A mixed methods study investigating patient's initial experiences after acquiring a surgical scar, burn injury, and/or amputation.

Introduction: Experiences of seeing an altered appearance for the first time can have an important influence on an individual's psychological wellbeing, their body image and their adjustment. Existing research has explored this experience in individuals with breast cancer and facial burns, but limited research has been conducted in other appearance altering conditions. The aim of this study was to explore patient's initial experiences viewing themselves after acquiring an appearance altering condition, including distress, preparedness and social support. Methods: Participants (n = 64) with a surgical scar, burn injury or amputation completed a mixed methods online survey. This survey included questions about practical elements of the experience, the support they received, their expectations, distress, and preparedness; as well as open questions regarding participant's feelings, fears, support and suggested improvements to the experience. Data analysis included statistical analysis and inductive content analysis. Discussion: Participants reported a variety of initial experiences. Some felt adequately prepared and supported, whilst others felt this could have improved. A strong correlation was found between perceived support and distress (rs = -.66, p = <.001) and preparedness and distress (rs = -.66, p = <.001). No significant differences in preparedness, distress or support were found according to gender, age, or condition. Conclusions: Whilst many participants reported satisfaction with viewing their appearance for the first time, some participants reported significant distress and a need for further support around this experience. This suggests an important role for healthcare providers in discussing expectations and providing appropriate patient support following injury or treatment.