Selected Factors Predictive of Pain in Burn Patients
Keywords:
anxiety, depression, pain, burn patientsAbstract
Abstract:
Objective: To study the predictive power that the selected factors of sex, age, depth and extent of wounds, comorbidity, anxiety, and depression had on pain in burn patients.
Design: Descriptive predictive study.
Methodology: The participant consisted of 126 purposively sampled adult burn patients treated at the burn clinics of one campus hospital and three tertiary care hospitals in Northeastern Thailand. Data were collected from April to October 2019 by means of 1) a demographic questionnaire; 2) the Charlson Comorbidity Index; 3) the Burn Characteristic Chart; 4) the Burn Specifc Pain Anxiety Scale; 5) the Depression Assessment Tool (9Q); and 6) the Pain Numeric Rating Scale. The data were analysed using Backward Multiple Linear Regression, with statistical signifcance set at the p-value of .05.
Results: The majority (69.84%) of the participants were male with an average age of 42.37 years (SD = 17.37). Nearly all of the participants (92.06%) reported moderate to severe pain scores (mean = 6.67, SD = 2.02). Flame burns were identifed by almost half of the participants (44.45%) as the most common cause of injury. The factors capable of signifcantly predicting levels of pain in the burn patients were anxiety (Beta = .443, p < .01) and depression (Beta = .372, p < .01), jointly explaining 57% of pain variation (adjusted R2 = .570, F = 84.00, p < .001). Sex, age, comorbidity, and depth and extent of wounds, on the other hand, were not found capable of predicting pain in burn patients.
Recommendations: It is recommended that clinical nursing practice guidelines be developed for nurses to increase burn patients’ ability to manage their anxiety and depression, so that they can cope more effciently with the pain and suffering caused by their burn wounds.
References
Li Y, Zhou L, Tang L, Liu M, Ming X, Shen F, et al. Burn patients’ experience of pain management:
a qualitative study. Burns 2012;38(2):180–6.
Moayedi M, Davis DK. Theories of pain: from specifcity to gate control. J Neurophysiol 2013;109(1):5-12.
Esfahlan AJ, Lotf M, Zamanzadeh V, Babapuor J. Burn pain and patients’ responses. Burns
;36(7):1129–33.
Deniz S, Arslan S. Pain and anxiety in burn patients. IJCS 2017;10(3):1723–8.
Thai Association for the Study of Pain. Clinical guidance for acute pain management. Bangkok: The Royal College of Anesthesiologists of Thailand; 2019. (in Thai)
Pancumyard S, Danaidutsadeekul S, Thosingha O, Muangman P, Tanvatanagul A. Factors related to
burn patients’ post-discharge quality of life. Journal of Thailand Nursing and Midwifery Council 2020;35(2):99-115. (in Thai)
De Cosmo G, Congedo E, Lai C, Primieri P, Dottarelli A, Aceto P. Preoperative psychologic and demographic
predictors of pain perception and tramadol consumption using intravenous patient-controlled analgesia. Clin
J Pain 2008;24(5):399–405.
Dadi N. Assessment of severity of burn pain and associated factors among burn patients in Yekatit 12
hospital [Dissertation]. Addis Ababa: Addis Ababa University; 2017.
Prasad A, Thode HC, Sandoval S, Singer AJ. The association of patient and burn characteristics with itching and pain severity. Burns 2019;45(2):348–53.
Loncar Z, Bras M, Mickovic V. The relationships between burn pain, anxiety and depression. Coll Antropol 2006;30(2):319–25.
Patrasuwan S. Pain perception and factors affected in topical phacoemulsifcation. Thammasat Thai
Journal of Ophthalmology 2016;11(2):91-102. (in Thai)
Edwards RR, Smith MT, Klick B, Blakeney P. Symptoms of depression and anxiety as unique
predictors of pain-related outcomes following burn injury. Ann Behav Med 2007;34(3):313-22.
Charlson ME, Charlson RE, Peterson JC, Marinopoulos SS, Briggs WM, Hollenberg JP. The Charlson comorbidity index is adapted to predict costs of chronic disease in primary care patients. J Clin Epidemiol 2008;61(12):1234-40.
Utriyaprasit, K. The relationship between recovery symptoms and functional outcomes in Thai CABG
patients [Dissertation]. Cleveland: Case Western Reserve University; 2001.
Sharar RS, Patterson RD. Burn pain. In: Gold SM, Gebhart FG, editors. Bonica’s management of pain. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2010. p. 1015-30.
Strong J, Griensven VH. Assessing pain. In: Gordon JG, Asmundson L, editors. Pain a textbook for health
professionals. 2nd ed. Edinburgh: elsevier; 2014. p. 91-113
Taal LA, Faber AW. The burn specifc pain anxiety scale: Introduction of a reliable and valid measure.
Burns 1997;23(2):147–50.
Prasansak J. Translation and reliability of the Burn specifc pain anxiety scale Thai version for burn
patients. Journal of Nursing Science and Health 2019;42(3):129-138. (in Thai)
Kongsuk T, Arunpongpaisal S, Maneethon N, Wansawek K, Kenbubpha K, Leejongpermpoon J. The development and validity of the 9-question depressive disorder diagnostic test in Thai I-san dialects. Bangkok:
Proceedings of 6th Annual International Mental Health Conference in Thailand; 2008. (in Thai)
Nedelec B, Carrougher G. Pain and pruritus postburn injury. J Burn Care Res. 2017;38(3):142-5.
Arif M, Ramprasad KS. Prevalence of anxiety and depression in burns patients in a tertiary care hospital.
IOSR-JDMS 2013;10(4):6–9.
Sousa DA, Sonavane S, Kurvey A. Psychological issues in adult burn patients. Delhi Psy J 2013;
(1):24-33.
