Psychological adjustments made by postburn injury patients: an integrative literature review

Abstract

Psychological adjustments made by postburn injury patients: an integrative literature review. This paper is a report of a review examining the variables that predispose individuals to significant psychological maladjustment following burn injury. The psychological sequelae of burn injury are well documented; however, the variables that influence individuals' adjustment following burn injury lack consideration. MEDLINE, Cumulative Index of Nursing and Allied Health, and Psychological Abstracts were searched using the keywords burn injury, psychological, psychosocial, rehabilitation, premorbid psychopathology, adjustment, reintegration, body image, post-traumatic stress disorder, depression, coping. Other sources were found from a manual search of nursing, medical and psychological literature and references of identified and related papers. The search strategy was limited to English-language research published between 1997 and 2008. An integrative review of the studies was conducted over a 6-month time period during 2007-2008. Burn patients are a heterogeneous group and typically have comorbidities. While preburn personality and coping strategies can influence long-term psychological adjustment, the relationship between postburn adjustment and burn size and severity, and gender are poorly understood. Much of the literature focuses on the prevalence of psychological maladjustment rather than on identifying variables that influence psychological adjustment. The diversity and complexity that characterize burn patients lead to unique adjustment difficulties. Recognizing these difficulties is the first step to offering appropriate intervention and treatment for this unique patient group.