title: Patient experiences of burn scars in adults and children and development of a health-related quality of life conceptual model: A qualitative study.
abstract: OBJECTIVE
  The aim of this study was to understand the impact of burn scars on health-related quality of life (HRQOL) from the perspective of adults and children with burn scars, and caregivers to inform the development of a conceptual model of burn scar HRQOL.
  
  
  METHODS
  Twenty-one participants (adults and children) with burn scars and nine caregivers participated in semi-structured, face-to-face interviews between 2012 and 2013. During the interviews, participants were asked to describe features about their (or their child's) burn scars and its impact on everyday life. Two coders conducted thematic analysis, with consensus achieved through discussion and review with a third coder. The literature on HRQOL models was then reviewed to further inform the development of a conceptual model of burn scar HRQOL.
  
  
  RESULTS
  Five themes emerged from the qualitative data: 'physical and sensory symptoms', 'impact of burn scar interventions', 'impact of burn scar symptoms', 'personal factors' and 'change over time'. Caregivers offered further insights into family functioning after burn, and the impacts of burn scars and burn scar interventions on family life. In the conceptual model, symptoms (sensory and physical) of burn scars are considered proximal to HRQOL, with distal indicators including functioning (physical, emotional, social, cognitive), individual factors and the environment. Overall quality of life was affected by HRQOL.
  
  
  CONCLUSIONS
  Understanding the impact of burn scars on HRQOL and the development of a conceptual model will inform future burn scar research and clinical practice.
authors.affiliation: Department of Occupational Therapy, Lady Cilento Children's Hospital, 501 Stanley St, South Brisbane, South Brisbane 4101, QLD, Australia; Centre for Burns and Trauma Research, Child Health Research Centre, Level 7, 46 Graham Street, South Brisbane 4101, QLD, Australia. Electronic address: Megan.Simons@health.qld.gov.au.
authors.forename: Megan
authors.initials: M
authors.lastname: Simons
authors.affiliation: Department of Occupational Therapy, Lady Cilento Children's Hospital, 501 Stanley St, South Brisbane, South Brisbane 4101, QLD, Australia. Electronic address: Nathaniel.Price@health.qld.gov.au.
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Price
authors.affiliation: Centre for Burns and Trauma Research, Child Health Research Centre, Level 7, 46 Graham Street, South Brisbane 4101, QLD, Australia; Department of Paediatric Surgery, Urology, Neonatal Surgery, Burns and Trauma, Lady Cilento Children's Hospital, Brisbane 4101, QLD, Australia; School of Medicine, The University of Queensland, St Lucia 4067, QLD, Australia. Electronic address: royk@uq.edu.au.
authors.forename: Roy
authors.initials: R
authors.lastname: Kimble
authors.affiliation: Centre for Burns and Trauma Research, Child Health Research Centre, Level 7, 46 Graham Street, South Brisbane 4101, QLD, Australia. Electronic address: z.tyack@uq.edu.au.
authors.forename: Zephanie
authors.initials: Z
authors.lastname: Tyack
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D002056:Burns / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D017028:Caregivers; D002648:Child; D002921:Cicatrix / Q000209:etiology / Q000503:physiopathology / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D000071066:Patient Reported Outcome Measures; D036301:Qualitative Research; D011788:Quality of Life; D055815:Young Adult
keywords: Burns; Cicatrix; Conceptual model; Health-related quality of life; Patient-reported outcomes