School of Physical and Occupational Therapy, McGill University, Canada.
Hôpital de réadaptation Villa Medica, Montréal, Québec, Canada.
Burns. 2021 Feb;47(1):175-189. doi: 10.1016/j.burns.2020.06.002. Epub 2020 Jun 20.
The Fear-Avoidance Model was developed with patients who had sustained neck and back injuries and describes a cascade of events after pain that is perceived as threatening, which may lead to avoidance of valued and meaningful life activities. The literature examining burn survivors suggests they may experience fear-avoidance, however, their lived experience has yet to be thoroughly explored and the evaluation tool that has been used is four items extracted from the Tampa Scale of Kinesiophobia that were modified for burn survivors, but never formally validated with this population. Therefore, the aim of this study was to explore, through a mixed methods approach, the lived experience of burn survivors with respect to fear-avoidance and determine whether the reduced four question Tampa Scale of Kinesiophobia (4TSK) reflects and accurately measures their experience. Burn survivors (n = 17) who had undergone surgical debridement and grafting were recruited. They completed the reduced 4TSK and participated in an in-depth interview to explore their lived experience regarding fear-avoidance and their opinions on the relevance of the questions. The interviews were analyzed using a thematic-analysis approach. Five major themes that represented the lived experience of fear-avoidance in burn survivors were identified: perceived vulnerability to re-injury, others as fear influencers, difficulties & hardships during recovery, engagement in activity, and active thoughts. Based upon the interviews researchers identified 9 potential fear-avoidant participants, which differed from the screening results from the reduced 4TSK (n = 12). Overall, this study demonstrated the potential uniqueness of the burn survivor population and provided insight into their lived experience of fear of movement or activities.
恐惧回避模型是针对颈部和背部受伤的患者开发的，描述了疼痛后可能导致回避有价值和有意义的生活活动的一系列事件。检查烧伤幸存者的文献表明，他们可能会经历恐惧回避，但是，他们的生活经历尚未得到充分探索，并且使用的评估工具是从 Tampa 运动恐惧症量表中提取的四个项目，这些项目经过修改适用于烧伤幸存者，但从未在该人群中进行正式验证。因此，本研究的目的是通过混合方法探索烧伤幸存者对恐惧回避的生活体验，并确定简化的 Tampa 运动恐惧症量表（4TSK）是否反映并准确测量他们的体验。招募了接受手术清创和植皮的烧伤幸存者（n=17）。他们完成了简化的 4TSK，并参加了深入访谈，以探讨他们对恐惧回避的生活体验以及对问题相关性的看法。访谈采用主题分析方法进行分析。确定了五个主要主题，代表了烧伤幸存者对恐惧回避的生活体验：对再次受伤的易感性，他人对恐惧的影响，康复期间的困难和艰辛，参与活动和积极的想法。根据访谈，研究人员确定了 9 名潜在的恐惧回避参与者，与简化的 4TSK 的筛查结果（n=12）不同。总体而言，这项研究表明烧伤幸存者人群具有潜在的独特性，并深入了解了他们对运动或活动的恐惧的生活体验。
