Providing psychoeducation throughout recovery and rehabilitation from burn injuries may offer opportunities to facilitate access to psychological support.
After sustaining a burn injury, the psychological toll on patients can be significant and may include adjusting to physical changes, post-traumatic stress disorder, anxiety and depression, pain, sleep disturbances, body image concerns, and challenges with intimate relationships, among other difficulties. The psychological effects of a burn injury can persist for years beyond the injury, and studies suggest that untreated psychological distress resulting from these injuries can prolong recovery.
Psychological concerns are prevalent across burn patients, but several risk factors may contribute to psychopathology, including premorbid mental health disorders, alcohol misuse, and suicidality. Identifying premorbid psychological symptoms before and after a burn injury is important for optimizing recovery. Clinicians need to understand how patients conceptualize psychological symptoms and their beliefs about the usefulness and availability of psychological treatment in this context, says Lianne McDermott, MSc. A better understanding of patient experiences during burns rehabilitation may improve access to psychological support and facilitate psychological recovery.
Seeking a Better Understanding of Facilitators & Barriers to Psychological Support
For a study published in the European Burn Journal, McDermott and colleagues qualitatively explored barriers and facilitators to accessing psychological support following a burn injury. Specifically, the authors aimed to understand patients’ perceptions of psychological support and the facilitators and barriers to accessing it. They also wanted to identify patient-reported gaps in psychological care during outpatient rehabilitation and to develop practical and feasible service recommendations to improve the patient experience, reduce barriers, and enable access to the psychology team.
The study explored perceptions of barriers and facilitators to accessing psychological support in 11 adult burn patients (5 women and 6 men) in a regional burns service in Southeast England. The participants were under the care of the burns unit and were not currently accessing psychological support. Semistructured interviews were then conducted, and responses were analyzed using thematic analysis.
Communication Critical to Fostering Uptake of Psychological Support
According to investigators, the four main overarching themes that influenced access to psychological support were: 1) communication between the patient and service; 2) beliefs about mental health; 3) environmental challenges; and 4) patient hope. Barriers to psychological support included prioritizing physical recovery, time constraints, and geographical and financial pressures. However, most participants suggested that increasing psychological presence after discharge and during outpatient appointments would facilitate access.
Based on the findings, the study group made recommendations to help the burns psychology team improve communication and increase awareness of psychological support (Table). Several strategies can be used to improve access to burn psychological care, including the provision of patient resources to increase awareness and reduce stigma and implementation of psychological skills training to encourage staff to recognize distress and respond appropriately. Other helpful approaches include training staff in cultural humility and increasing psychological presence in outpatient appointments and via routine follow-ups.
To engage with patients who have different beliefs about psychology and mental health, clinicians are recommended to use psychoeducation on support, therapy, and mental health following a burn injury. In addition, it is important to ensure that culturally adapted information is made available to family and patient caregivers. To further reduce barriers to accessing psychological support, psychologists should ensure patients have information about remote psychological therapy opportunities. To foster hope, clinicians can use patient education resources that include examples of positive experiences and stories from patients who accessed psychological support and are recovering well.
Increasing Opportunities for Facilitating Access
The study team reported that providing psychoeducation and increasing psychological presence throughout rehabilitation offers opportunities to facilitate access to psychological services for burn injury patients. “The focus should be on ensuring that the clinicians are psychologically informed and empathic when managing these patients,” McDermott says. The authors concluded that identifying psychological distress and responding appropriately may help minimize the negative psychological impact throughout patient recovery.
