Iran Journal of Nursing

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Seyedoshohadaee M, Seraj A, Haghani H. The Correlation of Resilience and Anxiety in the Candidate Burn Patients for Skin Grafting. IJN 2020; 32 (122) :69-79
URL: http://ijn.iums.ac.ir/article-1-3136-en.html

Background & Aims: Burns affect all aspects of life. In fact, burn victims face various problems and the incidence affects their life quality, especially the psychological dimension. The majority of burn victims suffer from psychological disorders after the incident. On the other hand, burn treatment is a prolonged and difficult process associated with painful procedures, physical problems, and deformities, long hospital stays, surgical treatments, and numerous psychological problems. Burn victims deal with a wide range of stressors that severely change their vital signs and may cause irreversible damages to various body systems, including anxiety. People with burn injuries often experience anxiety, which is usually associated with worry, physical changes (e.g., hypertension and increased heart rate), and tension. Pre-surgery anxiety is also one of the experiences of skin graft candidates. In general, anxiety is a physiological reaction that can prevent improvement and increase the need for anesthesia and post-surgical sedatives. In addition, it decreases the body’s immune responses and increases the risk of infection in patients. Resilience is a coping strategy that helps individuals deal with stressful situations and survive pathogenic disorders. In fact, resilience is a dynamic process that leads to the manifestation of positive adaptive behaviors in individuals when facing hardship. With this background in mind, this study aimed to determine the relationship between resilience and anxiety in skin graft burn candidates.
Materials & Methods: In this descriptive, correlational, and cross-sectional study, we selected samples using continuous sampling based on the inclusion criteria. The participants included skin graft candidates and the research setting was Mottahari Burns Hospital affiliated to Iran University of Medical Sciences. The sample size was determined at a 95% confidence interval and 80% test power while assuming a minimum correlation coefficient of 0.25 between resilience and anxiety of skin graft burn candidates following quantification in the formula. After receiving an introduction letter from the nursing and midwifery school and a license from the ethics committee of the university, the researcher referred to the mentioned hospital and explained the research objectives to supervisors and head nurses to gain their agreement and consent before sampling. In total, 130 subjects were selected including 65 men and 65 women in an age range of 18-60 years. Continuous sampling was carried out for one month (June 21^st-July 22^nd, 2019). It is notable that codes were used instead of names, and the research objectives were explained to the participants prior to the study. In addition, written informed consent was obtained from the participants or one of the immediate family members. Research tools included: 1) demographic characteristics questionnaire, Beck’s anxiety inventory (BAI), and the Connor-Davidson Resilience Scale (CD-RISC), which were filled 20-30 minutes before the surgery. In addition, data analysis was performed in SPSS version 16 using descriptive and inferential statistics in the form of a table and numerical indexes to describe research units. Moreover, mean and standard deviation, as well as Pearson’s correlation coefficient, analysis of variance, and independent t-test were applied to analyze the data.
Results: In this study, 66.2% of the patients received a resilience score above 50 and a mean resilience score of 64.57±22.25 was obtained. On the other hand, the mean anxiety score of 45.4% of the patients was extremely low (12.88±10.45), and reverse, a significant correlation was observed between the resilience and anxiety of the participants. In other words, an increase in the resilience score of the participants led to a decrease in their anxiety levels (r=-0.0808, P<0.001). The results were also indicative of a significant relationship between resilience and the variables of the level of education (P<0.001), economic status (P=0.001), occupational status (P=0.02), and place of residence (P=0.035). Furthermore, a significant association was found between the participants’ anxiety and the variables of the level of education (P=0.004), economic status (P=0.011), occupational status (P=0.03), and place of residence (P=0.016).
Conclusion: According to the results of the study, there was a reverse, significant correlation between resilience and anxiety, meaning that an increase in the resilience score led to a decrease in patients’ anxiety. In other words, the higher the resilience of patients, the lower their anxiety. Overall, skin graft burn candidates had low anxiety levels and moderate resilience. According to the results of the study, it is recommended that resilience be taught as a supplementary action along with other therapeutic approaches to reduce anxiety in burn victims before a skin graft. Moreover, due to the fact that the rate of resilience was lower in illiterate and low-income people, it is necessary to empower burn candidates to adapt to the conditions, prepare them before skin graft surgery, and prevent complications before, during, and after surgery. By doing so, we can increase resilience and decrease anxiety in these individuals. Our findings can help nursing managers hold in-service educational classes to emphasize the importance of resilience in a decrease of pre-surgical anxiety and increase their life quality.