title: Social challenges of visible scarring after severe burn: A qualitative analysis.
abstract: BACKGROUND
  Visible scarring after burn causes social challenges which impact on interpersonal connection. These have health impacts which may worsen outcomes for burn patients and reduce the potential for posttraumatic growth (PTG).
  
  
  OBJECTIVE
  The aim of the study was to investigate adult burn survivors' experiences of interpersonal relationships as potential barriers to posttraumatic recovery following hand or face burns.
  
  
  METHODS
  This qualitative study explored patient experiences of interpersonal situations. A purposive sample (n=16) who had visible burn scarring were interviewed more than two years after their burn.
  
  
  RESULTS
  Emotional barriers included the fear of rejection, feelings of self-consciousness, embarrassment and humiliation. Situational barriers included inquisitive questions, comments and behaviours of others. Responses depended on the relationship with the person, how they were asked and the social situation. Active coping strategies included positive reframing, humour, changing the self, and pre-empting questions. Avoidant coping strategies included avoidance of eye contact, closed body language, hiding scars, and learning to shut down conversations.
  
  
  CONCLUSIONS
  Emotional and situational barriers reduced social connection and avoidant coping strategies reduced the interaction of people with burns with others. Active coping strategies need to be taught to assist with social reintegration. This highlights the need for peer support, family support and education, and social skills training.
authors: University of Western Australia, Burn Injury Research Unit, 35 Stirling Highway, Crawley, Western Australia 6009, Australia. Electronic address: Lisa.Martin3@health.wa.gov.au.
authors: Lisa
authors: L
authors: Martin
authors: University of Western Australia, Clinical Psychology Research Unit, Western Australian Neuroscience Research Institute, Level 4, A Block, QEII Medical Centre, Nedlands, Western Australia 6009, Australia.
authors: Michelle
authors: M
authors: Byrnes
authors: Fiona Wood Foundation, Fiona Stanley Hospital, MNH (B) Main Hospital, Level 4, Burns Unit, 102-118 Murdoch Drive, Murdoch, Western Australia 6150, Australia; Burn Service of Western Australia, Fiona Stanley Hospital, MNH (B) Main Hospital, Level 4, Burns Unit, 102-118 Murdoch Drive, Murdoch, Western Australia 6150, Australia.
authors: Sarah
authors: S
authors: McGarry
authors: University of Western Australia, Burn Injury Research Unit, 35 Stirling Highway, Crawley, Western Australia 6009, Australia; Fiona Wood Foundation, Fiona Stanley Hospital, MNH (B) Main Hospital, Level 4, Burns Unit, 102-118 Murdoch Drive, Murdoch, Western Australia 6150, Australia; Burn Service of Western Australia, Fiona Stanley Hospital, MNH (B) Main Hospital, Level 4, Burns Unit, 102-118 Murdoch Drive, Murdoch, Western Australia 6150, Australia.
authors: Suzanne
authors: S
authors: Rea
authors: University of Western Australia, Burn Injury Research Unit, 35 Stirling Highway, Crawley, Western Australia 6009, Australia; Fiona Wood Foundation, Fiona Stanley Hospital, MNH (B) Main Hospital, Level 4, Burns Unit, 102-118 Murdoch Drive, Murdoch, Western Australia 6150, Australia; Burn Service of Western Australia, Fiona Stanley Hospital, MNH (B) Main Hospital, Level 4, Burns Unit, 102-118 Murdoch Drive, Murdoch, Western Australia 6150, Australia.
authors: Fiona
authors: F
authors: Wood
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D002056:Burns / Q000150:complications / Q000523:psychology*; D002921:Cicatrix / Q000209:etiology / Q000523:psychology*; D004645:Empathy; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012919:Social Behavior; D012934:Social Isolation / Q000523:psychology*; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D017741:Survivors / Q000523:psychology*; D014925:Wit and Humor as Topic; D055815:Young Adult
keywords: Burn; Coping; Interpersonal relationships; Posttraumatic growth; Social; Visible scarring