Early assessment and identification of posttraumatic stress disorder, satisfaction with appearance and coping in patients with burns

• Published in: BURNS 2016-12, Vol.42 (8), p.1678-1685
• Main Authors: Dahl, Oili, Wickman, Marie, Björnhagen, Viveca, Friberg, Mona, Wengström, Yvonne
• Format: Article
• Language: English
• Subjects: Adaptation; Adaptation, Psychological; Adult; Body image; Body Image - psychology; Body Surface Area; Burn; Burns - psychology; Burns - rehabilitation; Coping; Critical Care; Disfigurement; Dreams - psychology; Early Diagnosis; Female; Humans; Length of Stay - statistics & numerical data; Male; Medicin och hälsovetenskap; Middle Aged; Pain - psychology; Patient Satisfaction; Physical Appearance, Body; PTSD; Rehabilitation; Risk Factors; Stress Disorders, Post-Traumatic - diagnosis; Stress Disorders, Post-Traumatic - psychology; Surgical Procedures, Operative - statistics & numerical data; Trauma Severity Indices; Young Adult
• ISSN: 0305-4179; 1879-1409; 1879-1409
• DOI: 10.1016/j.burns.2016.09.012

Abstract Background The first year after severe burn is a psychologically challenging period for the patient. Patients may still struggle with burn-related physical and psychological problems such as posttraumatic stress disorder (PTSD) and body image dissatisfaction (BID). Aim This study investigates the presence of PTSD, BID and coping, at three, six and twelve months after discharge for early identification of patients in need of focused support during rehabilitation. Methods Fifty-two adult patients with different degrees of burns were followed at three, six and twelve months after discharge and 36 patients completed all assessment points. A standardized clinical protocol was used for systematic assessment of PTSD (IES-R), BID (SWAP-Swe) and Coping (CBQ). The follow-up included an intervention with a burn nurse as a complement to the existing program. Results Approximately half of the patients had a risk of developing PTSD three months after discharge from hospital, and body image dissatisfaction was found to potentially predict risk of PTSD during follow-up. Conclusions The findings suggest that it is important to include patients with less extensive burns in follow-up as this group is at risk of development of PTSD. Using standardized questionnaires in early follow-up along with assessment of body image dissatisfaction may facilitate detection of psychological problems.