Karen Badger

Attention Deficit-Hyperactivity Disorder in Children With Burn Injuries

This study explored the characteristics of children with burns who were also diagnosed with attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD). The study was intended to identify and better understand the risk factors for such injuries and to help direct future burn prevention and education efforts for children with these underlying disorders. We performed a retrospective, comparison group study of 103 pediatric burn patients ranging in age from 5 to 18 years. Forty-four children who were diagnosed with ADD or ADHD at the time of their burn injury were compared with a random sample of 59 burn-injured children without the diagnosis of ADD or ADHD. Variables analyzed included patient demographics, cause of burn, length of hospitalization, engagement in high risk behavior at the time of injury, presence of other developmental, mental health diagnoses, and/or school behavior problems. The ADD or ADHD group had a significantly greater incidence of mental health and school behavior problems than other children with burn injuries. They also had a significantly greater history of high risk behavior at the time of injury than the comparison group. Children with ADD or ADHD who also had an additional mental health diagnosis had a higher incidence of school behavior problems. Our findings suggest the need for additional studies of children with ADD or ADHD who sustain burn injuries. Children with ADD or ADHD who have school behavior problems and/or a tendency to engage in high-risk behavior may be at greatest risk for burn injuries and most likely to benefit from educational counseling or other modalities of burn prevention.

Describing compassionate care: the burn survivor's perspective.

Compassion is vital in burn care. Its delivery could be considered a professional duty and a characteristic of care that affects patient satisfaction. However, the description of compassionate care is underexplored in the burn care literature. This study investigates the concept of compassionate care and how it is described from the perspective of the burn survivor. A qualitative design with two focus groups at the Phoenix Society for Burn Survivors’ World Burn Congress was used to examine views of compassionate care directly through 31 burn survivors’ accounts to better understand the concept and its delivery within the context of burn care. Discussions were recorded and transcripts were analyzed for prominent themes and descriptive components. Participants were primarily Caucasian (77%), female (60%), with an average age of 47.6 years and an average TBSA burn of approximately 49% sustained approximately 12 years ago. Qualitative data analysis yielded primary themes of: 1) respect the person (subthemes were: establishing an empathic connection, restoring control through choice, providing individualized care, and going above and beyond), 2) communication (subthemes: interpersonal and informational), and 3) provision of competent care. The three primary themes were components of compassionate care; it was not defined by a single characteristic, behavior, or skill but might be best understood as the convergence of the three themes. Implications of findings and barriers to the provision of compassionate care are also discussed.

Near-death experiences, posttraumatic growth, and life satisfaction among burn survivors

ABSTRACT Survivors of large burns may face positive and negative psychological after-effects from close-to-death injuries. This study is the first to examine their near-death experiences (NDEs) and posttraumatic growth (PTG) and life satisfaction afterwards. With an available sample of 92 burn survivors, half met the criteria for an NDE using an objective scale. Those who indicated religion was a source of strength and comfort had high scores on life satisfaction, PTG, and the NDE Scale. Individuals with larger burns reported greater PTG than those with smaller total body surface area burned (TBSA). There were no significant differences on life satisfaction, PTG, or NDEs when examined by gender or years since the burn injury. Elements of the NDE most frequently reported were: An altered sense of time, a sense of being out of the physical body, a feeling of peace, vivid sensations, and sense of being in an “other worldly” environment. Social workers and other health providers need to be comfortable helping burn survivors discuss any NDEs and process these through survivors’ spirituality and religious belief systems as they recover.

Burn Survivors’ Near-Death Experiences: A Qualitative Examination:

Persons who come close to death but survive catastrophic accidents sometimes report very vivid experiences during times when their survival was in doubt, when they were believed to be dead, and during resuscitation efforts. This qualitative study builds upon existing research on near-death experiences (NDEs) by focusing on the oral accounts from a sample of individuals with large and life-threatening burns. The NDE accounts were obtained from burn survivors attending the Phoenix Society’s World Burn Congress and are similar to reports by notable researchers (Greyson, 2003; Moody, 1975; Ring, 1980) while reflecting the uniqueness of the individual survivor’s experiences. Six major themes are reported. Counselors and health professionals need to be aware of and educated about NDEs as these experiences can have profound effects upon the individual. Patients who have had NDEs may need to discuss them but fear professionals will reject their stories as being crazy.

Aftercare, Survivorship, and Peer Support

Burn recovery includes addressing any emotional, psychological, and social needs of the survivor and family. Providing support and resources is essential for a smooth transition from the acute phase of injury to rehabilitation and successful social and community reintegration. Priority psychosocial target areas are developing social skills, addressing body image concerns, and providing peer support. Peer support provides a unique perspective of shared experience that can instill hope and assist coping efforts of survivors and family. Health care professionals can be instrumental in connecting survivors to community support organizations. Discussed are considerations for aftercare planning and peer supports role.

Exploring Faculty Perceptions of Student Incivility in Social Work: Results from a National Survey

The literature suggests that incivility is a growing problem in college classrooms, but few studies have examined incivility within social work programs. Using a national sample of social work instructors (n=327), this study examined faculty experiences with social work student incivility in both undergraduate and graduate education. Results showed that some behaviors often deemed disrespectful or inattentive do occur in social work classrooms, and they occur more frequently in undergraduate classes than graduate classes. Although rare, hostile behaviors were also reported by faculty. Discussion of these findings includes recommendations for addressing incivility in the context of preparing social work students for professional practice.

Needs Assessment Planning: Starting Where You Are

Abstract Needs assessments are a useful part of the program development cycle. However, while step-by-step models are available to guide assessments, they may not be detailed enough for the pragmatic questions that arise. The planning process should be viewed as dynamic and flexible, able to be tailored to the agency’s specific organisational and environmental characteristics. This paper presents a practical discussion for social workers charged with planning and implementing a needs assessment. Practitioners are empowered to consider several concerns or issues simultaneously, to build upon their organisational knowledge, and start the process where it intuitively makes sense. Major issues discussed are: planning the needs assessment, evaluating contextual factors, and design considerations.