An exploratory study of pain, coping, and depressed mood following burn injury

The objectives of this descriptive study were to examine pain, coping, and depressed mood in patients with moderate to severe burn injuries. A secondary objective was to evaluate the appropriateness of prescribed analgesic regimens. Subjects (N = 31) reported high levels of pain intensity, pain distress, and depressed mood, and used many strategies to cope with their pain. The tendency to think the worst or catastrophize was positively associated with pain intensity (r = 0.51; P < .01) and pain distress (r = 0.42; P < 0.05). Depressed mood was significantly correlated with pain intensity (r = 0.45; P < 0.05), but not pain distress. A personal belief in control over pain (r = -0.45; P < 0.05) and one's ability to decrease pain (r = -0.48; P < 0.01) were negatively associated with depressed mood. Significant relationships also were found between severity of injury and depressed mood (r = 0.43; P < 0.05), and between surgical intensity and pain distress (r = 0.36; P < 0.05). Based on the pain management index, 91% of the routine and 84% of the procedural pain regimens were in the acceptable range. Generally, analgesics were prescribed on an "as needed" basis and subjects seldom received more than 50% of their prescribed dose. The finding that pain and depressed mood remain significant problems for burn-injured patients suggests that thoughtful pain assessment, pain management, and quality review are needed.