Nursing Care of a Patient After Burn According to Orem’s Self-Care Theory: A Case Report

Abstract

ABSTRACT

OBJECTIVES: Burn injuries result in lifelong physical and psychological scars, cause pain, and affect mental health, quality of life, ability to return to work, and death. Although the medical point of view is important for the burn nurse to contribute to patient care, theoretical nursing care should be encouraged. In this case report, we describe a patient with severe burns who received nursing care according to Orem ’s Self-Care Insufficiency Theory. MATERIALS AND METHODS: The 18-year-old male patient received second-degree and third-degree burns of 75% of total body surface area while using thinner to light a heater at work. Burn injuries covered his legs, arms, front body, back body, and certain parts of the face. The patient was transferred to Ankara Baskent University Hospital Burn Intensive Care Unit where he was hospitalized for 85 days. During this period, the patient underwent many surgical treatments, including escharotomy, debridement, and graft surgeries. RESULTS: Thirteen nursing diagnoses were made during his hospital stay. These diagnoses were risk of infection, fear, self-care deficit, risk of bleeding, acute pain, anxiety, impaired physical mobility, disturbed body image, deficient knowledge, impaired skin integrity, sleep pattern disturbance, deficient fluid volume, and imbalanced nutrition of less than body requirements. Contractures developed in the patient ’s legs, preventing him from walking upright. The patient was discharged with continuation of physical therapy, which included pain control during training, maintenance of movement and exercise, giving information about outpatient follow-up, skin care, protection from sun, and nutrition. CONCLUSIONS: With the nursing care applied and in accordance with Orem’s Self-Care Insufficiency Theory, apart from the surgical treatments, the patient ’s lack of knowledge was eliminated, his anxiety level was reduced, his fear was eliminated, his diet was adjusted, and his self-confidence was increased. At discharge, the patient was confident of his care.