Pain, coping, and depression following burn injury

Abstract

Pain, coping, and depression were examined in a convenience sample of 32 burn injured men and women. Subjects were interviewed 3 times at approximately weekly intervals. The first and third interviews focused on coping, the second interview focused on how burn pain is described and rated by burn injured subjects and their care providers. Three criterion variables, pain intensity, pain distress, and depression were used to measure coping outcome. Five variables, severity of injury, surgical intensity, baseline depression, duration of pain, and level of analgesic drug were predicted to influence coping. Although the burn wound was identified as the source of worst pain, when subjects were asked to rate wound, donor, and skin graft pain using the short form McGill Pain Questionnaire (MPQ-SF), no significant differences were found. Average pain intensity, average pain distress, and level of depression decreased significantly over time. Pain with routine activity and pain worst continued to be rated moderate to severe by most patients at the third interview. No changes were noted in coping strategy use when coping was measured using the Coping Strategies Questionnaire. Subjects' perceptions of their ability to control pain increased significantly over the three measurement sessions. Subjects' perceptions of their ability to decrease their pain increased but did not achieve significance. Significant correlations between predictor and criterion variables were found for severity of injury, duration of pain, level of analgesic drug, baseline depression, and perceptions of ability to control and decrease pain. Significant correlations were also found between the criterion variables and beliefs related to personal control and the tendency to catastrophize. A significant positive correlation was found between care provider estimates of pain distress today and the average self-reported pain distress score. Care provider estimates of pain intensity today did not correlate with the average self-reported pain intensity score. When t-test comparisons were made between care provider and patient ratings no significant differences were found.