A New Approach to Patients with Acute Hand Burns
Research conducted among patients that have suffered acute burns of the hand has affirmed that the healing process is often more complex and multi-faceted than is commonly believed. While sympathy over the physical pain may be forthcoming, the support needed by burn patients extends beyond this, calling for emotional, psychological and social reintegration.
A study conducted by Mrs Tanuja Dunpath, a Senior Tutor of Physiotherapy at UKZN, explored the experiences of adult patients admitted to public hospitals for rehabilitation. It also aimed to explore the experiences of Physiotherapy staff in the management of patients and their hand burn injuries, thus employing a patient and practitioner perspective.
The findings, presented at the College of Health Sciences’ Research Symposium at the Medical School, revealed that some of the most significant components of the burn experience from the patient’s perspective include the trauma of the incident, fear of the pain during therapy, and the anticipation of stigmatisation as a result of scarring. Therapists identified several factors that determined a patients’ level of participation and motivation in therapy. These included the psychological and emotional impact of the traumatic event, procedural pain, and family support.
Importantly, the findings emphasise the inequity attached to burn incidents which tend to affect the most vulnerable people in society: those living in poor socio-economic conditions without basic services and the expectation of a safe environment.
Dunpath said: ‘If you take a closer look, burn injuries commonly affect those living in poor social settings … They are in vulnerable situations already using candles and kerosene stoves as an everyday means of light and for cooking … These individuals are now further burdened with coping with their burn injuries.’
She said some of the burn patients in her study were breadwinners who relied on their hands and appendages to stay employed. In these cases, the injuries impacted on all aspects of the individual’s life and that of his or her family.
‘The psychological impact of the burn event cannot be understated. While the physical aspects of the experience may be addressed, the emotional impact is just as significant to the individual’s sense of well-being. A lot of grief and anger has to be dealt with as a result of the burn experience, particularly in the case of intentional burn incidents,’ said Dunpath.
One of the biggest challenges faced by the study participants was dealing with burn associated stigma – patients with burn injuries felt that people in the community would isolate, ridicule or laugh at them. Dunpath said physiotherapists need to collaborate with psychologists and social workers in order to facilitate a more positive experience of therapy, recovery and future outlook for patients.
Dunpath re-joined UKZN after practising Physiotherapy in the public sector in order to expand her experience as a Physiotherapist in an academic setting. The burn study was completed as part of her master’s degree. ‘I loved what I did in my master’s. I loved its outcome and I know my PhD will also focus on patients with burn injuries,’ said the mother of two.
She said her experience would not have been possible without the unconditional support of, and motivation from, her husband and supervisors Mrs Verusia Chetty (Physiotherapy) and Mrs Dain van der Reyden (Occupational Therapy).
What attracted Dunpath to Physiotherapy was her passion for working with people and providing them with the care, support and means of achieving their goals. ‘It’s a really hands-on profession and it helps to make collaborative decisions about patients’ futures and their recovery process.’
Dunpath also wants to develop her teaching skills as an academic, working with students in a clinical setting where they are also exposed to burn patients.