Survival after severe burns has improved in recent decades, but there is limited information on the course of recovery after surviving a burn and on factors that can affect recovery.The aims of this thesis were to investigate the occurrence of physical and psychological problems after burns, and to examine the consequences of psychological problems for the clinical management of burn patients.Three groups of consecutive patients who were treated at the Burn Unit at Uppsala University Hospital between 1980 and 2005 were included in the studies. The Burn Specific Health Scale (BSHS) was used for self-report of burn-specific aspects of health. Personality traits and coping strategies as psychological factors during recovery were examined with the Swedish universities Scales of Personality (SSP) and the Coping with Burns Questionnaire (CBQ). Presence of symptoms of posttraumatic stress were assessed with the Impact of Event Scale-Revised (IES-R), and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was used to determine the concurrent validity of the IES-R as a measure of Posttraumatic Stress Disorder (PTSD). Furthermore, the effect of pre-injury psychiatric morbidity on perceived health one year after injury was assessed.Both pruritus and nightmares…
Contents
Introduction
Why would a plastic surgeon write a doctoral thesis on psychological
problems after burns?
Burns and their treatment
The skin
Function
Skin anatomy and the burned skin
Pre-injury status and psychopathology
Personality Traits
Coping strategies
Psychiatric morbidity
Outcome
Physical problems
Pruritus (itching)
Post-traumatic Stress Disorder
Nightmares
“Health-related quality of life”
Background and Aims
Patients and Methods
Study populations
1980-1995 cohort
January 1996 – March 2000 cohort
March 2000 – January 2005 cohort
Instruments
Swedish universities Scales of Personality, SSP
Coping with Burns Questionnaire, CBQ
Burn Specific Health Scale, BSHS
DSM-IV related items concerning nightmares
Impact of Event Scale, IES
Structured Clinical Interview for DSM-IV Axis I disorders, SCID-I
Data analysis
Ethics
Results
Pruritus, personality traits and coping (paper I)
Nightmares after burns (paper II)
Nightmares and PTSD after burns (paper III)
Validation of the IES-R (paper IV)
Psychiatric morbidity and outcome (paper V)
Discussion
Methodological considerations
Sample
Methods
Design
The post-burn skin
Problems during and after wound healing
The skin as a psychological organ
Heat Sensitivity
Other outcome measures: Body Image and Treatment Regimens
Nightmares, PTSD and other psychiatric problems
Clinical implications
Future aspects
Conclusions
Acknowledgements
References
Author: Low, Janina Francisca Aili
Source: Uppsala University Library
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