The trauma bubble: patient and family experience of serious burn injury.

The aim of this study was to understand the lived experience of burn injury for Australian patients and families. Of specific interest was the period covering emergency and inhospital care and early experiences of transition into the community. Eighteen participants including patients with serious burn injury and close family members engaged in indepth, semistructured interviews. Data were analysed using Heideggerian phenomenology and were interpreted within the framework of Merleau-Ponty's philosophy of the body. Participants experienced substantial emotional trauma that was unrelated to burn size or severity. Emotional distress was highest amongst people with facial burns. Strong recollections of the accident and poorly managed pain seemed to exacerbate the experience of trauma. Patients described physical otherness, memories of consuming, embodied pain, and recycling of the initial catastrophe. Family members expressed vicarious suffering and were confronted by the physical otherness of their loved one. Participants were isolated in their "bubble of trauma" as they tried to contain grief and loss, and protect loved ones from their distress. Emotional trauma persisted after discharge challenging family functioning and adjustment. These findings support a systematic approach to identifying and responding to the emotional needs of patients and family, including early information about possible emotional reactions to traumatic events and proactive engagement with psychology services. Best practice approaches for early pain management should be a focus for both clinical care and further research.