Oaie Ecaterina, Piepenstock Emma, Williams Lisa
Burns Service, Chelsea & Westminster Hospital, London, UK.
Scars Burn Heal. 2018 Mar 22;4:2059513118765294. doi: 10.1177/2059513118765294. eCollection 2018 Jan-Dec.
Psychosocial screening of burn-injured patients is a National Burn Care Guideline and is increasingly used to identify individuals most in need of support. It can also generate data that can inform our understanding of patient reported concerns following a burn injury.
As part of routine care, 461 patients admitted to a burns unit were screened soon after admission using a psychosocial screen designed by the service. The questionnaire included items on pre-existing social support, coping, emotional and psychological difficulties, as well as current trauma symptoms and current level of concern about changed appearance following the burn.
Overall, patients reported low levels of appearance concerns (mean 3.7/10) and trauma symptoms (18% reporting flashbacks) in the initial days following a burn injury. In those who did report concerns, there were some significant associations with demographic and other variables. Patients who experienced flashbacks were younger and had a larger total body surface area (TBSA) burn. Higher levels of appearance concern were associated with younger women, larger TBSA and facial burns. However, the relationships found were weak and frequently confounded by other factors.
Overall, the findings indicate that initial trauma symptoms and appearance concerns are not inevitable in this group and there is no substitute for screening in identifying who is most at risk.
对烧伤患者进行心理社会筛查是一项国家烧伤护理指南，并且越来越多地用于识别最需要支持的个体。它还可以生成数据，有助于我们了解烧伤患者报告的担忧。
作为常规护理的一部分，对一家烧伤科收治的461例患者在入院后不久使用该科室设计的心理社会筛查工具进行筛查。问卷包括关于既往社会支持、应对方式、情绪和心理困扰的项目，以及当前的创伤症状和对烧伤后外貌改变的当前担忧程度。
总体而言，患者在烧伤后的最初几天报告的外貌担忧程度较低（平均3.7/10），创伤症状也较少（18%报告有闪回现象）。在那些确实报告有担忧的患者中，与人口统计学和其他变量存在一些显著关联。经历闪回现象的患者更年轻，烧伤的总体表面积（TBSA）更大。更高程度的外貌担忧与年轻女性、更大的TBSA烧伤面积和面部烧伤有关。然而，所发现的关系较弱，并且经常被其他因素混淆。
总体而言，研究结果表明，该群体中最初的创伤症状和外貌担忧并非不可避免，在识别谁是风险最高的人群方面，筛查无可替代。
