An exploration of burn survivors' experiences of pressure garment therapy at Tygerberg Academic Hospital

Pillay, Rogini (2014-04)

Thesis (MSc)--Stellenbosch University, 2014.

Thesis

ENGLISH ABSTRACT: Introduction: Pressure garment therapy (PGT) forms a significant part of burn rehabilitation. It is most commonly used to treat hypertrophic scars but the benefits of this intervention remain questionable. Adherence with this intervention also presents several challenges for the patient and clinician. Aim of the study: The aim of this study was to explore the experiences of adult burn survivors who participated in PGT during 2006 - 2010 at Tygerberg Academic Hospital (TAH). Methods: A phenomenological study design using qualitative research methods was implemented. Semi-structured interviews were conducted with eight burn survivors. The participants were chosen using purposive sampling methods. Thematic analysis was conducted using pre-determined themes from the literature as a starting point. Data was coded and categorised according to themes that emerged during data analysis. Results: The findings of the study revealed that several factors impacted on the participant’s experiences of pressure garment therapy. Factors related to the consequences of the burn injury included the participant’s loss of function, loss of participation, loss of self-confidence, financial dependence, emotional impact and impact on relationships. Factors related to pressure garment usage included physical effects, socio-emotional effects and the wearing schedule (which included maintenance and effort, adherence and time). Factors that contributed to adherence included support, inner strengths, knowledge, seeing a difference, seeing others, enablers to accessing the service and satisfaction with the service. Factors that contributed to non-adherence included lack of support, emotional turmoil and barriers to accessing the service. Participants made recommendations to improve the overall burn service at TAH. Conclusion: The findings of the study show that participants experienced PGT as a beneficial intervention. There were several complex factors that impacted the participants’ experiences of PGT. The most significant benefit as described by the participants was the improvements noted in scar appearance, whilst the main barrier was that the garments were cosmetically displeasing due to their colour.Recommendations: To adopt a person-centred approach to burn management, recommendations made include improvements needed within the occupational therapy service such as changing the colour of the garment material, the standardisation of the PGT treatment protocols and improving staff attitudes. Other recommendations include establishing a network for counselling services as well as an information pack for patients admitted to the burns unit.

AFRIKAANSE OPSOMMING: Drukklereterapie vorm ʼn belangrike deel van die rehabilitasie van brandwonde. Dit is die mees algemene behandeling vir hipertrofiese littekens, maar daar bestaan steeds twyfel aangaande die voordele van hierdie intervensie. Daar bestaan heelwat uitdagings, vir beide die terapeut en die pasiënt, om die behandelingsriglyne na te volg. Doel van die studie: Die doel van hierdie studie was om die ervarings van volwasse brandwond oorlewendes wat vanaf 2006 tot 2010 drukklereterapie by Tygerberg Akademiese Hospitaal ontvang het, te ondersoek. Metode: ʼn Fenomenologiese studie ontwerp is geimplïmenteer deur middel van kwalitatiewe navorsingsmetodes. Semi-gestruktureerde onderhoude is met agt brandwond oorlewendes gevoer. Die deelnemers is gekies deur doelgerigte steekproefneming metodes. Tematiese analise is uitgevoer met behulp van voorafbepaalde temas wat as beginpunt uit die literatuur geneem is. Data is gekodeer en gekategoriseer volgens temas wat na vore gekom het tydens data analise. Resultate: Die bevindings van die studie het aangedui dat verskeie faktore die deelnemers se ervarings van drukklereterapie beïnvloed het. Faktore wat met die gevolge van die brand beserings verband hou het die volgende ingesluit: verlies aan funksie, verlies aan deelname, verlies aan selfvertroue, finansiële afhanklikheid, emosionele impak en die impak op verhoudings. Die volgende faktore het verband gehou met die gebruik van drukklere: fisiese faktore, sosio-emosionele faktore en die dra skedule (dit sluit in onderhoud van die drukklere, moeite, volg van die dra skedule en tyd). Faktore wat bygedra het tot die navolging van die skedule het die volgende ingesluit: ondersteuning, innerlike krag, kennis, die sien van ʼn verskil, sien van ander, toegang tot die diens en tevredenheid met die diens. Die volgende faktore het bygedra tot nie-navolging: gebrek aan ondersteunning, emosionele verwarring en hindernisse tot toegang tot die diens. Deelnemers het aanbevelings gemaak om die brandwonde diens te verbeter. Slot: Die bevindings van die studie dui daarop dat die deelnemers drukklereterapie as ʼn voordelige intervensie ervaar het. Daar was verskeie komplekse faktore wat ʼn impak op drukklereterapie gehad het. Die grootste voordeel, soos beskryf deur deelnemers, was die verbetering in litteken voorkoms; terwyl die hoof hindernis was dat die drukklere kosmeties onaanvaarbaar was as gevolg van die kleur. Aanbevelings: Die volgende aanbevelings is gemaak om ʼn persoon-gesentreerde benadering tot brandwond behandeling te verseker: verbeterings benodig binne die arbeidsterapie diens, soos die verandering van die kleur van drukkleremateriaal, die standaardisering van drukklereterapie protokolle en die verbetering van personeel houdings. Ander aanbevelings sluit in ʼn netwerk vir beradingsdienste, sowel as ʼn inligtingspakket vir pasiente wat tot die brandwondeenheid toegelaat word.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/86310
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