Experiência de sobreviventes de queimaduras acerca da transição de alta hospitalar para o contexto domiciliar

Abstract

The experience of surviving severe burns involves adaptations regarding impairments in bodily, emotional and social functions resulting from the traumatic event. The grievance reflects in everyday life with severe impacts on the individual and their caregivers. Objective: to understand the experience lived by survivors of severe burns in the process of transition from hospital discharge to the home context. Method: Interpretive qualitative case study carried out in a reference center for burns in the state of Goias. Participants were survivors of outpatient follow-up, with a discharge period greater than 30 and less than 180 days. Data were collected from January to June 2022, using electronic medical records and semi-structured, face-to-face, and in-depth interviews. The interviews were recorded and transcribed. An interpretive thematic analysis, according to Braun and Clarke, was performed. Results: 13 survivors participated, eight women and five men, aged between 22 and 42 years. Thermal burns prevailed due to the passage of flammable solutions such as alcohol, followed by heated vapors and electric current discharge. The most frequent scenario was the home environment and the work context. The hospitalization period ranged from five to 69 days, and the most expected areas were the face and extremities. Three themes were identified: 1) the experience of hospitalization; 2) hospital discharge: expectations and challenges; and 3) the return to everyday life: difficulties, adaptations and overcoming limits. The experience of hospitalization refers to facing the challenges related to accepting the treatment, emotional stress, financial difficulties, moving away from family members due to the pandemic, dealing with pain, and experiencing positive and negative feelings concerning the treatment. Hospital discharge was characterized by recognizing a single criterion on the part of the survivors for the expectation of returning home being the graft take and the challenge of responsibility for the treatment at home. The return to everyday life was marked by difficulties, adaptations and overcoming the limits that involved facing disabilities related to mental, emotional, physical, financial, and social repercussions. The meanings of a lengthy and painful process were mentioned in the readaptation phase. In dealing with intense pain, the meaning of unsatisfactory results regarding the prescribed drugs was highlighted. The acceptance phase of the scars aroused ambiguous feelings of rejection and resignation. They expressed psychological changes such as nervousness, aggressiveness, and impulsiveness. The financial difficulty was treated as an emotional burden due to the loss of the role of the provider. The return to work and studies was narrated, corresponding to the barriers of the new reality. The support received by family members was understood with a feeling of gratitude and acceptance. The burn experience meant a break in the usual way of life, changing routines, conditions and environments