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Objetivos: Avaliar a relação entre a intensidade do prurido e os escores de ansiedade, depressão, estresse pós-traumático e a qualidade de vida relacionada à saúde em pacientes vítimas de queimaduras. Método: Estudo transversal, realizado em dois ambulatórios de hospitais de queimados localizados em municípios do interior paulista. A amostra foi constituída por 60 pacientes que responderam aos instrumentos de caracterização sociodemográfica e clínica, Escala Visual Numérica para avaliação da intensidade do prurido, Escala Hospitalar de Ansiedade e Depressão, Escala de Impacto de Eventos para avaliação do estresse pós-traumático e a versão brasileira da Freiburg Life Quality Assessment Wound. Resultados: A amostra caracterizou-se pelo predomínio do sexo masculino (73%). Correlações positivas significativas foram encontradas entre a intensidade de prurido e ansiedade (r=0,33), depressão (r=0,53), estresse pós-traumático (r=0,43) e escore total da Freiburg Life Quality Assessment Wound (r=0,63). Conclusão: Esses achados reforçam a importância da avaliação do prurido na atenção integral à vítima de queimadura visando à redução do impacto psicológico e melhora na qualidade de vida relacionada à saúde. (AU)

Objective: To assess the relationship between pruritus intensity and anxiety, depression, post-traumatic stress, and health-related quality of life scores in burn victims. Methods: A cross-sectional study, carried out in two outpatient clinics of burn hospitals located in municipalities in the countryside of São Paulo. The sample consisted of 60 patients who answered sociodemographic and clinical characterization instruments: the Visual Numerical Scale, to assess pruritus intensity, the Hospital Anxiety and Depression Scale, the Impact of Events Scale, to assess post-traumatic stress, and the Freiburg Life Quality Assessment Wound Module to Brazilian Portuguese. Results: The sample was characterized by a predominance of males (73%). Significant positive correlations were found between pruritus intensity and anxiety (r=0.33), depression (r=0.53), post-traumatic stress (r=0.43), and total Freiburg Life Quality Assessment Wound score (r=0.63). Conclusions: These findings reinforce the importance of assessing pruritus in comprehensive care for burn victims, aiming to reduce the psychological impact and improve health-related quality of life. (AU)

Objetivo: Evaluar la relación entre la intensidad del prurito y las puntuaciones de ansiedad, depresión, estrés postraumático y la calidad de vida relacionada a la salud en pacientes víctimas de quemaduras. Método: Estudio transversal, realizado en dos ambulatorios de hospitales de quemados ubicados en municipios del interior de São Paulo. La muestra se constituyó por 60 pacientes que respondieron a los instrumentos de caracterización sociodemográfica y clínica, Escala Visual Numérica para evaluación de la intensidad del prurito, Escala Hospitalaria de Ansiedad y Depresión, Escala de Impacto de Eventos para evaluación del estrés postraumático y la versión brasileña de la Freiburg Life Quality Assessment Wound. Resultados: La muestra se caracterizó por el sexo masculino (el 73%). Correlaciones positivas significativas se encontraron entre la intensidad de prurito y ansiedad (r=0,33), depresión (r=0,53), estrés postraumático (r=0,43) y puntuación total de la Freiburg Life Quality Assessment Wound(r=0,63). Conclusión: Esos hallazgos refuerzan la importancia de la evaluación del prurito en la atención integral a víctimas de quemadura, buscando la reducción del impacto psicológico y la mejora en la calidad de vida relacionada a la salud. (AU)

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INTRODUCTION: Shared paranoid disorder is characterised by the development of psychotic symptoms in people who have a close affective bond with a subject suffering from a mental disorder. This case is the first case of burn injuries reported in the context of this disorder. CASE: We describe a young couple, with a similar pattern of burns caused by contact with a griddle. The injuries are the result of the aggression caused by a relative of one of them, who presented psychotic symptoms, related to the previously undiagnosed spectrum of schizophrenia. CONCLUSIONS: The impact of this condition encompasses social, physical and psychological components, requiring multidisciplinary management and a high index of diagnostic suspicion.

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Fundamentos: Indivíduos com queimaduras sofrem com autoestima e depressão. Objetivo: Analisarpercepção dos participantes quanto ao sofrimento ocasionado pela queimadura, sintomatologia depressiva e interferência na autoimagem e relacionamento interpessoal. Métodos: Estudo qualitativo, longitudinal, descritivo, com 36 participantes atendidos em centro de referência a queimados de hospital escola do Sul do Brasil. Realizada entrevista semiestruturada, dados tratados pela Análise de Conteúdo. Resultados: Emergiu categoria sobre o sofrimento causado pela queimadura e impacto na autoimagem com três unidades temáticas. Dados apontam participantes insatisfeitos com autoimagem, desenvolveram sintomatologia depressiva em resposta às dificuldades que queimadura acarretou na vida de relação; apoio familiar foi decisivo ao enfrentamento da nova condição, relações afetivas foram resgatadas a beneficiar a recuperação.Conclusão e implicações para prática: Percepção dos participantes para autoimagem prejudicada associada a autoestima diminuída e sintomatologia depressiva, prejuízo para o relacionamento interpessoale apontam a importância da família no processo de recuperação e fortalecimento dos laços familiares durante e após tratamento da queimadura (AU).

Introduction: Individuals with burns suffer from self-esteem and depression. Objective: Analyze the participants' perception of the suffering caused by the burn, depressive symptoms, and interference in self-image and interpersonal relationships. Methods: Qualitative, longitudinal, descriptive study, with 36 participants seen at a reference center of care to burn people in a teaching hospital in southern Brazil. A semi-structured interview was conducted, and data were processed through Content Analysis. Results: The category about the suffering caused by the burn, and its impact on self-image emerged with three thematic units. Data suggest that participants dissatisfied with a self-image developed depressive symptoms in response to the difficulties that the burn caused in the life of a relationship; family support was decisive in coping with the new condition; affective links were rescued, benefiting the recovery.Conclusion and implications for practice: Participants' self-image perception damaged and associated with decreased self-esteem and depressive symptoms, impairment for the interpersonal relationship, and pointing out the importance of the family in the process of recovery and strengthening of family bonds during and after treatment of the burn (AU).

Fundamentos: Las personas con quemaduras sufren de autoestima y depresión. Objetivo: Analisar la percepción de los participantes sobre el sufrimiento causado por la quemadura, sintomatología depresiva y su interferencia en auto imagen e en el relacionamiento interpersonal. Métodos: estudio cualitativo, d longitudinal, descriptivo, con 36 participantes atendidos en un centro de quemados de un hospital universitario del sur de Brasil. Se realizó una entrevista semiestructurada, los datos fueron tratados por Análisis de Contenido. Resultados: La categoría sobre el sufrimiento provocado por la quemadura y el impacto en la autoimagen surgió con tres unidades temáticas. Los datos indican que los participantes insatisfechos con la imagen de sí mismos, desarrollaron síntomas depresivos en respuesta a las dificultades que la quemadura les causó en la vida de pareja; El apoyo familiar fue determinante para afrontar la nueva condición, se rescataron las relaciones afectivas en beneficio de la recuperación. Conclusión e implicaciones para la práctica: La percepción de los participantes de la autoimagen deteriorada asociada a disminución de la autoestima y síntomas depresivos, deterioro para el relacionamiento interpersonal y señalan la importancia de la familia en el proceso de recuperación y fortalecimiento de los lazos familiares durante y después. tratamiento de la quemadura (AU).

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ABSTRACT: In this article, we provide an overview of the literature on contributions of art making and medical art therapy for patients with burn injuries. The potential value of art therapy in addressing the complex physical and psychosocial needs of burn patients is discussed through examination of 7 peer-reviewed articles. Two case examples of burn survivors, 1 pediatric and 1 adult, are included to demonstrate the use of art therapy in an inpatient and outpatient setting, respectively. Art therapy and other intervention strategies for overall psychosocial adjustment of burn patients are often underutilized. Further research in art therapy is needed to examine the psychosocial aspects of burns patients and the potential role that medical art therapy may have in a burn care center.

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Glycerolized Nile tilapia skin (NTS) showed promising results when used for burn treatment in phases II and III randomized controlled trials. This pilot study aims to evaluate the effectiveness of lyophilized NTS (LNTS) as a temporary skin substitute for superficial partial-thickness burns by comparing it with silver-impregnated sodium carboxymethylcellulose dressing. This was a randomized, prospective, open-label, and controlled pilot study conducted in Fortaleza, Brazil, from April 2019 to December 2019. The 24 participants had ≥18 and ≤70 years of age and superficial partial-thickness burns affecting up to 10% of TBSA. Primary outcomes were the number of dressings performed and pain intensity, assessed via the Visual Analogue Scale and the Electronic von Frey. Secondary outcomes were the level of pain-related anxiety, assessed via the Burns Specific Pain Anxiety Scale, and analgesic consumption. In the test group, the number of dressings and the patient-reported pain after dressing-related procedures were lower. Analgesic intake, pain-related anxiety, and both patient-reported and objectively measured pain before dressing-related procedures were similar for the treatment groups. No adverse effects were detected. LNTS shares the same characteristics of an "'ideal'" wound dressing demonstrated by glycerolized NTS in previous studies. Also, it demonstrated noninferiority for burn management when compared with silver-impregnated sodium carboxymethylcellulose dressing. The safety and efficacy of LNTS demonstrated in this pilot study may allow the development of larger phases II and III RCTs in a near future.

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OBJECTIVES: To compare perceived stigmatization, symptoms of depression and self-esteem of adults from Brazilian general population with Brazilian burns survivors and to verify the possible correlations between these populations. METHOD: The general population and burn survivors administered the adapted Brazilian versions of the Perceived Stigmatization Questionnaire (BR-PSQ-R), Beck Depression Inventory (BDI) and Rosenberg Self-Esteem Scale (RSES). The Student's t-test for independent samples was employed to identify significant differences between the means of the results from the BR-PSQ-R, BDI and RSES instruments, and the Pearson correlation was used to detect correlations between constructs. The significance level was set at 0.05. RESULTS: Participants of this study included: 102 individuals from the general population and 240 burn survivors. The difference between the BR-PSQ-R mean scores of the two groups was not statistically significant (p = 0.077). The mean scores for the BDI (p = 0.001) and RSES (p = 0.001) where found to be lower in the general population, when compared to burn survivors. Moderate correlations were identified between the perceived stigmatization and depression (r = 0.43; p < 0.001) and perceived stigmatization and self-esteem (r = -0.35; p < 0.001). CONCLUSIONS: Participants from the general population and burn survivors exhibit similar levels of perception of stigmatization; the general population presented fewer symptoms of depression and a higher self-esteem when compared to burn survivors.

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Analyze the influence of deep-degree burns on the quality of life (QoL) of women at treatment in ambulatory after hospital discharge. A cross-sectional study was conducted at a reference public hospital for burns in Recife, Pernambuco, Brazil, from August 2017 to May 2018. Fifty adult women over 20 years old who suffered deep burns and were in outpatient rehabilitation treatment were included. The variables studied were biological, sociodemographic, and clinical. The dynamometry and goniometry tests and the instruments to verify the QV Burn-Specific Health Scale-Revised were included in the analysis. Multiple linear regression models were fitted to identify factors associated with the six domains of the QoL instrument. The results identified a greater negative influence of burns on the QoL of women when associated with the variables: dark-black skin color, low levels of education, low income, motion impairment in right upper limb and lesions less than 6 months in the face, head and neck region. It should be noticed that the overall QoL score presented a median of 92.0, a score considered high, revealing an important QoL impairment. Deep-degree burn victims had a great impact on physical, emotional, and psychological abilities, acting harmfully on their self-image and causing difficulties in the execution of their daily and professional life activities, which are reinforced by aspects such as social position, level of education, and extent and duration of injury, resulting in a low QoL.

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Introdução: O suicídio é um sério problema de saúde pública. Estima-se que para cada óbito existam 10 tentativas. Dentre os meios utilizados, as queimaduras têm destaque devido à gravidade das lesões, a alta taxa de letalidade e os grandes prejuízos funcionais, estéticos e psicológicos. As mulheres, por constituírem a maioria dos pacientes com história de tentativa de suicídio e morte por queimaduras, representam um grupo vulnerável que merece recorte para aprofundamento do estudo. Métodos: Estudo retrospectivo, de caráter descritivo de série temporal. Foi desenvolvido na Unidade Tratamento de Queimados e no Instituto de Medicina Legal em Brasília (DF), entre os anos de 2010 e 2015. Resultados: Foram identificadas 42 mulheres com história de suicídio por queimaduras, tentado ou consumado. Houve 15 óbitos relacionados diretamente à lesão térmica. Houve um predomínio da faixa etária entre 30 e 44 anos, seguida por 15 a 29 anos. Em 64,3% dos casos o evento aconteceu no DF. Em relação aos agentes etiológicos, o mais comum foi o álcool (71,4%). A média de superfície corporal queimada foi de 34,38%, sendo que as pacientes que faleceram apresentaram áreas queimadas maiores (59,53%) do que as que sobreviveram (20,4%). Conclusão: Os dados obtidos no DF corroboram informações da literatura. Apesar do progresso envolvendo manejo e tratamento dos pacientes queimados, a prevenção continua sendo a melhor atitude.

Introduction: Suicide is a serious public health problem. For every death, there are an estimated 10 suicide attempts. Among the means of suicide, burns are prominent due to the lesion severity, the high mortality rate, and the severe functional, aesthetic, and psychological damage. Women comprise the majority of patients with a history of attempting suicide and death by burns and represent a vulnerable group that deserves attention. Methods: This retrospective descriptive time-series study was performed in the Burn Treatment Unit at the Institute of Legal Medicine in Brasília, Distrito Federal (DF) between 2010 and 2015. Results: A total of 42 women with a history of suicide by burns, attempted or consummated, were identified; 15 deaths were directly related to the thermal injury. Suicide by burns was the most predominant among patients aged 30 to 44 years was observed, followed by those aged 15 to 29 years. In 64.3% of cases, the event occurred in the Brasília, Distrito Federal (DF). Alcohol was the most common etiological agent (71.4%). The average burned body surface area was 34.38%, and the patients who died presented larger burned areas (59.53%) than that in those who survived (20.4%). Conclusion: The data obtained from the Brasília, Distrito Federal (DF) corroborate information from the literature. Despite progress involving the management and treatment of burn patients, prevention remains the best strategy.

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Objetivo: Avaliar o nível de sobrecarga de cuidadores primários de crianças com queimaduras em tratamento de Fisioterapia ambulatorial em um hospital público da cidade do Recife, PE. Método: Trata-se de um estudo transversal descritivo com 27 cuidadores primários de crianças com queimaduras na faixa etária de 0 a 12 anos, em tratamento no ambulatório de Fisioterapia de um hospital público, na cidade do Recife. Utilizou-se um questionário para caracterização da amostra e a versão brasileira da Burden Interview Scale para avaliar o nível de sobrecarga dos voluntários. A análise dos dados foi de forma descritiva e estatística considerando p<0,05 para significância estatística. Resultados: A maioria dos cuidadores foram mulheres (mães) que apresentaram nível leve a moderado de sobrecarga física e emocional e se queixaram de falta de tempo para as suas próprias necessidades devido às tarefas domésticas e aos cuidados diários com a criança queimada. Os principais determinantes dessa sobrecarga foram: cuidador mais jovem, criança menor de 6 anos, renda familiar baixa (p=0,078) e tempo da lesão inferior a 1 ano. Conclusões: O aumento do nível de sobrecarga física e emocional dos cuidadores sugere a necessidade de serem implementadas ações que visem fornecer suporte psicossocial para os mesmos ao longo do processo de reabilitação, após a alta hospitalar dessas crianças

Objective: To evaluate burden level in primary caregivers of children with burns in outpatient physiotherapy treatment in a public hospital in the city of Recife, PE, Brazil. Methods: This is a descriptive cross-sectional study with 27 primary caregivers of children with burns in the age group 0 to 12 years old, undergoing treatment at the Physiotherapy outpatient clinic of a public hospital in the city of Recife. A questionnaire was used to characterize the sample and the Brazilian version of the Burden Interview Scale was used to evaluate the volunteers level of overload. The data analysis was descriptive and statistical considering p<0.05 for statistical significance. Results: Most caregivers were women (mothers) who presented mild to moderate level of physical and emotional overload and complained of lack of time for their own needs due to household chores and daily care with the burned child. The main determinants of this overload were: younger caregiver, child under 6 years old, low family income (p=0.078) and injury time less than 1 year. Conclusions: The increased level of physical and emotional burden of caregivers suggests the need to implement actions aimed at providing them with psychosocial support throughout the rehabilitation process, after discharge from these children

Objetivo: Evaluar el nivel de sobrecarga de cuidadores primarios de niños con quemaduras en tratamiento ambulatorio de Fisioterapia en un hospital público de la ciudad de Recife, PE, Brasil. Método: Se trata de un estudio transversal descriptivo con 27 cuidadores primarios de niños con quemaduras entre el rango de edad de 0 a 12 años, en tratamiento en el ambulatorio de Fisioterapia de un hospital público, en la ciudad de Recife. Se utilizo una encuesta para la caracterización del muestreo y la versión brasileña de la Burden Interview Scale a fin de evaluar el nivel de sobrecarga de los voluntarios. El análisis de los datos fue realizada de forma descriptiva y estadística, considerando p<0,05 para la significancia estadística. Resultados: La mayoría de los cuidadores fueron mujeres (madres) que presentaron un nivel leve a moderado de sobrecarga física y emocional, y se quejaron acerca de la falta de tiempo para sus propias necesidades, debido a las tareas domésticas y los cuidados diarios con el niño quemado. Los principales determinantes de esa sobrecarga fueron: cuidador más joven, niño menor de 6 años, ingreso familiar bajo (p=0,078) y tiempo de la lesión inferior a 1 año. Conclusiones: El mayor nivel de carga física y emocional de los cuidadores sugiere la necesidad de implementar acciones destinadas a proporcionarles apoyo psicosocial durante todo el proceso de rehabilitación, después del alta de estos niños.

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Objetivo: Identificar, na atuação do profissional de saúde na Unidade de Tratamento de Queimados (UTQ), a compreensão e o cuidado com os aspectos psicológicos do paciente. Método: Estudo qualitativo com caráter exploratório-descritivo. Os procedimentos metodológicos foram revisão bibliográfica e coleta de dados em entrevistas semiestruturadas com um grupo de profissionais atuantes em uma UTQ, com análise posterior dos discursos, por meio de abordagem fenomenológica em pesquisa. Resultados: Os profissionais identificam a UTQ como "lugar da dor", ressaltam as particularidades dos pacientes, o sofrimento psíquico intenso, e afirmam ser a experiência o principal recurso para o aprendizado do trabalho. Ainda indicam que, em sua formação, pouco preparo tiveram para atuar nessa unidade, principalmente no que se refere aos cuidados com os aspectos psicológicos. Conclusão: A UTQ necessita de saberes específicos para o cuidado com os pacientes e os cursos de formação em saúde não contemplam esse aprendizado, especialmente no que tange aos aspectos psicológicos, apontados como muito significativos em vítimas de queimaduras.

Objective: To identify, in the healthcare professionals performance in the Burn Treatment Unit (BTU), the understanding and care with the psychological aspects of the patients. Methods: Qualitative study with an exploratory-descriptive aspect. The methodological procedures were bibliographic review and data collection in semi-structured interviews with a group of working professionals at a Burn Treatment Unit, with a later analysis of the results, by means of a phenomenological approach in research. Results: Working professionals at BTU identify the place as "place of pain", emphasize the particularities of patients, the intense psychic suffering, and claim that experience is the main resource for learning the job. They still indicate that during their graduation few preparation was given to act in this area, principally with regard to care for the psychological aspects. Conclusion: BTQ needs specific knowledge to care for patients and health training courses do not contemplate this learning, especially regarding the psychological aspects, indicated as very significant in victims of burns. KEYWORDS: Burns. Burn Units. Psychological Trauma. Patient Care. Pain.

Objetivo: Identificar, en la actuación del profesional de la salud de la Unidad de Tratamiento Quemados (UTQ), la comprensión y el cuidado con los aspectos psicológicos del paciente. Método: estudio qualitativo de carácter exploratório-descriptivo. Los procedimientos metodológicos fueron revisión bibliográfica y recopilación de datos en entrevistas semi estructuradas con un grupo de profesionales actuantes en una UTQ, con análise posterior de los discursos, por medio de un enfoque fenomenológico en investigación. Resultados: Los profesionales identifican la UTQ como el "lugar del dolor", resaltan las particularidades de los pacientes, el sufrimiento psíquico intenso, y afirman ser la experiencia el principal recurso para el aprendizaje del trabajo. Todavía indican que tuvieron poco preparo durante su formación para actuar en esta unidad, principalmente en lo que se refiere a los cuidados con los aspectos psicológicos. Conclusion: La UTQ necesita de saberes específicos para el cuidado con los pacientes y los cursos de formación en salud no contemplan ese aprendizaje, principalmente en relación a los aspectos psicológicos, indicados como muy significativos en víctimas de quemaduras.

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OBJETIVO: Descrever as experiências vivenciadas por pessoas hospitalizadas com queimaduras. MÉTODO: Estudo exploratório descritivo, de abordagem qualitativa, realizado com 14 colaboradores, em um hospital de referência no tratamento de queimaduras no estado do Rio Grande do Norte, entre Março e Maio de 2016, utilizando a História Oral de Vida como método para coleta de dados e referencial metodológico. Realizou-se a análise de conteúdo temática de Bardin, emergindo quatro eixos temáticos que nortearam as discussões: lembranças do passado, momento da queimadura, comportamento frente a pele queimada e o tratamento e perspectivas de um futuro. RESULTADOS: Durante a hospitalização existe o sentimento de valorização da vida, saudade, dor, ansiedade, ociosidade, desejo de trabalhar e esperança. CONCLUSÃO: Infere-se que a hospitalização da pessoa queimada é complexa, envolve fatores físicos, emocionais e sociais, refletindo diretamente no seu comportamento, desejos, ações, reações e resposta ao tratamento.

OBJETIVO: Describir las experiencias de personas hospitalizadas con quemaduras. MÉTODO: Estudio exploratorio descriptivo, con enfoque cualitativo, realizado con 14 empleados, en un hospital de referencia en el tratamiento de quemaduras en el estado de Rio Grande do Norte, entre marzo y mayo de 2016, utilizando el Historial de vida oral como método de recolección de datos y marco metodológico. Se realizó el análisis de contenido temático de Bardin, surgiendo cuatro ejes temáticos que guiaron las discusiones: recuerdos del pasado; tiempo de quemado; comportamiento contra la piel quemada y el tratamiento y las perspectivas de futuro. RESULTADOS: durante la hospitalización hay un sentimiento de apreciación de la vida, anhelo, dolor, ansiedad, ociosidad, deseo de trabajar y esperanza. CONCLUSIÓN: Se infiere que la hospitalización de la persona quemada es compleja, involucra factores físicos, emocionales y sociales, que reflejan directamen su comportamiento, deseos, acciones, reacciones y respuesta al tratamiento.

OBJECTIVE: To describe the experiences of people hospitalized with burns. METHOD: A descriptive exploratory study, with a qualitative approach, carried out with 14 employees, in a reference hospital for the treatment of burns in the state of Rio Grande do Norte, between March and May 2016, using the Oral History as the collection method and methodological framework. Bardin's thematic content analysis was used, which resulted in the emergence of four thematic axes that guided the discussions: memories of the past; the moment of the burn; behavior in relation to burned skin and the treatment and outlook for the future. RESULTS: During hospitalization there is a feeling of appreciation for life, longing, pain, anxiety, idleness, desire to work and hope. CONCLUSION: It is inferred that the hospitalization of the burned person is complex which involves physical, emotional and social factors, directly reflecting on their behavior, desires, actions, reactions and response to treatment.

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BACKGROUND AND PURPOSE: The aim of the study was to analyze the factor structure and the reliability of the Brazilian-Portuguese version of the Burn Specific Health Scale-Revised (BSHS-R) in a sample of Brazilian burned adults. METHODS: This study was a cross-sectional study. The internal consistency was analyzed using Cronbach's α, considering coefficients ≥.70 as appropriate. We conducted confirmatory factor analysis (CFA) to test the hypothesis that the BSHS-R Brazilian-Portuguese version has a factor structure similar to the original. We assessed the factor structure of the BSHS-R Brazilian-Portuguese version by CFA, examining three models: three-factor, six-factor, and seven-factor structure. RESULTS: The participants were 299 burned adults. The CFA indicated good model fit indices for the seven-factor model (root mean square error of approximation = .062; goodness-of-fit index = .844; adjusted goodness-of-fit index = .809; Akaike information criterion = 1,054.06). The seven-factor BSHS-R Brazilian-Portuguese version showed Cronbach's α of .93. CONCLUSIONS: The BSHS-R Brazilian-Portuguese version with seven factors is reliable and valid and measures the perceived health status construct.

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RESUMEN Fundamento: El niño quemado es por definición un paciente quirúrgico, traumatizado y extremadamente complejo por las repercusiones vitales, funcionales, estéticas y psicológicas que presenta. Objetivo: Describir el comportamiento de las quemaduras de los niños en el Servicio de Quemados del Hospital Provincial General Camilo Cienfuegos de Sancti Spíritus para el manejo adecuado en la atención de urgencias. Metodología: Se realizó un estudio descriptivo, retrospectivo de corte transversal; la población de estudio fueron los 94 menores de 18 años atendidos en el servicio. Se tuvo en cuenta la edad, el sexo, el agente causal, el lugar de ocurrencia, la extensión y profundidad de las lesiones. Resultados: La edad que predominó fue de 0-4 años con incidencia superior en los varones. La mayor parte de las lesiones se produjeron en la casa y los agentes etiológicos fueron: los líquidos calientes o hirvientes y los metales calientes; siguió en frecuencia el indicador calle con el rozamiento y los accidentes por los rayos de bicicleta. Según su profundidad predominaron las quemaduras dérmicas A y AB y la extensión menor de 5 %. Conclusiones: La edad más frecuente en que se presentaron lesiones por quemaduras en la edad pediátrica fue de 0-4 años con mayor incidencia en los varones. Las quemaduras que predominaron fueron las dérmicas A y AB. La etiología más frecuente: las escaldaduras y los metales calientes y las lesiones de segundo grado. Es importante por ello el correcto manejo de urgencia del paciente quemado pediátrico, así como tener en cuenta medidas para la prevención de las quemaduras de los niños en la comunidad (AU)

ABSTRACT Background: The burned child is by definition a surgical patient, traumatized and extremely complex due to the vital, functional, aesthetic and psychological repercussions that he presents. Objective: To describe the behavior of the burns of children in the Burns Service at Camilo Cienfuegos General Provincial Hospital of Sancti Spíritus for the adequate management of emergency care. Methodology: A descriptive, retrospective cross-sectional study was carried out; the population studied was 94 children under 18 years assisted in the service. Age, sex, causal agent, place of occurrence, extent and depth of injuries were taken into account. Results: The predominant age was 0-4 years with a higher incidence in males. Most of the injuries occurred in the house and the etiological agents were: hot or boiling liquids and hot metals; followed by the indicator referred to frictions and accidents by bicycle spokes in the street. According to their depth, the skin burns A and AB predominated and the extension was less than 5%. Conclusions: The most frequent age in which burns injuries occurred in the pediatric age was 0-4 years with the highest incidence in males. The prevailing burns were skin burns A and AB. The most frequent etiology: scalds and hot metals and second degree injuries. Therefore, the correct emergency management of the burned pediatric patient is important, as well as taking into account some measures for the prevention of burns of children in the community.

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RESUMEN Fundamento: El niño quemado es por definición un paciente quirúrgico, traumatizado y extremadamente complejo por las repercusiones vitales, funcionales, estéticas y psicológicas que presenta. Objetivo: Describir el comportamiento de las quemaduras de los niños en el Servicio de Quemados del Hospital Provincial General Camilo Cienfuegos de Sancti Spíritus para el manejo adecuado en la atención de urgencias. Metodología: Se realizó un estudio descriptivo, retrospectivo de corte transversal; la población de estudio fueron los 94 menores de 18 años atendidos en el servicio. Se tuvo en cuenta la edad, el sexo, el agente causal, el lugar de ocurrencia, la extensión y profundidad de las lesiones. Resultados: La edad que predominó fue de 0-4 años con incidencia superior en los varones. La mayor parte de las lesiones se produjeron en la casa y los agentes etiológicos fueron: los líquidos calientes o hirvientes y los metales calientes; siguió en frecuencia el indicador calle con el rozamiento y los accidentes por los rayos de bicicleta. Según su profundidad predominaron las quemaduras dérmicas A y AB y la extensión menor de 5 %. Conclusiones: La edad más frecuente en que se presentaron lesiones por quemaduras en la edad pediátrica fue de 0-4 años con mayor incidencia en los varones. Las quemaduras que predominaron fueron las dérmicas A y AB. La etiología más frecuente: las escaldaduras y los metales calientes y las lesiones de segundo grado. Es importante por ello el correcto manejo de urgencia del paciente quemado pediátrico, así como tener en cuenta medidas para la prevención de las quemaduras de los niños en la comunidad.

ABSTRACT Background: The burned child is by definition a surgical patient, traumatized and extremely complex due to the vital, functional, aesthetic and psychological repercussions that he presents. Objective: To describe the behavior of the burns of children in the Burns Service at Camilo Cienfuegos General Provincial Hospital of Sancti Spíritus for the adequate management of emergency care. Methodology: A descriptive, retrospective cross-sectional study was carried out; the population studied was 94 children under 18 years assisted in the service. Age, sex, causal agent, place of occurrence, extent and depth of injuries were taken into account. Results: The predominant age was 0-4 years with a higher incidence in males. Most of the injuries occurred in the house and the etiological agents were: hot or boiling liquids and hot metals; followed by the indicator referred to frictions and accidents by bicycle spokes in the street. According to their depth, the skin burns A and AB predominated and the extension was less than 5%. Conclusions: The most frequent age in which burns injuries occurred in the pediatric age was 0-4 years with the highest incidence in males. The prevailing burns were skin burns A and AB. The most frequent etiology: scalds and hot metals and second degree injuries. Therefore, the correct emergency management of the burned pediatric patient is important, as well as taking into account some measures for the prevention of burns of children in the community.

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Objetivo: Identificar a produção do conhecimento sobre qualidade de vida e aspectos relacionados a partir da percepção de crianças e adolescentes queimados. Método: Revisão integrativa da literatura nas bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde e National Library of Medicine National Institutes of Health, utilizando descritores em português, inglês e espanhol: Qualidade de Vida; Queimaduras; Criança; Adolescente; Reabilitação; Estilo de Vida; Valor da Vida; Terapia Ocupacional; Atividade Motora; Unidades de Queimados; Emoções; Autoimagem; Imagem Corporal; Autonomia Pessoal; Bullying; e Apoio Social; e palavras-chave: Atividade física; Queimados; Sentimentos; e Autopercepção. Foi realizada busca direta na Revista Brasileira de Queimaduras, em junho de 2017, tendo sido selecionados 620 artigos publicados entre 2011 e 2017. Desses, apenas 11 foram incluídos. Resultados: Duas temáticas foram levantadas: 1) qualidade de vida de crianças e adolescentes que sofreram queimaduras ou aspectos associados (idade, superfície corporal queimada, local do corpo atingido, tempo transcorrido da queimadura, ambiente de atendimento, relação familiar e uso de estratégias de camuflagem da cicatriz); 2) Instrumentos de medida, sendo os mais utilizados: The Paediatric Quality of Life Inventory e Burn Outcomes Questionnaire. Conclusões: Pesquisas que avaliam a Qualidade de Vida a partir da concepção de crianças e adolescentes precisam ser garantidas em consonância com os determinantes sociais que influenciam a saúde e a qualidade de vida após a alta hospitalar. Além disso, destaca-se a importância dos avanços em estudos de validação de instrumentos para consolidar práticas e oportunizar o cuidado efetivo.

Objective: To identify the production of knowledge regarding the quality of life and related aspects from the perception of burned children and adolescents. Methods: Integrative literature review. The Latin American and Caribbean Literature in Health Sciences and National Library of Medicine National Institutes of Health databases were consulted using the following descriptors in the Portuguese, English and Spanish languages: Quality of Life; Burns; Child; Adolescent; Rehabilitation; Lifestyle; Value of Life; Occupational therapy; Motor Activity; Burned Units; Emotions; Self-image; Body image; Personal Autonomy; Bullying; and Social Support; and the keywords: Physical activity; Burned; Feelings; and Self-perception. A direct search was conducted at the Brazilian Journal of Burns in June 2017, having been selected 620 articles published between 2011 and 2017. Only 11 were included. Results: Two themes emerged: 1) quality of life of children and adolescents who suffered burns or associated aspects (age, burned body surface, body location reached, burn time, care environment, family relationship and use of scar camouflage strategies); 2) Measurement instruments, the most used being: The Pediatric Quality of Life Inventory and Burn Outcomes Questionnaire. Conclusions: Research that evaluates Quality of Life from the conception of children and adolescents needs to be guaranteed in line with the social determinants that influence health and quality of life after hospital discharge. In addition, the importance of advances in validation studies of instruments to consolidate practices and to provide effective care is highlighted.

Objetivo: Identificar la producción de conocimiento sobre calidad de vida y aspectos relacionados desde la percepción de los niños y adolescentes quemados. Método: Revisión integradora de la literatura en las bases de datos Literatura Latino-Americana y del Caribe en Ciências da Saúde y National Library of Medicine National Institutes of Health, utilizando los descriptores en portugués, inglês y español: Calidad de vida; Quemaduras; Niños; Adolescentes; Rehabilitación; Estilo de vida; Valor de la vida; Terapia ocupacional; Actividad motora; Unidad de quemados; Emociones; Autoimagen; Imagen corporal; Autonomía personal; Bullying; y Apoyo social; y las palabras-clave: Actividad física, Quemados; Sentimientos; y Autopercepción. Realizada búsqueda directa en la Revista Brasileña de Quemaduras en junio de 2017. Seleccionados 620 artículos, publicados entre 2011 y 2017, incluídos 11. Resultados: Fueron planteadas dos temáticas: 1) calidad de vida de niños y adolescentes que sufrieron quemaduras y aspectos asociados (edad, superficie corporal quemada, lugar del cuerpo afectado, tiempo transcurrido de la quemadura, ambiente de atención, relación familiar y uso de estrategias de camuflaje de la cicatriz); 2) Instrumentos de medida más utilizados: The Paediatric Quality of Life Inventory y Burn Outcomes Questionnaire. Conclusiones: Las investigaciones que evalúan la calidad de vida a partir de la concepción de niños y adolescentes necesitan ser garantizadas en consonancia con los determinantes sociales que influencian la salud y la calidad de vida. Se destacan avances en estudios de validación de instrumentos para consolidar prácticas y oportunizar el cuidado efectivo.

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OBJECTIVE To know the strategies of coping reported by the nursing team that works at a burn center. METHOD This is a qualitative, descriptive and exploratory study carried out with four nurses and six practical nurses at a burn center in southern Brazil. The data was collected from September to November 2013 through semi-structured interviews, and it was analyzed through the content analysis technique, which happened with the software Atlas.ti 7.0. RESULTS Two themes have emerged: coping focused on the problem, and coping focused on the emotion. Among the main strategies of coping focused on the problem, decision-making and re-evaluation actions should be highlighted; and in the coping focused on the emotion, actions centered on resigned acceptance and emotional extravasation stand out. CONCLUSIONS As the professionals interviewed opted for objective and practical strategies, compatible with coping based on the problem, it is believed that the elaboration is influenced by the workers' individual, collective and institutional contexts.

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BACKGROUND: In many companies, investigations of accidents still blame the victims without exploring deeper causes. Those investigations are reactive and have no learning potential. OBJECTIVE: This paper aims to debate the historical organizational aspects of a company whose policy was incubating an accident. METHODS: The empirical data are analyzed as part of a qualitative study of an accident that occurred in an oil refinery in Brazil in 2014. To investigate and analyse this case we used one-to-one and group interviews, participant observation, Collective Analyses of Work and a documentary review. The analysis was conducted on the basis of concepts of the Organizational Analysis of the event and the Model for Analysis and Prevention of Work Accidents. RESULTS: The accident had its origin in the interaction of social and organizational factors, among them being: excessively standardized culture, management tools and outcome indicators that give a false sense of safety, the decision to speed up the project, the change of operator to facilitate this outcome and performance management that encourages getting around the usual barriers. CONCLUSIONS: The superficial accident analysis conducted by the company that ignored human and organizational factors reinforces the traditional safety culture and favors the occurrence of new accidents.

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Currently, there is no questionnaire to assess perceived stigmatization among people with visible differences in Brazil. The Perceived Stigmatization Questionnaire (PSQ), developed in the United States, is a valid instrument to assess the perception of stigmatizing behaviours among burn survivors. The objective of this cross-sectional and multicentre study was to assess the factor structure, reliability and validity of the Brazilian Portuguese version of the PSQ in burn patients. A Brazilian version of the 21-item PSQ was answered by 240 adult burn patients, undergoing rehabilitation in two burns units in Brazil. We tested its construct validity by correlating PSQ scores with depression (Beck Depression Index-BDI) and self-esteem (Rosenberg Self-Esteem Scale-RSE), as well as with two domains of the Revised Burn Specific Health Scale-BSHS-R: affect and body image, and interpersonal relationships. We used Confirmatory Item Factor Analysis (CIFA) to test whether the data fit a measurement model involving a three-factor structure (absence of friendly behaviour; confusing/staring behaviour; and hostile behaviour). We conducted Exploratory Factor Analyses (EFA) of the subscale in a 50% random sample of individuals (training split), treating items as ordinal categorical using unweighted least squares estimation. To assess discriminant validity of the Brazilian version of the PSQ we correlated PSQ scores with known groups (sex, total body surface area burned, and visibility of the scars) and assessed its reliability by means of Cronbach's alpha and using test-retest. Goodness-of-fit indices for confirmatory factor analysis were satisfactory for the PSQ, but not for the hostile behaviour subscale, which was modified to improve fit by eliminating 3 items. Cronbach's alphas for the PSQ refined version (PSQ-R) ranged from 0.65 to 0.88, with test-retest reliability 0.87 for the total score. The PSQ-R scores correlated strongly with depression (0.63; p < 0.001), self-esteem (-0.57; p < 0.001), body image (-0.63; p < 0.001), and interpersonal relationships (-0.55; p < 0.001). PSQ-R total scores were significantly lower for patients with visible scars (effect size = 0.51, p = 0.029). The PSQ-R showed reliability and validity comparable to the original version. However, the cross-cultural structure of the subscale "hostile behaviour" and sensitivity to change of the PSQ should be further evaluated.

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