Pain experiences in adult burn survivors during rehabilitation and recovery: A qualitative systematic review.

Abstract

Despite advancements in burn care, pain persists despite multidisciplinary management efforts. This review aimed to synthesise the qualitative research that explored the impact of pain on burn survivors' rehabilitation and recovery. In September 2023, PubMed, CINAHL, and Scopus were searched for peer-reviewed published research in English. Nineteen articles from 17 studies met the inclusion criteria. The review used Thomas and Harden's thematic synthesis framework for qualitative research evidence. Two descriptors of pain were described, physical and psychological pain. Pain in burn survivors, both physical and psychological, was complex, intertwined, and dynamic across three stages: before, during, and after interventions. This was found to closely align with Cleary et al.'s trauma-informed model of care in burn settings, which emphasises a three-stage process, underlining that pain is not static but evolves and fluctuates, necessitating adaptive and patient-centred burn care and post-treatment mental health support. Adopting a Trauma-Informed Care (TIC) approach in burn injury settings is crucial. Individuals post-burn encounter varying degrees of physical and psychological pain, which for some remains persistent. Using patient-reported measures throughout recovery deepens the understanding of burn survivors' pain, respecting their personal experiences and insights. It is essential to conduct future longitudinal research and push for a burn-specific qualitative pain assessment to address these complex needs effectively.