Psychosocial Aspects of Burn Care, from Etiology to Treatment to Recovery

A special issue of European Burn Journal (ISSN 2673-1991).

Deadline for manuscript submissions: closed (31 January 2022) | Viewed by 24004

Special Issue Editors


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Guest Editor
Hopkins Burn Center, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
Interests: burns; rehabilitation psychology; pain; sleep; coping and adjustment with chronic illness

E-Mail Website
Guest Editor
The Johns Hopkins Hospital, Baltimore, MD 21287, USA
Interests: plastic surgery; burn care; critical care; business of surgery; surgical education

Special Issue Information

Dear colleagues,

This Special Issue will focus on the psychological and social aspects of burn injuries. Emphasis will be placed on the role of these factors in the continuum of the rehabilitation process, from the acute phase of hospitalization through the long-term adjustment after discharge. Our goal is to further the understanding of psychological risk and resilience factors that contribute to burn survivors’ quality of life and bring forward evidence-based intervention for the treatment of psychological consequences of burn injuries such as depression, anxiety, sleep disorders, and post-traumatic stress disorder. We welcome submissions related to psychological assessment, prevalence, and treatment of mood disorders, coping and adjustment, social support and adjustment, and innovations in treatment and use of technology in burn survivors. Experimental and research articles, up-to-date reviews, and commentaries are all welcome.

Dr. Sheera F. Lerman
Prof. Dr. Scott Hultman
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. European Burn Journal is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 971 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • burn injury
  • burn psychology
  • burn rehabilitation
  • pain
  • sleep
  • posttraumatic stress disorder
  • depression
  • anxiety
  • coping and adjustment
  • social support
  • quality of life

Published Papers (9 papers)

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Research

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11 pages, 514 KiB  
Article
Relations among Stigma, Quality of Life, Resilience, and Life Satisfaction in Individuals with Burn Injuries
by Jack D. Watson and Paul B. Perrin
Eur. Burn J. 2022, 3(1), 145-155; https://doi.org/10.3390/ebj3010012 - 15 Feb 2022
Cited by 4 | Viewed by 2281
Abstract
This study examined the relations among burn stigma, quality of life, resilience, and life satisfaction, hypothesizing that higher stigma and lower burn-related quality of life would lead to lower life satisfaction; however, resilience would moderate this relation. A sample of 89 participants was [...] Read more.
This study examined the relations among burn stigma, quality of life, resilience, and life satisfaction, hypothesizing that higher stigma and lower burn-related quality of life would lead to lower life satisfaction; however, resilience would moderate this relation. A sample of 89 participants was recruited from an outpatient clinic of a burn center in a critical care hospital. Participants completed a battery of measures assessing these constructs. Results suggested that burn stigma was associated with reduced life satisfaction after accounting for other variables. Multiple regression models found that burn stigma predicted both affect and body image but not interpersonal relationship quality or sexuality. Interpersonal relationship quality, sexuality, affect, and body image all predicted life satisfaction. Both affect and body image partially accounted for the relation between stigma and life satisfaction, and resilience accounted for the relation between stigma and affect. Findings reinforce previous literature that has shown a relationship between stigma and life satisfaction but also emphasizes the role of resilience and burn-related quality of life. Individuals who experience a burn injury may have innate resilience abilities, which allow them to bounce back from stressors; thus, resilience can be a targeted strength to bootstrap in order to improve adjustment outcomes. Full article
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11 pages, 522 KiB  
Article
Current Practices and Beliefs Regarding Screening Patients with Burns for Acute Stress Disorder and Posttraumatic Stress Disorder: A Survey of the American Burn Association Membership
by Mallory B. Smith, Shelley A. Wiechman, Samuel P. Mandell, Nicole S. Gibran, Monica S. Vavilala and Frederick P. Rivara
Eur. Burn J. 2021, 2(4), 215-225; https://doi.org/10.3390/ebj2040016 - 01 Nov 2021
Cited by 5 | Viewed by 2149
Abstract
Stress disorders are common after burn injuries and universal screening is recommended. This study describes current screening practices and provider beliefs regarding screening for stress disorders in patients with burns in the US. This was a 31-question survey distributed to the American Burn [...] Read more.
Stress disorders are common after burn injuries and universal screening is recommended. This study describes current screening practices and provider beliefs regarding screening for stress disorders in patients with burns in the US. This was a 31-question survey distributed to the American Burn Association. Sixty-two percent of 121 respondents indicated their institution formally screened for ASD and/or PTSD. The most common reason for not screening was a lack of mental healthcare providers (46%), lack of funding (26%) and lack of time (20%). The timing of screening, the person administering the screening, and the method of screening varied for both pediatric and adult patients. Most respondents (87%) believed screening should be a standard of care, but only 32% were comfortable screening pediatric patients and 62% were comfortable screening adults. While screening for ASD and PTSD is recommended for patients with burns, our study indicates that screening is not a current standard of care. Lack of mental healthcare providers, funding, and time are contributing factors. Among those institutions that screen, a uniform screening practice does not exist. Full article
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Review

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14 pages, 317 KiB  
Review
What Fuels the Fire: A Narrative Review of the Role Social Determinants of Health Play in Burn Injuries
by Kimberly H. Khoo, Emily S. Ross, Joshua S. Yoon, Tomer Lagziel, Feras Shamoun, Joseph S. Puthumana, Julie A. Caffrey, Sheera F. Lerman and Charles Scott Hultman
Eur. Burn J. 2022, 3(2), 377-390; https://doi.org/10.3390/ebj3020033 - 16 Jun 2022
Cited by 4 | Viewed by 1943
Abstract
Social determinants of health (SDOH) are the conditions where people live, learn, work, and play that affect their health and quality of life. There has been an increasing focus on the SDOH in the field of medicine to both explain and address health [...] Read more.
Social determinants of health (SDOH) are the conditions where people live, learn, work, and play that affect their health and quality of life. There has been an increasing focus on the SDOH in the field of medicine to both explain and address health outcomes. Both the risk of burn injuries and outcomes after burns have been found to be associated with multiple aspects of the SDOH. This narrative review seeks to explore the main domains of the social determinants of health, reiterate their importance to the general and burn injury population, examine each’s association with risks of burn injuries and burn-related outcomes, and provide an overview of the current burn research landscape that describes the social determinants of health. Full article
11 pages, 298 KiB  
Review
Treatment Adherence Interventions for Burn Patients: What Works and What Role Can Motivational Interviewing Play?
by Christian R. R. Goans, Karen J. Meltzer, Blake Martin and Kimberly Roaten
Eur. Burn J. 2022, 3(2), 309-319; https://doi.org/10.3390/ebj3020026 - 06 Apr 2022
Cited by 1 | Viewed by 2382
Abstract
The unique challenges burn patients face along the trajectory of recovery necessitate an interdisciplinary team approach to care. As much as providers rely on care-team members for delivery of optimal treatment, the patient must be an active collaborator in their care. Optimal burn [...] Read more.
The unique challenges burn patients face along the trajectory of recovery necessitate an interdisciplinary team approach to care. As much as providers rely on care-team members for delivery of optimal treatment, the patient must be an active collaborator in their care. Optimal burn recovery outcomes hinge on treatment adherence. In addition to general challenges faced in ubiquity by burn patients, there are specific patient populations for whom treatment adherence is particularly challenging. Although psychological interventions have been used successfully with burn patients, very few are appropriate for both inpatient and outpatient care environments and most do not focus on treatment adherence. This paper reviews unique facets of Motivational Interviewing (MI) that may be applicable in interdisciplinary burn treatment teams across inpatient and outpatient settings to optimize treatment adherence. Full article
10 pages, 7392 KiB  
Review
Cross-Cultural Review of Sexuality, Relationships, and Body Image after Burns: Analysis of the BSHS-B
by Joseph S. Puthumana, Emily S. Ross, Patrick R. Keller, Carolyn S. Drogt, Kimberly H. Khoo, Eliana F. Duraes, Charles S. Hultman and Sheera F. Lerman
Eur. Burn J. 2022, 3(1), 197-206; https://doi.org/10.3390/ebj3010017 - 24 Feb 2022
Viewed by 2074
Abstract
Burn survivors are at risk for dissatisfaction with body image, relationships, and sexuality due to disfiguring changes secondary to the injury. This review compares available global data on BSHS-B psychosocial scores. Twenty-four studies were included in the final analysis encompassing 14 countries; significant [...] Read more.
Burn survivors are at risk for dissatisfaction with body image, relationships, and sexuality due to disfiguring changes secondary to the injury. This review compares available global data on BSHS-B psychosocial scores. Twenty-four studies were included in the final analysis encompassing 14 countries; significant differences were found in scores across all BSHS-B psychological sub-sections of affect, body image, interpersonal relationships, and sexuality. On the whole, psychological well-being after burn injury was lower in Asian and South Asian countries compared to Europe or the United States. This study provides information for providers in burn centers caring for patients from a variety of cultural contexts and begins to steer initiatives to remedy psychological inequities in global burn care. Full article
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9 pages, 660 KiB  
Review
Spiritual Healing: A Triple Scoping Review of the Impact of Spirituality on Burn Injuries, Wounds, and Critical Care
by Tomer Lagziel, Malik Muhammad Sohail, Harold G. Koenig, Jeffrey E. Janis, Stephen J. Poteet, Kimberly H. Khoo, Julie A. Caffrey, Sheera F. Lerman and Charles S. Hultman
Eur. Burn J. 2022, 3(1), 188-196; https://doi.org/10.3390/ebj3010016 - 24 Feb 2022
Cited by 1 | Viewed by 2674
Abstract
Burn patients are unique because their recovery requires prolonged hospital admissions, often complicated by a myriad of medical and surgical complications as well as psychological and emotional challenges. Religion and spirituality have been linked to improved health outcomes in other medical fields. Our [...] Read more.
Burn patients are unique because their recovery requires prolonged hospital admissions, often complicated by a myriad of medical and surgical complications as well as psychological and emotional challenges. Religion and spirituality have been linked to improved health outcomes in other medical fields. Our scoping review aimed to examine the available literature for evidence of the impact of spirituality on burns, complex wounds, and critical care to shed more light on the relationship between spirituality and the conditions treated by multidisciplinary burn center teams. We performed three systematic reviews to examine the relationship between spirituality and these conditions. Searches were performed using MeSH terms utilizing four databases (MEDLINE via PubMed, Embase, Cochrane, Web of Science, and Scopus). A systematic and independent title/abstract screening was carried out by two independent reviewers and a full-text review was followed. Our review demonstrated a clear lack of overlap between study outcomes and lack of objective spirituality measurements. Most articles primarily focused on psychological outcomes, such as stress or mental health, instead of objective measures such as wound size or scar formation. We found a trend toward better psychological outcomes in patients with more spirituality, either pre-existing or interventional. To increase comparability and uniformity of outcomes, future studies would benefit from utilizing standardized spiritual assessment tools and objective wound metrics. Full article
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13 pages, 269 KiB  
Review
When Is Being Sad on the Burn Unit Pathological? Differential Diagnosis of Demoralization, Adjustment Disorder and Major Depressive Disorder in Burn Survivors
by Marissa L. Beal, Sheera F. Lerman and Idris E. Leppla
Eur. Burn J. 2022, 3(1), 122-134; https://doi.org/10.3390/ebj3010010 - 10 Feb 2022
Cited by 1 | Viewed by 2048
Abstract
Many burn survivors have pre-existing psychiatric conditions or develop psychological or psychiatric symptoms over the course of their hospital stay. Patients often present with low mood and neurovegetative symptoms which can be conceptualized as demoralization, adjustment disorder, or major depressive disorder. We review [...] Read more.
Many burn survivors have pre-existing psychiatric conditions or develop psychological or psychiatric symptoms over the course of their hospital stay. Patients often present with low mood and neurovegetative symptoms which can be conceptualized as demoralization, adjustment disorder, or major depressive disorder. We review the literature on these syndromes in burn survivors and present three cases that highlight the continuum of these syndromes for patients who present with symptoms of depression following a burn injury. We discuss the clinical challenges of differentiating these syndromes as well as psychotherapeutic and psychopharmacologic considerations and recommendations. Full article
32 pages, 490 KiB  
Review
Screening and Assessment for Psychological Distress among Burn Survivors
by Valerie G. Loehr, William F. Goette and Kimberly Roaten
Eur. Burn J. 2022, 3(1), 57-88; https://doi.org/10.3390/ebj3010008 - 03 Feb 2022
Cited by 6 | Viewed by 3901
Abstract
Given the high rates of psychological distress after burn injury, thorough screening and assessment for psychosocial factors and psychiatric pathology should be routinely completed for individuals with burn injuries. Burn survivors experience unique psychosocial changes and injury sequelae, such as body image concerns, [...] Read more.
Given the high rates of psychological distress after burn injury, thorough screening and assessment for psychosocial factors and psychiatric pathology should be routinely completed for individuals with burn injuries. Burn survivors experience unique psychosocial changes and injury sequelae, such as body image concerns, trauma-related pathology, and itching. Screening for these factors is integral to understanding how these may be contributing to psychological distress. Proactively identifying distress and psychiatric pathology is important to optimize physical and emotional outcomes. The aim of this manuscript is to summarize information about the available screening and assessment tools for psychological distress among burn survivors. Full article

Other

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33 pages, 487 KiB  
Systematic Review
Resilience and Posttraumatic Growth after Burn: A Review of Barriers, Enablers, and Interventions to Improve Psychological Recovery
by Alix Woolard, Indijah Bullman, Amira Allahham, Treya Long, Helen Milroy, Fiona Wood and Lisa Martin
Eur. Burn J. 2022, 3(1), 89-121; https://doi.org/10.3390/ebj3010009 - 09 Feb 2022
Cited by 5 | Viewed by 2920
Abstract
Burn injuries are traumatic experiences that can detrimentally impact an individual’s psychological and emotional wellbeing. Despite this, some survivors adapt to psychosocial challenges better than others despite similar characteristics relating to the burn. Positive adaptation is known as resilience or posttraumatic growth, depending [...] Read more.
Burn injuries are traumatic experiences that can detrimentally impact an individual’s psychological and emotional wellbeing. Despite this, some survivors adapt to psychosocial challenges better than others despite similar characteristics relating to the burn. Positive adaptation is known as resilience or posttraumatic growth, depending on the trajectory and process. This review aimed to describe the constructs of resiliency and growth within the burn injury context, examine the risk factors that inhibit resilience or growth after burn (barriers), the factors that promote resilience or growth after burn (enablers), and finally to assess the impact of interventions that have been tested that may facilitate resilience or growth after burn. This review was performed according to the recently updated Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines. An electronic search was conducted in November 2021 on the databases PubMed, Medline (1966-present), Embase (1974-present), PsycINFO for English-language peer-reviewed academic articles. There were 33 studies included in the review. Findings were mixed for most studies; however, there were factors related to demographic information (age, gender), burn-specific characteristics (TBSA, time since burn), person-specific factors (personality, coping style), psychopathology (depression, PTSD), and psychosocial factors (social support, spirituality/religion, life purpose) that were evidenced to be related to resilience and growth. One qualitative study evaluated an intervention, and this study showed that a social camp for burn patients can promote resilience. This study has presented a variety of factors that inhibit or encourage resilience and growth, such as demographic, individual, and social factors. We also present suggestions on interventions that may be used to promote growth following this adverse event, such as improving social support, coping styles and deliberate positive introspection. Full article
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