Meaningful Occupations Impacted by Burn Injuries

PURPOSE: Burn injuries can impact an individual’s quality of life and ability to return to meaningful occupations including leisure, self-care, and employment. During the rehabilitation phase of recovery, the main priority is to reintegrate burn survivors back into society. Limited research has focused on the impact a burn injury can have on survivors’ identity in regard to meaningful occupations. The purpose of this study was to identify types of meaningful occupations that were affected following a burn injury and how the injury affected an individual’s identity in society. The researchers also investigated whether barriers existed to returning to meaningful occupations and whether burn survivors were engaging in new meaningful occupations as a result of their burn injury.

DESIGN: Participants in this qualitative study were selected through purposive sampling during outpatient occupational therapy (OT) visits to the North Carolina (NC) Jaycee Burn Center in Chapel Hill. The inclusion criteria were as follows: (1) patients who sustained a hand burn with or without burns to the wrist, forearm, elbow, or proximal portion of the arm after May 1, 2015; (2) any depth of burn; (3) ages 19–65 yr; and (4) currently receiving outpatient OT at NC Jaycee Burn Center. Patients were excluded if they had sustained burn injuries that did not involve the hand, did not speak English, or had open wounds.

METHOD: A semistructured interview comprising 12 questions was conducted with all participants by telephone or in person. The researchers collected the following information from each participant: sociodemographic data, history of burn injury, range of motion of the involved joints, and hand grip strength. The researchers individually analyzed each participant’s responses and categorized them into occupations, performance patterns, and client factors based on descriptions from the Occupational Therapy Practice Framework: Domain and Process (American Occupational Therapy Association, 2014, p. S19). The researchers used visual coding strategies for each interview to identify, organize, and determine patterns in the narrative.

RESULTS: Ten participants were recruited, and nine completed the study. Three themes were identified following data analysis: Change in Occupations, Post-Emotional Experience, and Addition of New Occupations. Instrumental activities of daily living (IADLs) were occupations and roles that were frequently reported to be interrupted following a burn injury. Participants commonly reported negative emotions such as anger, depression, worry, and fear when describing how their burn injuries affected their ability to participate in meaningful occupations, roles, and self-identity. For IADLs, home exercise programs were reported as a new occupation. However, the participants’ responses described how their new meaningful occupations impeded their ability to participate in other meaningful occupations.

CONCLUSION: OT practitioners’ role in the burn rehabilitation process is to help patients return to their prior level of functional status in order for them to participate in their meaningful occupations. Research has noted that the larger the size of the burn, the greater impact it will have on quality of life. However, small burns can significantly impact an individual’s ability to return to meaningful occupations and identity in society; every burn has a story.

IMPACT STATEMENT: OT’s role in burn rehabilitation will influence and increase burn survivors’ quality of life through the skilled services we provide based on the foundation OT was built on.

References

American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain and process (3rd ed.). American Journal of Occupational Therapy, 68(Suppl. 1), S1–S48. https://doi.org/10.5014/ajot.2014.682006