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Cited by 144Burn Injury Management and OutcomesFamily and Patient Care in Intensive Care UnitsDermatologic Treatments and Research

The DOI matches its Crossref record; 1 of the 1 references it cites were found in a registry or an index.

Psychosocial aspects of burn injuries

Open access
Wiechman, Shelley A, Patterson, David R·2004·BMJ
DOI 10.1136/bmj.329.7462.391PMC PMC509350
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Abstract

With the increased survival of patients with large burns comes a new focus on the psychological challenges and recovery that such patients must face.Most burn centres employ social workers, vocational counsellors, and psychologists as part of the multidisciplinary burn team.Physiological recovery of burn patients is seen as a continual process divided into three stages-resuscitative or critical, acute, and long term rehabilitation.The psychological needs of burn patients differ at each stage. Resuscitative or critical stageThe psychological characteristics of this stage include stressors of the intensive care environment, uncertainty about outcome, and a struggle for survival.The intensive care environment can be both overstimulating and understimulating with the monotony of lying in a hospital bed for weeks.Cognitive changes such as extreme drowsiness, confusion, and disorientation are common during this phase.More severe cognitive changes such as delirium and brief psychotic reactions also occur, usually as a result of infections, alcohol withdrawal, metabolic complications, or high doses of drugs.Patients may also be intubated, which greatly limits direct communication. TreatmentIn depth psychological intervention is of minimal value at this phase, since physical survival is the primary goal.Patients should be encouraged to cope with the frighteningly unusual circumstances of the intensive care unit through whatever defences are available to them, even primitive strategies such as denial and repression.Supportive psychological interventions should focus on immediate concerns, such as sleep, pain control, and protecting patients' coping strategies.Non{pharmacological approaches to pain control, such as hypnosis and relaxation, can be effective.Medical staff can also effectively intervene during this early stage of recovery by working with a patient's family members.Family members may be anxious and distressed while observing the patient undergo treatment, which fosters the same response in the patient.It is important to help family members understand this effect and help them to convey a sense of hope and calmness to the patient.

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  1. Patterson DR Ford GR . Burn injuries. In: Frank RG, Elliott TT, eds. Handbook of rehabilitation psychology. Washington DC: American Psychological Association, 2000: 145–62 · DOI

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Metadata

Authors
Wiechman, S. A., & Patterson, D. R.
Affiliations
University of Washington (US)
ORCID
Wiechman, Shelley A
Venue
BMJ
Publisher
BMJ
Published
2004-08-12
Volume
329
Issue
7462
Pages
391-393
ISSN
  • 0007-1447 (ISSN-L)
  • 0959-8138
  • 1468-5833
DOI
10.1136/bmj.329.7462.391
PMC
PMC509350
OpenAlex
W2001313503
Cited by
144
References
1
Citations by year
2026: 11 · 2025: 11 · 2024: 8 · 2023: 7 · 2022: 6 · 2021: 15 · 2020: 8 · 2019: 11 · 2018: 7 · 2017: 6 · 2016: 5 · 2015: 5 · 2014: 3 · 2013: 9 · 2012: 3
FWCI
2.16
Type
journal article
Language
en
Open access
Licence
www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
Locations
  • BMJ (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Burn Injury Management and Outcomes
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Family and Patient Care in Intensive Care Units
  • Health Sciences › Medicine › Dermatology › Dermatologic Treatments and Research
Keywords
burns, psychosocial aspects, psychological recovery, intensive care unit, delirium, cognitive impairment, pain management, non-pharmacological pain management, family support, rehabilitation, coping strategies
MeSH terms
Burns, Humans, Long-Term Care, Pain, Psychotherapy

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