Askay, S.W., Stricklin, M., Carrougher, G.J., Patterson, D.R., Klein, M.B., Esselman, P.C., & Engrav, L.H. (2008, December 3). Using Q methodology to identify reasons for distress in burn survivors postdischarge. Journal of Burn Care Research (Epublication ahead of print, available

Abstract: Reasons for distress after burn injuries have not been codified based on any type of acceptable empirical or statistical technique. The unique design methodology proposed in this study can identify the most common reasons cited for causing distress in burn survivors after discharge. A Q-sort task was developed with the assistance of our burn advisory group. After identifying 50 possible reasons for distress after discharge, each reason was placed on a laminated game card. In compliance with Q methodology, a game board was developed that allowed patients to rank order each reason from “not causing distress” to “causing significant distress.” A total of 69 burn survivors were enrolled in the study at four different time points: 1 month, 6 months, 1 year and 2 years postdischarge. After factor analysis, four factors accounted for all of the participants across time points. This indicates that at least four distinct groups of people can be categorized according to themes raised in rating reasons for distress. This Q-sort technique allowed us to capture the complexity of conceptualizing human distress by categorizing clusters of reported problems into similar groups. This methodology shows great promise for developing interventions that target unique needs of burn survivors.

The authors are variously associated with the Department of Rehabilitation Medicine, University of Washington School of Medicine; the Federal University of Piaui, Brazil; and the Department of Surgery, Division of Plastic Surgery, University of Washington School of Medicine, Seattle.