Pain Management

Resilience and Severe Burns

“…However, focusing on and actively monitoring pain levels provides "near total control over mental events" and leads to better understanding and regulation of the sensory experience (Cioffi & Holloway, 1993, p. 280). When pain is experienced as uncontrollable, unavoidable, or unbearable, adaptive coping deteriorates and less healthy responses (e.g., catastrophizing, aggression) become more likely (Bush & Maron, 1994). The perception of pain is influenced by the way a person copes with it, and clients should be encouraged to manage or structure their own pain experience by understanding the biological sources of their suffering (Bush & Maron, 1994;Mannon, 1985).…”

“…To be able to support their patient, professionals should help families as soon after the patient enters the hospital as possible. Counseling can strengthen the family's ability to provide emotional support and improve clients' compliance with treatment and rehabilitation regimens (Brown et al, 1994;Bush & Maron, 1994). "Dad said I was the ninth wonder of the world; he gave me a lot of encouragement."…”

“…Families should be the first to accept physical and psychological changes in their loved one (Bernstein, 1976). "I needed my family to say the scars are there but it's OK." Daily parent visits are associated with improved psychological functioning among burned children (Bush & Maron, 1994). Without exception, all consultants who had been burned as children agreed that having a parent stay with them in the hospital was important.…”

“…When pain is experienced as uncontrollable, unavoidable, or unbearable, adaptive coping deteriorates and less healthy responses (e.g., catastrophizing, aggression) become more likely (Bush & Maron, 1994). The perception of pain is influenced by the way a person copes with it, and clients should be encouraged to manage or structure their own pain experience by understanding the biological sources of their suffering (Bush & Maron, 1994;Mannon, 1985). In addition, clients can be taught to control pain through relaxation, biofeedback, imagery, and self-hypnosis (Achterberg, Kenner, & Lawlis, 1988;Ewin, 1984;Margolis, Domangue, Ehleben, & Shrier, 1983;Sanders, 1987).…”

“…"Dad said I was the ninth wonder of the world; he gave me a lot of encouragement." Family interventions, beginning as soon as the patient enters the hospital, should incorporate (a) a systems perspective; (b) counselor "joining" techniques; (c) grief counseling; (d) assessment of premorbid family functioning; (e) the processing of associated feelings of stress, guilt, inadequacy, and depression; (f) behaviorally oriented treatments (such as modeling and role playing of appropriate parenting skills with feedback); (g) cognitive restructuring to alter unrealistic parental expectations; and (h) group counseling that offers the family additional support, facilitates trust in the hospital staff and treatment regimens, and provides education about aspects of burn care and parents' supportive roles (Armstrong et al, 1994;Bayley & Moore, 1983;Brown et al, 1994;Bush & Maron, 1994;Cella, Perry, Kulchycky, & Goodwin, 1988;Cella, Perry, Poag, Amand, & Goodwin, 1988;Kaslow, Koon-Scott, & Dingle, 1994;LeMaster, 1983). One parent of a child with burns in a hospital that did not provide these services was dismayed when she was "asked to make decisions that I wasn't ready to make.…”