Page 144 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

Burns 119

A large proportion of the burns literature also focusses on
the relationship between personality type, coping strategies
and post-burn adjustment. It has been reported that neuroti-
cism, a trait largely associated with pessimism, negative affect
and introversion, is one particular personality trait associated
with adjustment difficulties (Klinge et al. 2009 ). Hence, it has
been suggested that wound care clinicians need to integrate
assessments that explore personality traits that may result
in maladjustment and the adoption of dysfunctional coping
strategies (Gilboa et al. 1999a , b ). For example, patients who
display optimism, ‘self-mastery’, or self-efficacy (ability to
influence their outcomes) and hope prove to adjust more
positively, whereas neurotic and introverted traits resulted in
greater adjustment issues (Gilboa et al. 1999a , b ).
Additionally, such patients were also more susceptible
to post-traumatic stress disorder (PTSD; Fauerback et al.
1997 ; van Loey et al. 2003 ). Research has highlighted
the prevalence of PTSD in burn survivors with van Loey
et al. 2003 discovering 28 % of their participants to be
meeting the DSM-IV criteria for either PTSD or partial
PTSD. Furthermore, Bryant ( 1996 ) found that 60 % of burn
patients were classified with PTSD or a subclinical form of
PTSD. A major predictor of PTSD was the patient’s concern
about self-image related to the scarring resulting from the
burn in addition to the adoption of avoidant coping styles
(something that will be discussed later in relation to implica-
tions on wound healing). Hence, it is important for clinicians
to acknowledge the associated between patients expressed
concern over scarring and potential negative emotional reac-
tions and adjustments.
Overall, it is essential that the patient who has suffered a
wound is assessed adequately from a psychological perspec-
tive. There are a number of measures that may be useful
in this regard. Table 5.1 highlights some of these and their
benefits.
The measures reported in Table 5.1 are but some of the
many measures that are available to the practising clinician to
measure appropriate psychological variables. More of these

are reported in other chapters, including the Chaps. 2 , 3 and 7 .