The research questions were approached using quantitative and qualitative methods.

The results showed that most family members demonstrate normal to mild levels of psychological symptoms, while one third demonstrate moderate to severe symptoms during care. The symptoms decreased over time and could be predicted to a certain degree by early symptoms.

Further, family members’ report of HRQoL is similar to that of the general population. An improvement is seen over time and HRQoL could be predicted in part by earlier life events and psychological symptoms.

Family members’ experiences were explored in an interview study. Qualitative content analysis revealed that the time in hospital is stressful, although there were experiences of a positive character.  Family members might benefit from being cared for in a more individualized way. The communication between health care providers and the family members could be improved.

Finally, a qualitative content analysis revealed that family members’ experiences and views concerning support is highly individual. There were experiences of sufficient support as well as lack of professional support. Treatment of family members should be modified according to personal circumstances, and it is important to actively include family members in the care process, both before and after discharge.

In summary, being a family member of a burn survivor is a distressful experience, not only during care but in many cases also after discharge. The treatment of family members within burn care should be individualized. Some persons are more vulnerable than others and it might be possible to identify those in need of support while care is still ongoing.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2013. 56 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 935
Keyword
Critical care, Burns, Experiences, Health-related quality of life, Family members, Nursing, Support, Psychological symptoms
National Category
Nursing Surgery Psychiatry
Research subject
Psychiatry; Caring Sciences in Medical Sciences
Identifiers
urn:nbn:se:uu:diva-208626 (URN)978-91-554-8768-3 (ISBN)
Public defence
2013-11-22, Auditorium Minus, Gustavianum, Akademigatan 3, Uppsala, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2013-10-29 Created: 2013-10-06 Last updated: 2014-01-23

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Bäckström, JosefinEkselius, LisaGerdin, BengtWillebrand, Mimmie

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