Impact of Scarring on Occupational Performance and Self-Efficacy

Qualitative pair-reviewed journal article examines the influence of scarring on patient’s quality of life in relation to the psychological impairments influencing cosmetic appearance and self-efficacy: And physical impairments causing restrictions to occupational participation (Bock, Schmid-Ott, Malewski & Mrowietz, 2006). The study determined the scar symptoms which influence individuals home life, personal relationships, occupational difficulties, social life, leisure pursuits, emotional reactions and self-confidence, which have been outlined below:

Physical Symptoms 
Social Symptoms 
-  Tight / pulling sensation when scaring is present over a joint, leads to impaired range of motion, strength, occupational engagement and performance of activity of daily living.
-  Contractors
-  Stigmatisation
-  Decreased self-confidence
-  Interrupts / interferes with communication
- Declined participation in leisure activities were scars are visible e.g. swimming 

Majority of patients reported being dissatisfied with the cosmetic appearance of their scars, leading individuals to feel abnormal. Patients felt stigmatised by society believing others were looking at their scars and judging them, leading to impaired occupational participation (Brown, McKenna, Siddhi, McGrouther & Bayat, 2008). Leading patient to experienced declined self-efficacy, causing impaired belief in their abilities to successfully accomplish functional tasks or succeed in social situation. 

References:
Bock, O., Schmid-Ott, G., Malewski, P., & Mrowietz, U. (2006). Quality of life of patients with keloid and hypertrophic scarring. Archives of Dermatological Research297(10), 433. doi: 10.1007/s00403-006-0651-7 

Brown, B. C., McKenna, S. P., Siddhi, K., McGrouther, D. A., & Bayat, A. (2008). The hidden cost of skin scars: Quality of life after skin scarring. Journal of Plastic, Reconstructive & Aesthetic Surgery61(9), 1049-1058. doi: 10.1016/j.bjps.2008.03.020 

Comments

  1. This sheds light on the social symptoms and how they affect those who suffer from burns. Usually I have heard predominantly about the healing process of burns rather than how the scars can impact and hinder someone in engaging in every day activities!

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    1. Thank you for your comment it is nice hearing my audiences feedback. The reference I used when writing this blog, which is outlined below is an extremely interesting read, which you may be interested in exploring. As it highlights and informatively documents individuals’ personal experiences, perspectives and real-life examples of how skin scaring had effected their everyday engagement in task and quality of life.

      Brown, B. C., McKenna, S. P., Siddhi, K., McGrouther, D. A., & Bayat, A. (2008). The hidden cost of skin scars: quality of life after skin scarring. Journal of Plastic, Reconstructive & Aesthetic Surgery, 61(9), 1049-1058. doi: 10.1016/j.bjps.2008.03.020

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  2. My Dad suffered from some pretty serious burns as a young child for which he needed skin grafts. I remember him talking about how he got bullied all throughout his schooling years because of it - which has definitely had some lasting psychological effects. Great to know that there are new technologies out there that can help!!
    PS. Does this stuff work on all types of scarring i.e. stretch marks during pregnancy or is that different because its caused by something else?

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    Replies
    1. Thank you for your comment it is nice hearing my audiences feedback. I argue with you; social stigmatization and social isolation are huge influences and can leave a person with lasting psychological effects. I have had previous placement experience with children’s who’s burns influences social school engagement and in talking to staff from the Burns Support Group I have notice there is an increasing need for education to be provided in school around scarring. Education which is aimed at increasing knowledge around scaring and treatment intervention like pressure garment to intern decrease the stigmatization and social isolation patients experience. This is an area of occupational therapy I am extremely passionate about and hope to explore it further.

      Silicone Gel creams, which can be brought over the counter are predominately used in the prevention and management of stretch marks. However, if stretch markers are servery visible or causing problems with participation in everyday life activities, laser or light therapy and plastic surgery are possible treatment option. Followed by occupational therapy interventions including: silicone product, massage and moisturisation, to prevent the raising of the surgical scarring.

      You may be interesting in exploring the following journal article which is a systematic review examining the use of topical agents including: silicone and moisturisation products to the skin to help reduce the appurtenance of stretch marks.

      Moore, J., Kelsberg, G., & Safranek, S. (2012). Do any topical agents help prevent or reduce stretch marks? 61(12): 757-758. doi: 10.1136/ebn.10.2.54

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  3. I did't realize the huge impact scarring has on everyday functioning. Great blog.

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    Replies
    1. Thank you for your comment it is nice hearing my audiences feedback.

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