Experiences of guilt, shame and blame in those affected by burns: A qualitative systematic review

Background: A significant burn can severely impact the lives of survivors and their carers. This systematic review sought to incorporate the experiences of guilt, blame and shame across the lifespan for burn survivors, their families as well as the experiences of the parents of burned children. Methods: A systematic review of qualitative studies on the experiences and perspectives of guilt, blame and shame by those affected by burn trauma across the lifespan. The databases, Pubmed, Scopus, EMBASE, CINAHL, PsychINFO were systematically searched. Authors independently rated the reporting of the qualitative studies included. Thematic synthesis was used to analyse the data. The search identified 230 papers. Eighteen research papers met the study inclusion criteria. Results: Guilt and ruminations of guilt, blame attribution and shame and body image were identified during thematic analysis as pivotal factors across the lifespan for burn survivors, their families as well as the experiences of the parents of burn injured children. Accounts presented, suggest that the impact of burns on the lives of the survivor and family covers a diverse spectrum of impact; personal, cultural and societal. Conclusion: From the findings of the literature searches and the post-burn experiences described in this review there is a gap in the psychological care for burn survivors and their caregivers. This is specifically relevant around issues of parental guilt and blame, ruminations of guilt and shame as well as body image. These findings may not be new to burns professionals but the key message is that management of these issues fall short of delivering comprehensive post trauma care. Identifying and highlighting the importance of residual psychosocial problems will ultimately influence positive outcomes for burn survivors.