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Psychosocial rehabilitation after burn injuries

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VOL: 97, ISSUE: 48, PAGE NO: 47

James Partridge, DSc, MSc, MA, is chief executive, Changing Faces

The report of the National Burn Care Review, published in April (www.baps.co.uk), contained a comprehensive analysis of the state of burn care in the UK. Its findings were worrying but its analysis and proposals were confidently made, with multidisciplinary consensus, that much needed to be done to change the present arrangements.

The report of the National Burn Care Review, published in April (www.baps.co.uk), contained a comprehensive analysis of the state of burn care in the UK. Its findings were worrying but its analysis and proposals were confidently made, with multidisciplinary consensus, that much needed to be done to change the present arrangements.

In particular, the NBCR placed great importance on the psychological and psychosocial impact of burn injuries - burns are now recognised as very challenging for the individual and family, affecting self-esteem and self-confidence. While psychosocial rehabilitation should be an integral part of burn care services, there is a major gap in provision in this area, with very few burns units providing trained psychological support of any kind.

Wounds from burns and many other causes threaten the integrity of a person's self-image. Wounds to the face can be particularly problematic, but the little quality research in this field does not show a correlation between the size or location of a wound and the psychosocial distress it causes; so-called minor disfigurements can be equally or more distressing than severe conditions. The problems experienced after wounding concern traumatic shock, loss of self-belief, acute self-consciousness, difficulties in school, work and relationships, and many stem from social interaction difficulties. The effect on the family should also not be underestimated.

The good news is that over the past 10 years there has been a real effort to develop a range of psychosocial interventions for health care professionals to choose from in tackling these problems. To name a few: the development of ways to address in-patient trauma has moved forward, as has interest in burn camps and social skills weekends as useful ways to empower children and teenagers; at the charity Changing Faces we have produced a range of self-help guides for all age groups to assist them in dealing with burn injuries. Shortly there will be an accredited postgraduate course available for specialist professionals at the University of the West of England on the management of the psychosocial aspects of disfiguring conditions - the first course is planned to start in February 2002.

Healing the inner scars left by burns and wounds needs to be a central objective for all professionals engaged in wound care. Planning from day one can make it happen successfully.

For information on the proposed postgraduate course contact Changing Faces, e-mail: info@changingfaces.co.uk or write to Changing Faces, 1 & 2 Junction Mews, London W2 1PN

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