الفهرس 
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Abstract
Sever burn injuries are devastating and sudden, unpredictable forms of trauma may affect the victim both physically and psychologically. Burn is a type of injury to skin or other tissues caused by heat, chemical, electricity, radiation or friction. Scalds from hot liquids, steam, building fires, flammable liquids and gases which are the most common causes of burns and the injury occurs in all ages groups. Burn victims often face extreme physical and psychological problems (Kemp, Herndon & Lawson, 2014).
The aim of this study was to assess physical and psychological problems among patients with second degree burn. This study was conducted at Department of Burn, at El - Demerdash Hospital affiliated to Ain Shams University. This setting provide services for all burn patients in Cairo at availability services: daily change dressing for all patients, giving medications, health teaching about degree of burn and care after discharge.
The subjects of this study was composed of 100 patients with second degree burn in the previously mentioned setting with inclusion criteria. This study was conducted at Department of Burn, at El-Demerdash Hospital affiliated to Ain Shams University. An approval was obtained from Faculty of Nursing at Ain Shams University with explaining the aim of study to obtain the permission and cooperation. Data were collected in 14 July, 2017 and finished to collect data at 23 September, 2017. Every meeting lasted from 15-20 minutes to collected data from every patients.
Tools of data collection
1- Socio demographic characteristics and clinical data
2- Assessment psychological problems (self esteem scale, Body image scale and depression scale)
3- Assessment physical problems (Health specific scale of burn)
The study findings were as follows:
• Majority of studied patients were between 30-50 years, following by 18-30yrs then 50 & more (44.0, 43.0 & 14.0 respectively).
• More than half of patients were female, single and from urban area (25.0, 51.0 & 55.0 respectively). In addition, less than half of them had intermediate education followed by illiterate (46.0 & 20.0 respectively). About half (51.0) of them were not working.
• Causes of burn among studied patients were fire or flame, liquid or boiling, electricity, radiation and chemical means (41.0, 27.0, 26.0, 5.0 & 1.0 respectively). In addition, more than two fifths of them had burn percentage of 21-25 %.
• Three fifths of patients with second degree burn were not feel that they had a number of good qualities and not satisfying with their self (63.0, 60.0 respectively).
• Less than half of studied second degree burn patients sometimes feel loss of interest in life, low self esteem and had trouble making up their mind about things (46.0, 43.0 and 37.0 respectively).
• Less than half of studied second degree burn patients feel that burn make them unattractive to others ashamed and hypersensitivity constantly because their burn and sometimes think people doesn’t touch them (41.0, 40.0 & 44.0 respectively).
• More than three fifths of studied second degree burn patients unable performing their old duties, dressing their self, getting in and out of chair, able picking up coins from a flat surface, eating with utensils, unlocking a door and singing your name (76.0, 74.0,71.0, 69.0, 69.0, 65.0 respectively).
• There is no significant relation between psychological problems (depression, body image and self - esteem) and physical problems among studied patients with second degree burn R= .179 & p. value=.075
• There is no significant relation between studied patients` demographic data as regards their psychological and physical and problems, P<0.05.
Conclusion
Findings of the current study conclusion can be deducted the following:
Burn injuries had a negative impact on studied patients in the form of physical problems using burn specific health scale for assessment of physical problems for second degree burn patients. More than half of patients were suffered from physical health problems as performing old job, dressing themselves. In addition, as regards psychological problems, about two thirds were suffered from depression, self esteem and body image problems. Finally, there is no significant relation between psychological and physical problems.
Recommendations
In light of the study findings, the following recommendations were proposed:
For Education :-
1- Developing the role of psychiatric mental health nursing for the patients with burn in nursing curricula:-
2-Ongoing burn rehabilitation program for physical, occupational and psychological therapy which needed for all patients to reduce the feelings of hopelessness and enhancing the ability of returning normal activity.
3-Integrate physical and emotional changes in nursing curriculum to enhance the nurse’s level of emotional changes to able to predict, identify and help in process of developing the physical and emotional changes of patients.
For families:-
Psycho educational program for family to facilitate an increased understanding of the illness as well as to suggest strategies that may be useful in dealing with difficult behavior.
Clinically:-
A construction an integrated approach by incorporating psychosocial intervention to improve self esteem, self image and depression.
For Research:-
1-A further research is needed to carry out qualitative studies about the physical, emotional, social and spiritual consequences of second degree burn.
2-Assessing psychosocial problems and facing the family and patients with second degree burn.
For community:-
1-Continuous training program of a holistic approaches (health education, physical, psychosocial and spiritual support for the patients with second degree burn.
2-Support workers and suitable respite and residential care facilities are also needed.
3-Expand public awareness through mass media about stages of burn and the effect of being emotionally stable on mental health and all life aspects.