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Block 4 week 2 Dani > Psychosocial Aspects of Burns > Flashcards

Psychosocial Aspects of Burns Flashcards

1
Q

What are the three stages of recovery for burn victims?

A

stage 1: resuscitative or critical stage
stage 2: acute stage
stage 3: long term rehab

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2
Q

Different stages of recovery have different (blank) and treatment issues.

A

psychological characteristics

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3
Q

Where do we find stage 1 patients?

A

in the ICU : (

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4
Q

What are these:
stressors of ICU (over or understimulation)
delirium and brief psychiotic reactions (from infections, drugs, withdrawals or metabolic complications)
intubation may limit communication
pain
sleep disturbances
family is anxious and distressed

A

Psychosocial issues facing stage 1 recovery burn patients

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5
Q

What are the treatment issues associated with stage 1 (resuscitative or critical stage)?

A 
physical survival
coping skills
pain managment
comfort
educate and support family membranes
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6
Q

What is the medical focus of stage 2 (acute stage)?

A

restorative care

resting and procedural pain

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7
Q

What is the treatment like for stage 2?

A

painful and can be retraumatizing

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8
Q 
What are these:
understanding impact of injuries
guilt/anger
grief
loss of faith
depression (23-61%)
anxiety (13-47%)
sleep disturbance
premorbid psychopathology
actue stress disorder (1st month)
PTSD (after first month)
A

psychosocial issues facing stage 2 (acute stage)

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9
Q

So describe an individual in the acute stage (stage 2)?

A

angry, hurting, traumatized, sleep deprived patient who is grieving

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10
Q

What is AST (acute stress disorder)?

A

exposure to trauma
3 or more dissociative symptoms
reexperiencing
last from 2 days to 4 weeks after event

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11
Q 
What are these:
numbing, detachment, absence of emotional responsiveness
reduction in awareness of surroundings
derealization
depersonalization
dissociative amnesia
A

Dissociative symptoms

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12
Q

What is this:
event involved threat of harm
response involved intense fear, helplessness, or horror (disorganization and agitation in children)

A

exposure to trauma

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13
Q

What is PTSD?

A

being exposed to a traume with 1 or more intrusion symptoms , 1 or more symptoms of avoidance of stimuli (internal or external), 2 or more symptoms of negative alterations in cognitions and mood, 2 or more symptoms of increased arousal and reactivity, last more than one month

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14
Q

(blank) is the inability to keep memories of the event from returning. (blank) is an attempt to avoid stimuli and triggers that may bring back those memories

A

intrusion

Avoidance

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15
Q

Do ASD symptoms always turn into PTSD?

A

no

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16
Q

Using (blank), symptoms often resolve on their own (especially if there is no premorbid psychology)

A

pyschoeducation

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17
Q

What is the treatment for depression, anxiety, anger, grief, pain?

A

psychotherapy w/ pain managment (drugs, relaxation, imagery, hypnosis, distraction through virtual reality, CBT) and encouraging coping skills rather than avoidance.

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18
Q

Use (blank) for the treatment of sleep, depression, anxiety, or pain.

A

pharmacotherapy

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19
Q

(blank) support is important for recovery.

A

social

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20
Q

(blank) should be treated through referral to therapy after discharge

A

premorbid pyschopathology

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21
Q

What stage is long term rehabilitation?

A

stage 3

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22
Q

What is this:
after discharge from hospital
involves attempt to reintegrate into society (SCARED response)
May involved continued outpatient treatment (procedures, surgery, physical rehabilitation)

A

Long term rehabilitation (stage 3)

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23
Q

What is the SCARED response?

A

What burn victims experience after integrating with society:

Staring, curiousity, anguish, recoil, embarrassment, dread

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24
Q 
What are these:
adjusting to practical limitation of injury
physical issues
development issues
depression, anxiety, grief, PTSD
Adjustments
A

Psychological issues associated with stage 3

25
Q

What are some physical problems associated with stage 3?

A

itching, limited endurance, decrease in function, amputations, disfigurement

26
Q 
What are these:
physical appearance, body image, lowered self-esteem 
identity
return to work/school (may need vocational rehabilitation)
financial problems
family strain
changing roles
sexual dysfunction
social withdrawal versus social support
A

Adjustments that are made during stage (3: psychological issues)

27
Q

What are the treatment issues that need to be addressed for stage 3 patients?

A 
outpatient psychotherapy
social skills training
prepare burn victim's community
encourage social support
improve self-esteem; manage disfigurement
vocational rehab
address premorbid psychopathology
28
Q

What do you use outpatient psychotherapy for?

A

adjustment, grief, depression, anxiety, PTSD

29
Q

T or F

Most pediatric burn patients adjust well, with 20-50% of most samples experiencing mild-moderate difficulties

A

T

30
Q

T or F

Approx. 30% of any given adult sample demonstrates moderate-severe psychological and/or social difficulties

A

T

31
Q

T or F

Most burn survivors achieve a satisfying quality of life after the burn

A

T

32
Q

Tell me about burns and children

A

burns are common in children, but most survive well, but they can become aggressive, depressed and axious with low self esteem and PTSD symptoms

33
Q

Greater difficulties in adjustement are associated with burns on (blank) areas of skin

A

exposed (face, upper limbs)

34
Q

Children’s reactions of burns may be mediated by reactions of their (blank) who often feel distress, guilt and can be overprotective.

A

mother

35
Q

Younger children have (blank) psychosocial adjustment than adolescents.

A

better

36
Q

Do adolescents who move a lot adjust better or worse to burns?

A

worse

37
Q

Did severity of burn indicate better ability to cope in adolescents?

A

no

38
Q

In a study by Pallua, kunsebeck, and noah, they looked into psychosocial adjustments after 5 years after burn injury, what did they find out?

A

Physical function was best predictor.
Location of burns was next best predictor
extend of body surface burned was less predictive

39
Q

What affects all areas of quality of life with burn victims?

A

physical limitations and functions

40
Q

(blank) burns create disadvantage in social reintegration.

A

visible

41
Q

What did Gilboa (study) find out about long-term psychosocial adjustment after burns?

A

(brains good (no change in personality or IQ), job change, increased family time, may get divorced, decreased sex life : (, improved self esteem after 1 year)

42
Q

IS the size of burn or length of a hospitalization a good predictor of whether or not a person will adjust well to their burns?

A

NO :)

43
Q

(blank) account for 40% of the variance in predicting psychosocial adjustment

A

social factors

44
Q

So all in all who are the best at adjusting to burns?

A

extroverts, who are hopeful :)

45
Q

(blank): these traits support and enable the victim to recruit social and emotional support

A

personality

46
Q

What should treatment reinforce? s

A

ocial support, positive personality traits, and effective coping mechanisms

47
Q

What is this:

appraisal of situation, reaction to social environment.

A

coping mechanisms

48
Q 
Other researchers (Blakeney et al.) have emphasized that outcomes (blank) depend on: 
Extent of the injury 
Depth of the burn
Total area burned/scarred
Amputations

Instead, adjustment (blank) depends on:
Quality of family and social support
Patient’s willingness to take social risks, extroversion

A

do NOT

Do

49
Q

According to blakeney, what are the guidelines for treatment of burns?

A

normal person will have normal recovery, but the process will be difficult and take 2 years, and adaptation will be difficult and the “family” must be included in pnt’s treatment

50
Q

What three personal skills should be promoted in treatment of burns?

A

self-efficacy, social skills, and social risk-taking.

51
Q

Therapy for burn victims involves defining a new (blank)

A

self-image

52
Q

The new (blank) should involve more than one of “burn survivor” over time

A

self-image

53
Q

The (blank) from burns involved different psychosocial issues and treatment needs.

A

stages of recovery

54
Q

(blank) involves grieving what was lost and building a new life, including new identities.

A

psychosocial adjustment

55
Q

(blank) plays a vital role in adjustment for burn victims and should be encouraged.

A

Social support

56
Q

When patients are in the ICU and its all crazy in there how should they cope?

A

by any means necessary so denial or repression or whatever is encouraged

57
Q

What are the most commonly used anelgesics?

A

opoids (if you dont want to use this you can you NO, or anxiolytics)

58
Q

Both procedural pain and background are difficult to deal with, why do some patient’s prefer procedural pain?

A

because it has an end in sight

Block 4 week 2 Dani (8 decks)

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