Psychosocial care of persons with severe burns

Family Presence in the Adult Burn Intensive Care Unit During Dressing Changes

“…5,8,22 The patients' family and friends are identified as important sources of support and are often asked to perform daily dressing changes, including dressing removal, wound cleansing, and redressing, at home, with little or no preparation. 5,8,23 Primary concerns patients identify when being discharged are recognition of wound complications and infections and treatment of wound pain. 23 Discharge readiness is a complex issue that involves attention to patient-specific variables, including education, psychosocial evaluation, and home environment.…”

“…4 Evidence [5][6][7][8] indicates that these restrictions contribute to patients' and family's dissatisfaction and to their knowledge deficit when it comes time to care for burn patients at home.…”

Acute burns of the hands – physiotherapy perspective

“…Family support was identified as a crucial factor that empowered the patient to progress in therapy however therapists also expressed the need to ensure that family members were aware of the treatment goals and encouraged independence in everyday tasks. Blakeney et al (2008) expressed that in some cultures family tend to overprotect individuals with disfiguring conditions in order to express their care, concern and support but this may unintentionally serve as a hindrance to progression in therapy again this emerged as a subtheme in this study 9 .…”

“…According to Blakney et al 2008 emotional liability and anger may be observed in patients during this trying time and often it is the family or therapist who are at the receiving end of angry outbursts which are best understood as necessary ventilation by the patient 9 . It is the actual threat of death which often produces feelings of overwhelming fear or helplessness and this forms the emotional basis for an individual's response to trauma 23 .…”

“…Physiotherapists caring for patients with burn injuries may face very unique dilemmas and challenges, as they often out of necessity have to inflict pain on an individual that is already traumatised, anxious and fearful in order for that patient to recover 8 . The acute phase of rehabilitation is also critical for the patient and rehabilitation professional, as common psychological responses reported following burn injury include: fear, anxiety, anger and emotional distress 9,10 and often require intervention of a supportive or psychological nature.…”