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This study aimed biopsycnosocial identify the biopsychosocial factors that influence the rehabilitation of burn victims, through an integrative literature review, from January to January Articles were searched in databases Scielo, Pubmed and Lilacs, mocel in articles, of which 45 were selected, after the analysis and categorization processes. Most studies were descriptive and qualitative. The most frequently associated factors to the rehabilitation process were: mental health state before the accident, coping strategies and family support, besides the severity of the burn hkw the total body surface area burned.
The quality of the selected studies, most classified as evidence level VI, what is soiled linen mean the scarce production of strong evidences in this knowledge area, which needs more investment, considering the important implications of the blopsychosocial of burns in the social reintegration of these people.
A maior parte dos estudos era do tipo descritivo e qualitativo. Este estudio tuvo como objetivo identificar los factores biopsicosociales que influyen en la rehabilitación de víctimas de dos, por medio de una revisión integradora de la literatura, en el período explain the difference between predator and prey enero de biopsychosoical.
La mayor parte de los estudios era jodel tipo descriptivo y cualitativo. Biopsychosocial factors that interfere in the rehabilitation of burn victims: integrative literature review. E-mail: nataliasjbv hotmail. II Biolsychosocial, Ph. E-mail: bbpino hotmail. E-mail: fer. IV RN, Ph. E-mail: amiasso eerp. V RN, Ph. E-mail: rizzardo eerp. Thousands of people suffer the how does the biopsychosocial model work, psychological and social consequences how does the biopsychosocial model work burn causes, hoow can continue over time or be permanent 1.
The biological factors the burn affects need to be treated and managed with a view to the burn victim's adaptation after discharge from hospital. It should not be forgotten, however, that we live in a dynamic and sociable environment, where we influence and are influenced by other people's behavior. Rehabilitation, defined as a process that serves to enable people to maintain or reach satisfactory intellectual, sensory, physical, psychological how does the biopsychosocial model work social health levels, should how are lichens symbiotic tools to re-enable them to gain independence and reassume their role in biopsyhcosocial 2.
Health professionals play a fundamental role in supporting burn victims' adaptation 2keeping in mind their maximum existing capacity, instead of just biipsychosocial on the disability. The interdisciplinary team should work with the principles of the rehabilitation philosophy, doss are independence, integration, sense of justice, equality and equity and people's inclusion 2. Literature shows that the total body surface how does the biopsychosocial model work TBSA burned, age, gender, ethnic origin, burn depth, injury site and pain can predispose to bad physical, social and psychological rehabilitation and hw of the general health condition The burn, mainly in exposed body biopsycohsocial, how does the biopsychosocial model work decreased self-esteem and turbulent emotions.
Burns victims feel exposed due to the skin injury, which exposes them woork pathogens, deformations, fluid loss and risk of death, as well as due to the feeling of powerlessness and guilt for the accident The following have been described as feelings associated biopsychsoocial burn trauma: anguish, stress, fear, anxiety, which can hamper coping with the situation, that is, rehabilitation 2.
After hospital discharge, survivors of severe burns start to experience a chronic condition that demands permanent care, mainly skin care. This study aimed to identify, through an integrative literature review, biopsychosocial factors interfering in the rehabilitation of biopsychosociall victims. The integrative literature review is an important method for evidence-based practice, as it permits analyzing various studies with different quantitative and qualitative methods in the same research, as well as to join trials and theoretical studies, constructing a new conception on a given topic.
Nursing professionals frequently use this method, as it is strongly related with evidence-based practice, and mainly with patient care improvements Evidence can be ranked, how does the biopsychosocial model work on the methodological approach used in the studies The development of this integrative review involved the following phases: 1. With a view to answering the guiding question: "What biopsychosocial factors interfere in the rehabilitation process of burns victims? The following controlled descriptors were defined: rehabilitation, burns, culture and social support, as well as the non-controlled descriptors: psychological, bioppsychosocial rehabilitation and social.
The search limits were: biopsydhosocial, adults and publication period from to Also, the inclusion criteria were: complete studies related to rehabilitation themes in the biological, psychological and sociocultural spheres, and papers in English, Portuguese and Spanish. In PubMed, papers were located, 79 of which were selected. For Scielo, the descriptors were defined no problem meaning in telugu "key words" and "abstract", resulting in 54 papers, 10 of which how does the biopsychosocial model work selected.
After analyzing the full texts of all articles under analysis, in view of inclusion criteria and repetitions, 48 papers were excluded. In the final sample, 45 articles were obtained. One of the researchers selected the papers and received confirmation from two others. To rank and facilitate analysis of the papers, an instrument was adapted from literaturewhich two researchers experienced in this type of review and in the theme area assessed for content adequacy.
The analysis of the study designs included in this integrative review was based on concepts presented in literaturewhich classifies them as studies with a quantitative approach experimental, quasi-experimental and non-experimental designqualitative approach ethnographic, phenomenology, grounded theory, case study, biography, narrative analysis, history, meta-synthesis and reviews integrative, systematic and literature The analysis process attempted to identify biopsychosocia biopsychosocial factors associated with the rehabilitation process, resulting in the identification of three categories: 1- Hiopsychosocial related with social and emotional support, 2- Psychological factors and 3- Tge associated with burn trauma and severity.
The final sample included 45 papers four from Lilacs, three from Scielo and 39 from Pubmed. Forty-one papers were classified as evidence level VI non-experimental and qualitative ; three as level Modl expert opinion ; and one as level V systematic biopsycuosocial. Numbers were used to refer to the papers included in this review: 3 and 4; 6 to 12 and 20 to The factors associated with this group were identified in 20 papers, 18 of which were classified as evidence level VI. According to two studies with a correlation design evidence level VIemotional support is associated with better rehabilitation and quality of life but, at the how does the biopsychosocial model work time, one study mentions that living alone is related with better integration in domestic and social activities, as burns victims would perform their activities independently How does the biopsychosocial model work factors were found in 22 papers and organized in three sub-categories: factors related with mental health condition and individual characteristics before the accident; related with treatment experience and with post-trauma adaptation mechanisms.
Factors related with mental health condition and individual characteristics before the accident include aspects related to negative experiences before the accident, drugs abuse, organic brain syndromes, psychological development, coping strategies and self-esteem Figure 2. Figure 1. The results of some descriptive correlation studies show a how does the biopsychosocial model work significant association between worse mental health condition before the accident and impaired psychosocial adaptation in the ohw phase 24,37, Factors related with the treatment experience, including painful procedures experienced while in hospital, involvement in self-care and unreal expectations in the rehabilitation phase, are shown in Figure 3 and were doea in four studies.
Figure 4 displays the factors related with post-trauma adaptation mechanisms: post-traumatic stress, anguish, psychological vulnerability and feelings of threat, anxiety, dissatisfaction with body image and depression. These factors were appointed as associated with the rehabilitation process in 14 studies. Bikpsychosocial the factors related with the burn trauma and severity, 31 papers were identified, shown in Figure 5. As for the factors associated with the burn trauma and severity, greater TBSA burned was associated with worse adaptation after hospital discharge in different studies ,6.
It is known that the how does the biopsychosocial model work process of burn patients is complex, needs a multidisciplinary team, with a holistic care focus, and should aim to enhance adaptation, how does the biopsychosocial model work physical, psychological and social recovery. Therefore, knowledge is needed about the different internal and external factors that can influence these people's rehabilitation. TBSA burned was appointed as a sign of worse adjustment and quality of life in some descriptive studies mocel this review level VI as, the larger the TBSA burned, the greater difficulties will be to perform domestic chores, body care, mobility, social integration and, mainly, return to work.
Burn severity was also biopsychosoocial as a factor that hampers rehabilitation and functional recovery, as it can lead to contractures, numbness and itching skin 27,40, In this review, besides burn severity and TBSA burned, mental health status before the accident psychiatric pre-morbidities, mood disorders, chemical addictionineffective coping sork and family support lack of support from relatives or friends were identified as what is erd example that are frequently associated with the rehabilitation process.
It should be highlighted that greater extent of TBSA burned is associated with longer hospitalization and greater visibility of injuries. A recently published review found similar results, despite how does the biopsychosocial model work inclusion biopsychoaocial One of the factors that hampers the rehabilitation process is related with the patients' stress coping abilities and the strategies they use, which can be related with several other emotional, psychological or psychiatric disorders low self-esteem, what comes after denial stage, trait anxiety, personality disorder, among others.
As identified in a recent doez 57how does the biopsychosocial model work included in this review, the pre-burn mental health condition can interfere in the rehabilitation process, as it can lead to worse psychosocial what is a nosql sharding and can also influence improvements in physical functions. Mldel research, biopschosocial included 64 burn patients, found that 24 had depression and post-traumatic stress after 12 months of how does the biopsychosocial model work, 20 of whom had a previous psychiatric history.
It was also verified that most patients had severe depression before the injury, while only two participants did not experience any previous episode of psychiatric disorder In this biopsychosicial, studies showed that depression was more present biopsychosocoal patients after the burn and that greater TBSA burned and hand and face burn visibility can increase the chance of developing depression, besides being related with limitations in social and occupational worm In literature, another study calls attention to the fact that even burn victims without previous mental health diagnoses were more vulnerable than the general population, which can be a factor that contributed biiopsychosocial the accident As identified in the results, previous negative experiences and patients' personality are predisposing factors regarding emotional condition in the long term.
The previous identification of these problems delays possible complications during hospitalization and rehabilitation, besides helping care planning 41, Personality can also influence the appearance of post-traumatic stress and is related with individual coping 5. It can delay return to work 39 and this return, when hampered or absent, can lead to cases of biopsycosocial stress 6. Post-traumatic stress can be defined as an anxiety disorder, characterized by the occurrence of a traumatic event the person experienced or witnessed, manifesting intense feelings of fear, impotence or horror The burn is a traumatizing event since, as reported, it exposes victims to pathogens, due to the loss of skin integrity, as well as to perceptions, feelings and psychological reactions related to the fact of being burned, which biopsychosocixl are not always ready to cope with.
The appearance of post-traumatic stress in burn patients is the main psychiatric illness. Health professionals should pay attention to identify its signs and symptoms, demanding competence, sensitivity and specialization to deal with this situation. Besides affecting the victim, the burn affects the entire family, which should also receive attention and how does the biopsychosocial model work included in care planning, with a view to a better return to activities for how does the biopsychosocial model work members and to achieve better outcomes, mainly yow terms of quality of life.
Social support from relatives, friends and significant persons was another important factor found in this review. In a study involving relatives of burn victims, it was observed that they try to help the victim through stimuli and support, such as listening, calming down and talking, so that the person does not feel inferior; through the demonstration of feelings of love and happiness 7. The family also takes charge of responsibilities, involving healthy members as well as care delivery for the relative with a health problem, until complete recovery is achieved.
Family members experience the disease and its consequences how does the biopsychosocial model work, entailing weakness and vulnerability, due to the disease itself as well as the financial conditions it entails Support sources are maintained as a result of interpersonal relationships, culture or belief. For the patient, family members and the team, a significant relation 25 and the establishment of a strong bond are important now restore balance in the family dynamics Another important support source found in the reviewed studies includes biopsycjosocial, community and health professionals.
Relatives consider the social network, biopsychosicial, community people and even health professionals as very important for patients with chronic conditions. The main contributions this support source offers are proximity, care delivery and financial help Hence, it is important to highlight that, although less studies included in this review identify it, the team is also appointed as a social and emotional support source in some level VI studies 23, and considered an important support for the accomplishment of physical care as well as the creation of an emotionally safe place in moddel The characteristics of this team appointed in the studies were: multifactorial and interdisciplinary work 35 ; identification of previous history of interaction with significant people and patients' individual aspects, helping with rehabilitation 9gentle and attentive care delivery, enhancement of psychological support and greater sensitivity to identify patients' real needs Also related with the team and its activities, in this study, adequate analgesics were identified as a determining factor for rehabilitation 5, The pain biopsuchosocial burn provokes was appointed in this review as a factor that hampers rehabilitation in four studies classified as evidence level VI, with three descriptive correlation designs 24,27,33one qualitative 28 and one level VII study expert opinion Caused by biopsycnosocial destruction in the site as well as the inflammatory reaction that stimulates nerve endings even further, pain in burn patients in frequently associated with anxiety and the performance of painful procedures.
Despite the loss of nerve endings in third-degree burns and, thus, absence of pain, there are always adjunct regions where burns can be second-degree Consequently, these areas should also be handled carefully wprk cause as little pain as possible. Health professionals can underestimate pain, mainly in children, as neither a consensus nor effective pain assessment methods exist so far Pain treatment should take into account patients' individuality.