Quality of life and psychopathological risk of burn patients: a narrative review

Journal title PSICOLOGIA DELLA SALUTE
Author/s Lucia Sideli, Alice Mulè, Maria Valentina Barone, Caterina La Cascia, Alessia Prestifilippo, Angela Di Pasquale, Daniele La Barbera
Publishing Year 2016 Issue 2016/2
Language Italian Pages 20 P. 86-105 File size 215 KB
DOI 10.3280/PDS2016-002005
DOI is like a bar code for intellectual property: to have more infomation click here

Below, you can see the article first page

If you want to buy this article in PDF format, you can do it, following the instructions to buy download credits

Article preview

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

Despite the advances of medicine and surgery, burn traumas still represent a significant cause of impairment and disability, which exert a significant impact on quality of life and are related to several psychopathological outcomes, such as depression and post-traumatic stress disorder. This narrative non-systematic review aims at outlining the main findings related to quality of life, psychopathological symptoms, risk and protective factors, assessment tools, and psychological interventions targeted to burn patients. Results show that the natural history of burn injuries is a complex process involving a variety of factors, such as body image dissatisfaction, coping strategies, and social support. It seems clear that the assessment of burn trauma should consider not only functional and aesthetic features, but also psychological and social consequences. Furthermore, it is fundamental that, in addition to surgical, medical, and rehabilitation treatments, psychological interventions would be available to burn patients and their family members.

Keywords: Burn trauma, quality of life, psychiatric symptoms, risk factors, health psychology.

  1. Amoyal N., Mason S., Gould N., Corry N., Mahfouz S., Barkey A. and Fauerbach J. (2011). Measuring coping behavior in patients with major burn injuries: a psychometric evaluation of the BCOPE. Journal of Burn Care & Research, 32 (3): 392-398. DOI: 10.1097/BCR.0b013e318217f97
  2. Anzarut A., Chen M., Shankowsky H. and Tredget E. (2005). Quality-of-life and outcome predictors following massive burn injury. Plastic and Reconstructive Surgery, 116 (3): 791-797. DOI: 10.1097/01.prs.0000176257.22583.4
  3. Beck A.T., Steer R.A. and Brown G.K. (1996). Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation.
  4. Beck A.T., Steer R.A. and Brown G.K. (2000). BDI − FastScreen for Medical Patients (BDI). San Antonio, TX: Pearson.
  5. Blades B., Mellis N., Munster A. (1982). A burn specific health scale. J Trauma, 22 (10): 872–875.
  6. Blake D.D., Weathers F.W., Nagy L.M., Kaloupek D.G., Gusman F.D., Charney D.S. and Keane T.M. (1995). The development of a Clinician-Administered PTSD Scale. J Trauma Stress, 8 (1): 75-90. DOI: 10.1002/jts.249008010
  7. Blakeney P.E., Rosenberg L., Rosenberg M. and Faber A.W. (2008). Psychosocial care of persons with severe burns. Burns, 34 (4): 433-440. DOI: 10.1016/j.burns.2007.08.00
  8. Blumenfield M. and Reddish P.M. (1987). Identification of psychologic impairment in patients with mild-moderate thermal injury: small burn, big problem. Gen Hosp Psychiatry, 9 (2): 142-146. DOI: 10.1016/0163-8343(87)90026-
  9. Brooks R. (1996). EuroQol: the current state of play. Health Policy, 37 (1): 53-72. DOI: 10.1016/0168-8510(96)00822-
  10. Brusselaers N., Monstrey S., Vogelaers D., Hoste E. and Blot S. (2010). Severe burn injury in Europe: a systematic review of the incidence, etiology, morbidity, and mortality. Crit Care, 14 (5): R188. DOI: 10.1186/cc930
  11. Cabulon E.A., Cardoso J.R., Maciel S.M., Martins J.T., Robazzi M.L. and Cardelli A.A. (2015). Quality of life of individuals treated in an outpatient burn treatment centre: Application of the BSHS-R. Burns, 41 (3): 528-535. DOI: 10.1016/j.burns.2014.08.01
  12. Carver C., Scheier M.F. and Weintraub J.K. (1989). Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology, 56 (2): 267-283. DOI: 10.1037/0022-3514.56.2.26
  13. Carver C. (1997). You want to measure coping but your protocol’s too long: consider the brief COPE. International Journal of Behavioral Medicine, 4 (1): 92-100. DOI: 10.1207/s15327558ijbm0401_6
  14. Cash T.F. (2000). MBSRQ users’ manual. Norfolk, VA: Old Dominion University.
  15. Conversano C., Lensi E., Testi C. and Gremigni P. (2010). The burn patient: factors associated with post-traumatic stress disorder and directions for intervention. Riv Psichiatr, 45(4): 221-233. DOI: 10.13140/2.1.3525.184
  16. Cook D., Mulrow C.D. and Haynes B. (1997). Systematic reviews. Synthesis of best evidence for clinical decisions. Ann Int Med, 126 (5): 376-380. DOI: 10.7326/0003-4819-126-5-199703010-0000
  17. Cukor J., Wyka K., Leahy N., Yurt R. and Difede J. (2015). The treatment of posttraumatic stress disorder and related psychosocial consequences of burn injury: a pilot study. J Burn Care Res, 36(1): 184-192. DOI: 10.1097/BCR.000000000000017
  18. Davidson J.R.T., Book S.W., Colket J.T., Tupler L.A., Roth S., David D. and Feldman M. (1997). Assessment of a new self-rating scale for post-traumatic stress disorder. Psychol Med, 27 (1): 153-160. DOI: 10.1017/S003329179600422
  19. Difede J., Cukor J., Lee F. and Yurt R. (2009). Treatments for common psychiatric conditions among adults during acute, rehabilitation, and reintegration phases. Int Rev Psychiatry, 21(6): 559-569. DOI: 10.3109/0954026090334408
  20. Di Pasquale A., Lisi A. and Masellis M. (2002). Model of psychological support for burn patients: analysis of the results of eight years experience. Annals of Burns and Fire Disasters, 15 (2): 83-89.
  21. Dyster-Aas J., Willebrand M., Wikehult B., Gerdin B. and Ekselius L. (2008). Major depression and posttraumatic stress disorder symptoms following severe burn injury in relation to lifetime psychiatric morbidity. J Trauma, 64 (5): 1349-1356. DOI: 10.1097/TA.0b013e318047e00
  22. Edgar D., Dawson A., Hankey G., Phillips M. and Wood F. (2010). Demonstration of the validity of the SF-36 for measurement of the temporal recovery of quality of life outcomes in burns survivors. Burns, 36 (7): 1013-1020. DOI: 10.1016/j.burns.2010.03.00
  23. Esselman P.C., Thombs B.D., Magyar-Russell G. and Fauerbach J.A. (2006). Burn rehabilitation: state of the science. American Journal of Physical Medicine and Rehabilitation, 85 (4): 383-413. DOI: 10.1097/01.phm.0000202095.51037.a
  24. Falder S., Browne A., Edgar D., Staples E., Fong J., Rea S. and Wood F. (2009). Core outcomes for adult burn survivors: a clinical overview. Burns, 35 (5): 618-641. DOI: 10.1016/j.burns.2008.09.00
  25. Fauerbach J.A., Lawrence J.W., Munster A.M., Palombo D.A. and Richter D. (1999). Prolonged adjustment difficulties among those with acute posttrauma distress following burn injury. Journal of Behavioural Medicine, 22 (4): 359-378. DOI: 10.1023/A:101872610330
  26. Fauerbach J.A., Lezotte D., Hills R.A., Cromes G.F., Kowalske K., de Lateur B.J. and Wiechman S.A. (2005). Burden of burn: a norm-based inquiry into the influence of burn size and distress on recovery of physical and psychosocial function. Journal of Burn Care & Research, 26 (1): 21-32.
  27. First M.B., Spitzer R.L., Gibbon M. and Williams J.B.W., editors (1996). Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition (SCID-I/P). New York: Biometrics Research, New York State Psychiatric Institute.
  28. Gilboa D., Friedman M. and Tsur H. (1994). The burn as a continuous traumatic stress: implications for emotional treatment during hospitalization. J Burn Care Rehabil, 15 (1): 86-91.
  29. Goncalves N., Melo Ade S., Caltran M.P., Pedro I.C., Pan R., Nascimento L.C. and Rossi L.A. (2014). Sexuality in burn victims: an integrative literature review. Burns, 40 (4): 552-561. DOI: 10.1016/j.burns.2013.11.00
  30. Hahn A.P., Jochai D., Caufield-Noll C.P., Hunt C.A., Allen L.E., Rios R. and Cordts G.A. (2014). Self-inflicted burns: a systematic review of the literature. J Burn Care Res, 35 (1): 102-19. DOI: 10.1097/BCR.0b013e31828b0a4
  31. Hobbs K. (2015). Which factors influence the development of post-traumatic stress disorder in patients with burn injuries? A systematic review of the literature. Burns, 41 (3): 421-430. DOI: 10.1016/j.burns.2014.10.01
  32. Hoffman H.G., Chambers G.T., Meyer W.J, Arceneaux L.L., Russell W.J., Seibel E.J. and Patterson D.R. (2011). Virtual reality as an adjunctive non-pharmacologic analgesic for acute burn pain during medical procedures. Ann Behav Med, 41 (2): 183-191. DOI: 10.1007/s12160-010-9248-
  33. Kildal M., Andersson G., Fugl-Meyer A.R., Lannerstam K. and Gerdin B. (2001). Development of a brief version of the Burn Specific Health Scale (BSHS-B). J Trauma, 51 (4): 740-6.
  34. Kildal M., Willebrand M., Andersson G., Gerdin B. and Ekselius L. (2005). Coping strategies, injury characteristics and long-term outcome after burn injury. Injury, 36 (4): 511-518. DOI: 10.1016/j.injury.2004.06.013
  35. Klinge K., Chamberlain D.J., Redden M. and King L. (2009). Psychological adjustments made by postburn injury patients: an integrative literature review. Journal of Advanced Nursing, 65 (11): 2274-2292. DOI: 10.1111/j.1365-2648.2009.05138.
  36. Lawrence J.W., Heinberg L.J., Roca R., Munster A., Spence R. and Fauerbach J.A. (1998). Development and validation of the Satisfaction with Appearance Scale: Assessing body image among burn-injured patients. Psychological Assessment, 10 (1): 64-70. DOI: 10.1037/1040-3590.10.1.6
  37. Lawrence J.W. and Fauerbach J.A. (2003). Personality, coping, chronic stress, social support and PTSD symptoms among adult burn survivors: a path analysis. J Burn Care Rehabil, 24 (1): 63-72. DOI: 10.1097/01.bcr.0000045663.57246.e
  38. Malloy K.M. and Milling L.S. (2010). The effectiveness of virtual reality distraction for pain reduction: a systematic review. Clin Psychol Rev, 30 (8): 1011-1018. DOI: 10.1016/j.cpr.2010.07.00
  39. Mason S.T., Esselman P., Fraser R., Schomer K., Truitt A. and Johnson K. (2012). Return to Work After Burn Injury: A Systematic Review. Journal of Burn Care & Research, 33 (1): 101-109. DOI: 10.1097/BCR.0b013e318237443
  40. Moi A.L., Wentzel-Larsen T., Salemark L., Wahl A.K. and Hanestad B.R. (2006). Impaired generic health status but perception of good quality of life in survivors of burn injury. Journal of Trauma-Injury, Infection, and Critical Care, 61 (4): 961-969. DOI: 10.1097/01.ta.0000195988.57939.9a
  41. Moi A.L., Vindenes H.A. and Gjengedal E. (2008). The experience of life after burn injury: a new bodily awareness. J Adv Nurs, 64 (3): 278-286. DOI: 10.1111/j.1365-2648.2008.04807.
  42. Noronha D.O. and Faust J. (2007). Identifying the variables impacting post-burn psychological adjustment: a meta-analysis. J Pediatr Psychol, 32 (3): 380-391. DOI: 10.1093/jpepsy/jsl01
  43. Orwelius L., Willebrand M., Gerdin B., Ekselius L., Fredrikson M. and Sjoberg F. (2013). Long term health-related quality of life after burns is strongly dependent on pre-existing disease and psychosocial issues and less due to the burn itself. Burns, 39 (2): 229-235. DOI: 10.1016/j.burns.2012.11.01
  44. Öster C., Willebrand M., Dyster-Aas J., Kildal M. and Ekselius L. (2009). Validation of the EQ-5D questionnaire in burn injured adults. Burns, 35 (5): 723-732. DOI: 10.1016/j.burns.2008.11.00
  45. Öster C., Kildal M. and Ekselius L. (2010). Return to work after burn injury: burn-injured individuals’ perception of barriers and facilitators. J Burn Care Res, 31 (4): 540-550. DOI: 10.1097/BCR.0b013e3181e4d69
  46. Öster C., Willebrand M. and Ekselius L. (2013). Burn-specific health 2 years to 7 years after burn injury. J Trauma Acute Care Surg, 74: 1119-1124. DOI: 10.1097/TA.0b013e318283cca
  47. Patterson D.R., Everett J.J., Bombardier C.H., Questad K.A., Lee V.K. and Marvin J.A. (1993). Psychological effects of severe burn injuries. Psychological Bulletin, 113 (2): 362-378. DOI: 10.1037/0033-2909.113.2.362
  48. Peck M.D. (2011). Epidemiology of burns throughout the world. Part I: Distribution and risk factors. Burns, 37 (7): 1087-1100. DOI: 10.1016/j.burns.2011.06.00
  49. Peck M.D. (2012). Epidemiology of burns throughout the World. Part II: intentional burns in adults. Burns, 38 (5): 630-637. DOI: 10.1016/j.burns.2011.12.02
  50. Perry S., Difede J., Musngi G., Frances A.J. and Jacobsberg L. (1992). Predictors of posttraumatic stress disorder after burn injury. American Journal of Psychiatry, 149 (7): 931-935. DOI: 10.1176/ajp.149.7.93
  51. Quinn T., Wasiak J. and Cleland H. (2010). An examination of factors that affect return to work following burns: a systematic review of the literature. Burns, 36 (7): 1021-1026. DOI: 10.1016/j.burns.2009.10.00
  52. Radloff LS. (1977). The CES-D Scale: a self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3): 385-401.
  53. Reed D.L., Thompson J.K., Brannick M.T. and Sacco W.P. (1991). Development and validation of the Physical Appearance State and Trait Anxiety Scale (PASTAS). Journal of Anxiety Disorders, 5: 323-332. DOI: 10.1016/0887-6185(91)90032-
  54. Renneberg B., Ripper S., Schulze J., Seehausen A., Weiler M., Wind G., and Liedl A. (2014). Quality of life and predictors of long-term outcome after severe burn injury. Journal of Behavioral Medicine, 37 (5): 967-976. DOI: 10.1007/s10865-013-9541-
  55. Schwarzer R. and Schwarzer C. (1996). A critical survey of coping instruments. In: Zeidner M. and Endler S., editors, Handbook of coping: theory, research, applications. New York: Wiley, pp. 107-132.
  56. Seehausen A., Ripper S., Germann G., Hartmann B., Wind G. and Renneberg B. (2015). Efficacy of a burn-specific cognitive-behavioral group training. Burns, 41(2): 308-316. DOI: 10.1016/j.burns.2014.07.00
  57. Shapiro, F. (2014). The role of Eye Movement Desensitization and Reprocessing (EMDR) Therapy in medicine: addressing the psychological and physical symptoms stemming from adverse life experiences. Perm J, 18(1), 71-77. DOI: 10.7812/TPP/13-09
  58. Sundara D.C. (2011). A review of issues and concerns of family members of adult burn survivors. Journal of Burn Care & Research, 32 (3): 349-57. DOI: 10.1097/BCR.0b013e318217f6c
  59. Sveen J., Ekselius L., Gerdin B. and Willebrand M. (2011). A prospective longitudinal study of posttraumatic stress disorder symptom trajectories after burn injury. The Journal of Trauma and Acute Care Surgery, 71 (6): 1808-1815. DOI: 10.1097/TA.0b013e31822a30b
  60. Tahir S.M., Memon M.M., Ali S.A. and Rasheeed S. (2011). Health related quality of life after burns: are we really treating burns? J Ayub Med Coll Abbottabad, 23 (2): 152-156. DOI: 10.1016/j.burns.2014.11.00
  61. Tanzi F., Montali F., Camizzi G. and Caleffi E. (2012). Tra gli altri come gli altri: approccio psicologico sul paziente ustionato. XX Congresso Nazionale della Società Italiana delle Ustioni (SIUST) 3-6 Ottobre 2012, Ostuni (Brindisi). Retrieved from: http://www. siust.info/allegati/abstract_congresso_siust_2012/med/abstract_camozzi-tanzi.pdf
  62. Tengvall O., Wickman M. and Wengstrom Y. (2010). Memories of pain after burn injury ‒ the patient’s experience. J Burn Care Res, 31 (2): 319-327. DOI: 10.1097/BCR.0b013e3181d0f5d
  63. Thombs B.D., Bresnick M.G. and Magyar-Russell G. (2006). Depression in survivors of burn injury: a systematic review. General Hospital Psychiatry, 28 (6): 494-502. DOI: 10.1016/j.genhosppsych.2006.08.010
  64. Thombs B.D., Haines J.M., Bresnick M.G., Magyar-Russell G., Fauerbach J.A. and Spence R.J. (2007). Depression in burn reconstruction patients: symptom prevalence and association with body image dissatisfaction and physical function. General Hospital Psychiatry, 29 (1): 14-20. DOI: 10.1016/j.genhosppsych.2006.09.00
  65. Thombs B.D., Notes L.D., Lawrence J.W., Magyar-Russell G., Bresnick M.G. and Fauerbach J.A. (2008). From survival to socialization: A longitudinal study of body image in survivors of severe burn injury. Journal of Psychosomatic Research, 64 (2): 205-212. DOI: 10.1016/j.jpsychores.2007.09.00
  66. Tuohig G.M., Saffle J.R., Sullivan J.J., Morris S. and Lehto S. (1995). Self-inflicted patient burns: suicide versus mutilation. J Burn Care Rehabil, 16 (4): 429–436. DOI: 10.1097/00004630-199507000-0000
  67. Van Loey N.E.E., Faber A.W. and Taal L.A. (2001). Do burn patients need burn specific multidisciplinary outpatient aftercare: research results. Burns, 27 (2): 103-110. DOI: 10.1016/S0305-4179(00)00099-
  68. Van Loey N.E.E. and Van Son M.J.M. (2003). Psychopathology and psychological problems in patients with burn scars. American Journal of Clinical Dermatology, 4 (4): 245-272. DOI: 10.2165/00128071-200304040-0000
  69. Wallis H., Renneberg B., Ripper S., Germann G., Wind G. and Jester A. (2006). Emotional distress and psychosocial resources in patients recovering from severe burn injury. Journal of Burn Care & Research, 27 (5): 734-741. DOI: 10.1097/01.BCR.0000238094.33426.0
  70. Ware Jr J.E. and Sherbourne C.D. (1992). The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Medical Care, 30 (6): 473-483. DOI: 10.1186/s12912-015-0068-8
  71. Wasiak J., Paul E., Lee S.J., Mahar P., Pfitzer B., Spinks A. and Gabbe B. (2014a). Patterns of recovery over 12 months following a burn injury in Australia. Injury, 45 (9): 1459-64. DOI: 10.1016/j.injury.2014.02.01
  72. Wasiak J., Lee S.J., Paul E., Mahar P., Pfitzer B., Spinks A. and Gabbe B. (2014b). Predictors of health status and health-related quality of life 12 months after severe burn. Burns, 40 (4): 568-574. DOI: 10.1016/j.burns.2014.01.02
  73. Weiss D.S. and Marmar C.R. (1997). The impact of event scale – revised. In Wilson J. P. and Keane T. M., editors, Assessing psychological trauma and PTSD, 399-411. New York: Guilford Press, pp.168-189.
  74. Wiechman S.A. and Patterson D.R. (2004). ABC of burns: Psychosocial aspects of burn injuries. BMJ: British Medical Journal, 329 (7462): 391-391. DOI: 10.1136/bmj.329.7462.391
  75. Wikehult B., Willebrand M., Kildal M., Lannerstam K., Fugl-Meyer A.R., Ekselius L. and Gerdin B. (2005). Use of healthcare a long time after severe burn injury; relation to perceived health and personality characteristics. Disabil Rehabil, 27 (15): 863-870. DOI: 10.1080/09638280500030753
  76. Willebrand M., Kildal M., Ekselius L., Gerdin B. and Andersson G. (2001). Development of the coping with burns questionnaire. Personality and Individual Differences, 30 (6): 1059-1072. DOI: 10.1016/S0191-8869(00)00096-
  77. Willebrand M., Andersson G., Kildal M. and Ekselius L. (2002). Exploration of coping patterns in burned adults: cluster analysis of the coping with burns questionnaire (CBQ). Burns, 28 (6): 549-554. DOI: 10.1016/S0305-4179(02)00064-
  78. Willebrand M., Andersson G. and Ekselius L. (2004). Prediction of psychological health after an accidental burn. The Journal of Trauma and Acute Care Surgery, 57 (2): 367-374. DOI: 10.1097/01.TA.0000078697.69530.0
  79. Willebrand M. and Kildal M. (2008). A simplified domain structure of the burn-specific health scale-brief (BSHS-B): a tool to improve its value in routine clinical work. The Journal of Trauma and Acute Care Surgery, 64 (6): 1581-1586. DOI: 10.1097/TA.0b013e31803420d
  80. Willebrand M. and Kildal M. (2011). Burn Specific Health up to 24 Months After the Burn ‒A Prospective Validation of the Simplified Model of the Burn Specific Health Scale-Brief. The Journal of Trauma and Acute Care Surgery, 71 (1): 78-84. DOI: 10.1097/TA.0b013e3181e97780
  81. Wisely J.A., Hoyle E., Tarrier N. and Edwards J. (2007). Where to start? Attempting to meet the psychological needs of burned patients. Burns, 33 (6): 736-746. DOI: 10.1016/j.burns.2006.10.37
  82. Wisely J.A., Wilson E., Duncan R.T. and Tarrier N. (2010). Pre-existing psychiatric disorders, psychological reactions to stress and the recovery of burn survivors. Burns, 36 (2): 183-191. DOI: 10.1016/j.burns.2009.08.00
  83. World Health Organization (2009). Global health risks: mortality and burden of disease attributable to selected major risks. Geneva: World Health Organization.
  84. World Health Organization (2014). Burns. Fact sheet N°365.
  85. Yoder L.H., Nayback A.M. and Gaylord K. (2010). The evolution and utility of the burn specific health scale: A systematic review. Burns, 36 (8): 1143-1156. DOI: 10.1016/j.burns.2010.01.00
  86. Zigmond A.S. and Snaith R.P. (1983). The hospital anxiety and depression scale. Acta Psychiatr Scand, 67 (6): 361-370. DOI: 10.1111/j.1600-0447.1983.tb09716.

  • Applications, opportunities, and challenges in using Telehealth for burn injury management: A systematic review Mohammad Hosein Hayavi-Haghighi, Jahanpour Alipour, in Burns /2023 pp.1237
    DOI: 10.1016/j.burns.2023.07.001

Lucia Sideli, Alice Mulè, Maria Valentina Barone, Caterina La Cascia, Alessia Prestifilippo, Angela Di Pasquale, Daniele La Barbera, La qualità della vita e il rischio psicopatologico dei pazienti ustionati: una revisione narrativa della letteratura in "PSICOLOGIA DELLA SALUTE" 2/2016, pp 86-105, DOI: 10.3280/PDS2016-002005