Coping with burn injury: Research summary and a new model of the influence of coping on psychological complications

Abstract

The level of evidence accrued to date precludes definitive recommendations. However, tentative recommendations can be offered in light of the knowledge gathered up to this point. First, the psychosocial care of individuals with burn injuries must be universally available and must incorporate routine assessment during the acute care phase. Second, assessment should include pre-injury level of health and function, history of psychological distress, and social support, as well as several indices of psychological distress (e.g., depression, posttraumatic distress, body image dissatisfaction), methods of coping with the burn injury and its complications, and, identifying health-promoting individual strengths (e.g., self-efficacy, resilience, optimism) and social resources. Third, intervention during hospitalization (versus after discharge) is probably optimal because the distress is severe, openness to care is enhanced, concern with stigmatization is reduced, and access to services is more universal than it will ever be following discharge. Fourth, interventions that focus on enhancing coping skills and improving physical and psychological resilience/efficacy/ competence are likely to be welcomed, useful, and most likely be of continued enduring benefit. Finally, in order to develop evidence-based practice, there is an urgent need for well-designed studies (e.g., randomized, controlled trials), testing such interventions in the burn-injured population. © 2007 Springer Science+Business Media, LLC. All rights reserved.