Burn Patients

  • Jeanne Achterberg-Lawlis
  • Cornelia Kenner


The multisensory onslaught of the burn ward speaks of abject stress for both patient and treater. Burn treatment has advanced dramatically during the past 30 years, so much so that only approximately 10% of all burn patients admitted for treatment die and the outlook is good except for patients with very extensive burns (70% of the body surface or greater) or for very young or old patients. Unfortunately, the type of treatment necessary to salvage previously unsalvageable lives is as much a part of the stressful aura of the burn unit as is the patient’s response to the trauma itself. In fact, burn injury might be one of the few conditions where patients tend to recall the treatment with more horror than the trauma itself (Andreasen, Noyes, & Hartford, 1972). For this reason it is important to begin with some discussion of treatment protocols in order to provide the context for both the short- and long-term psychological implications. Following that, the existing research on the psychological impact and sequelae will be presented, particularly as findings relate to potential psychotherapeutic involvement. Finally, the few existing (but promising) techniques for behavioral intervention will be reported. The emphasis throughout will be on adult burn patients solely because of space considerations.


Psychological Reaction Mental Health Team Passive Exercise Psychiatric Complication Burn Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. Achterberg, J., & Lawlis, G. F. Imagery of cancer: A diagnostic tool for the process of disease. Champaign, Ill.: Institute for Personality and Ability Testing, 1978Google Scholar
  2. Achterberg, J., & Lawlis, G. F. Bridges of the bodymind. Champaign, Ill.: Institute for Personality and Ability Testing, 1980.Google Scholar
  3. Adler, A. Neuropsychiatric complications of victims of Boston’s Cocoanut Grove disaster. Journal of the American Medical Association, 1943, 123. 1098–1101.CrossRefGoogle Scholar
  4. Andreasen, N. J. C. Neuropsychiatric complications in burn patients. International Journal of Psychiatry in Medicine, 1974, 5, 161–171.PubMedCrossRefGoogle Scholar
  5. Andreasen, N. J. C., & Norris, A. S. Long-term adjustment and adaptation mechanisms in severely burned adults. The Journal of Nervous and Mental Diseases,1972, 154(5), 352–362.CrossRefGoogle Scholar
  6. Andreasen, N. J. C., Norris, A. S., & Hartford, C. E. Incidence of long-term psychiatric complications in severely burned adults. Annals of Surgery, 1971, 174, 785–793.PubMedCrossRefGoogle Scholar
  7. Andreasen, N. J. C. Noyes, R., & Hartford, C. E. Factors influencing adjustment of burn patients during hospitalization. Psychosomatic Medicine, 1972, 34, 517–525.PubMedGoogle Scholar
  8. Andreasen, N. J. C., Noyes, R., Hartford, C. E., Brodland, G., & Proctor, S. Management of emotional reactions in seriously burned adults. New England Journal of Medicine, 1972, 286, 65–69.PubMedCrossRefGoogle Scholar
  9. Artz, C. P. The burn patient. Nursing Forum, 1965, 4, 87–92.PubMedCrossRefGoogle Scholar
  10. Artz, C. P., & Moncrief, J. A. The treatment of burns (2nd ed.). Philadelphia: W. B. Saunders, 1969.Google Scholar
  11. Bernstein, M. P. Significant values of hypoanesthesic: Three clinical examples. American Journal of Clinical Hypnosis, 1965, 7, 259–260.CrossRefGoogle Scholar
  12. Chang, F. C., & Herzog, B. Burn morbidity: A follow-up study of physical and psychological disability. Annals of Surgery, 1976, 183(1), 34–37.PubMedCrossRefGoogle Scholar
  13. Cobb, S., & Lindemann, E. Cocoanut Grove bums: Neuropsychiatric observations. Annals of Surgery, 1943, 117, 814–824.PubMedGoogle Scholar
  14. Crasilneck, H. B., Stirman, J. A., Wilson, B. J., McCraine, E. J., & Fogelman, M. J. Use of hypnosis in the management of bums. Journal of the American Medical Association, 1955, 158, 103–106.PubMedCrossRefGoogle Scholar
  15. Cromes, G. F., Robinson, C., Turrentine, M. The effects of relaxation training on anxiety and pain during burn wound debridement. Paper presented at the 40th annual assembly of the American Academy of Physical Medicine and Rehabilitation, New Orleans, November 15, 1978.Google Scholar
  16. Dahinterova, J. Some experiences with hypnosis in the treatment of burns. International Journal of Clinical and Experimental Hypnosis, 1967, 15, 49–53.PubMedCrossRefGoogle Scholar
  17. Davidson, S. P., & Noyes, R. Psychiatric nursing consultation on a bum unit. American Journal of Nursing, 1973, 73, 1715–1718.PubMedGoogle Scholar
  18. Erickson, E. H. Identity: Youth and crisis. New York: W. H. Norton, 1968.Google Scholar
  19. Fagerhaugh, S. Y. Pain expression and control on a burn care unit. Nursing Outlook, 1974, 22, 645–650.PubMedGoogle Scholar
  20. Finer, B. L., & Nylen, B. O. Cardiac arrest in the treatment of burns and report on hypnosis as a substitute for anesthesia. Plastic and Reconstructive Surgery,1961, 27, 49–55CrossRefGoogle Scholar
  21. Hamburg, D. A. & Adams, J. E. A perspective on coping behavior. Archives of General Psychiatry, 1967, 17, 277–284.PubMedCrossRefGoogle Scholar
  22. Hamburg, D. A., Artz, C. P., Reiss, E., Amspacher, W. H., & Chambers, R. E. Clinical importance of emotional problems in the care of patients with burns. New England Journal of Medicine, 1953, 248, 355–359.PubMedCrossRefGoogle Scholar
  23. Hamburg, D. A., Hamburg, B., & deGoza, S. Adaptive problems and mechanisms in severely burned patients. Psychiatry, 1953, 16, 1–20.PubMedGoogle Scholar
  24. Helm, P., Head, M. D., Pullium, G., O’Brien, M., & Cromes, C. F. Burn rehabilitation: A team approach. Symposium on bums. Surgical Clinics of North America, 1978, 58(6), 1263–1277.PubMedGoogle Scholar
  25. Imbus, S. H., & Zawacki, B. J. Autonomy for patients when survival is unprecedented. New England journal of Medicine, 1977, 297(6), 308–311.PubMedCrossRefGoogle Scholar
  26. Kjaer, G. C. D. Psychiatric aspects of thermal burns. Northwest Medicine, 1969, 68, 537–541.PubMedGoogle Scholar
  27. Kübler-Ross, E. On death and dying. New York: Macmillan, 1969.Google Scholar
  28. Miezala, P. Psychological parameters of burn patient care. In Practical approach to burn management. Deerfield, Ill.: Flynt Laboratories, 1977.Google Scholar
  29. Miezala, P. Post bum psychological adaptation: An overview. Critical Care Quarterly, 1978, 13, 93–110.Google Scholar
  30. Miller, W. C., Gardner, N., & Mlott, S. R. Psychological support in the treatment of severely burned patients. Journal of Trauma, 1976, 16, 722–725.PubMedCrossRefGoogle Scholar
  31. Mlott, S. R., Lira, F. T., & Miller, W. C. Psychological assessment of the burn patient. Journal of Clinical Psychology, 1977, 33, 425–430.PubMedGoogle Scholar
  32. Morris, J., & McFadd, A. The mental health team on a burn unit: A multidisciplinary approach. journal of Trauma, 1978, 18(9), 658–663.PubMedCrossRefGoogle Scholar
  33. Noyes, R., Jr., Andreasen, N. J. C., & Hartford, C. E. The psychological reaction to severe burns. Psychosomatics, 1971, 12(6), 416–422.PubMedGoogle Scholar
  34. Noyes, R., Jr., Frye, S. J., Slymen, D. J., & Canter, A. Stressful life events and burn injuries. Journal of Trauma, 1979, 19(3), 141–144.PubMedCrossRefGoogle Scholar
  35. Pennisi, V. R. Deatherage, J., Templeton, J., & Capozzi, A. The psychogenic dependency of the acute burn patient. In P. Matter, T. L. Barclay, & Z. Konickova (Eds.) Research in burns. Bern. Hans Huber, 1971.Google Scholar
  36. Quindlen, E. A., & Abram, H. S. Psychosis in the burned patient: A neglected area of research. Southern Medical Journal, 1969, 62, 1463–1466.PubMedCrossRefGoogle Scholar
  37. Schafer, D. W. Hypnosis use on a burn unit. The International Journal of Clinical and Experimental Hypnosis, 1975, 23(1), 1–14.CrossRefGoogle Scholar
  38. Seligman, R. A psychiatric classification system for burned children. American Journal of Psychiatry, 1974, 13(1), 41–46.Google Scholar
  39. Shires, G. T. Care of the trauma patient. New York: McGraw-Hill Book Co., 1979Google Scholar
  40. Simmons, R. D., McFadd, A., Frank, H. A., Green, L. C., Malin, R. M., & Morris, J. L. Behavioral contracting in a burn care facility: A strategy for patient participation. Jour-nal of Trauma,1978, 18(4), 257–260.Google Scholar
  41. Solnit, A. J., & Priel, B. Psychological reactions to facial and hand burns in young men. Psychoanalytic Study of the Child, 1975, 30, 549–566.PubMedGoogle Scholar
  42. Steiner, H., & Clark, W. R. Psychiatric complications of burned adults: A classification. Journal of Trauma, 1977, 17(2), 134–143.PubMedCrossRefGoogle Scholar
  43. Sternbach, R. A. Pain patients: Traits and treatment. New York: Academic Press, 1974Google Scholar
  44. Wakeman, R. J., & Kaplan, J. Z. An experimental study of hypnosis in painful burns. American Journal of Clinical Hypnosis, 1978, 21(1),3–12.PubMedCrossRefGoogle Scholar
  45. Weinstein, D. L. Imagery and relaxation with a burn patient. Behaviour Research and Therapy, 1976, 14, 481.PubMedCrossRefGoogle Scholar
  46. Weisenberg, M. (Ed.). Pain: Clinical and experimental perspectives. St. Louis: C. V. Mosby, 1975.Google Scholar
  47. Weisenberg, M. Pain and pain control. Psychological Bulletin, 1977, 84, 1008–1044.PubMedCrossRefGoogle Scholar
  48. Weisz, A. E. Psychotherapeutic support of burn patients. Modern Treatment, 1967, 4, 1291–1303.PubMedGoogle Scholar

Copyright information

© Plenum Press, New York 1982

Authors and Affiliations

  • Jeanne Achterberg-Lawlis
    • 1
  • Cornelia Kenner
    • 2
  1. 1.Department of Rehabilitation ScienceDallasUSA
  2. 2.Department of SurgeryUniversity of Texas Health Science CenterDallasUSA

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