title: Qualitative analysis of a psychological supportive counseling group for burn survivors and families in Malawi.
abstract: OBJECTIVE
  While psychological care, including supportive group therapy, is a mainstay of burn treatment in the developed world, few reports of support groups for burn survivors and their caregivers in the developing world exist. This study records the findings of a support group in Malawi and provides a qualitative analysis of thematic content discussed by burn survivors and caregivers.
  
  
  METHODS
  We established a support group for burn survivors and caregivers from February-May 2012 in the burn unit at Kamuzu Central Hospital in Lilongwe, Malawi. Sessions were held weekly for twelve weeks and led by a Malawian counselor. The group leader compiled transcripts of each session and these transcripts were qualitatively analyzed for thematic information.
  
  
  RESULTS
  Thematic analysis demonstrated a variety of psychological issues discussed by both survivors and caregivers. Caregivers discussed themes of guilt and self-blame for their children's injuries, worries about emotional distance now created between caregiver and survivor, fears that hospital admission meant likely patient death and concerns about their child's future and burn associated stigma. Burn survivors discussed frustration with long hospitalization courses, hope created through interactions with hospital staff, the association between mental and physical health, rumination about their injuries and how this would affect their future, decreased self-value, increased focus on their own mortality and family interpersonal difficulties.
  
  
  CONCLUSIONS
  The establishment of a support group in our burn unit provided a venue for burn survivors and their families to discuss subjective experiences, as well as the dissemination of various coping techniques. Burn survivors and their caregivers in Malawi would benefit from the establishment of similar groups in the future to help address the psychological sequelae of burns.
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA; Department of Psychiatry, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Vanderbilt University School of Medicine, Nashville, TN 37232-0740, USA; Kamuzu Central Hospital, UNC Project, P-Bag 101, Lilongwe, Malawi.
authors.forename: Brian S
authors.initials: BS
authors.lastname: Barnett
authors.affiliation: Kamuzu Central Hospital, UNC Project, P-Bag 101, Lilongwe, Malawi.
authors.forename: Macjellings
authors.initials: M
authors.lastname: Mulenga
authors.affiliation: Department of Surgery, University of North Carolina, CB#7228, Chapel Hill, NC 27514-7228, USA.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Kiser
authors.affiliation: Department of Surgery, University of North Carolina, CB#7228, Chapel Hill, NC 27514-7228, USA. Electronic address: anthchar@med.unc.edu.
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Charles
mesh_terms: D000293:Adolescent; D000328:Adult; D002056:Burns / Q000523:psychology / Q000534:rehabilitation*; D017028:Caregivers / Q000523:psychology*; D003376:Counseling; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008295:Malawi; D008297:Male; D008875:Middle Aged; D011615:Psychotherapy, Group; D036301:Qualitative Research; D012657:Self-Help Groups; D017741:Survivors / Q000523:psychology*; D055815:Young Adult
keywords: Africa South of the Sahara; Burns; Group; Malawi; Psychotherapy