@2024 Afarand., IRAN
ISSN: 2252-0805 The Horizon of Medical Sciences 2013;19(2):59-65
ISSN: 2252-0805 The Horizon of Medical Sciences 2013;19(2):59-65
Effect of Therapeutic Communication on Pain Anxiety and Burn Wounds Healing Status
ARTICLE INFO
Article Type
Original ResearchAuthors
Manzari Z. S. (1)Memariyan R. (*)
Vanaki Z. (2)
(*) Department of Nursing, Faculty of Medicine, Tarbiat Modares University, Tehran, Iran
(1) Department of Internal Surgery, Faculty of Nursing & Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
(2) Department of Nursing, Faculty of Medicine, Tarbiat Modares University, Tehran, Iran
Correspondence
Address: Department of Nursing, Faculty of Medicine, Tarbiat Modares University, Junction of Jalal-e-al-e-Ahmad and Chamran Highway, Tehran, IranPhone: +982182883585
Fax: +982182883856
memari_r@modares.ac.i
Article History
Received: June 18, 2012Accepted: June 18, 2013
ePublished: June 25, 2013
ABSTRACT
Aims
The main type of anxiety in burned patients is the one caused by pain. Emotional support can tranquilize patients during the process of care and treatment. This research has been conducted to study how Therapeutic Communication can help reduce the pain anxiety and how it affects recovery from burn wounds.
Materials & Methods This quasi-experimental research was conducted in a period of ten months in 2005 in the women’s burn ward of Imam Reza hospital in Mashhad. The sample included 60patients, who were selected non-randomly and were divided into two groups of 30 women,half in intervention and half in control group. The data collection tools were self-report checklist to determine pain anxiety and the observation checklist to observe the extentof burn wound healing. The Therapeutic Communication plan was implemented for the intervention group. Data were analyzed by SPSS 12 software using Chi-square, independent T and Variance Analysis tests.
Findings No significant statistical difference regarding the rate of anxiety (P=0.63) and wound healing (p=0.73) was observed between control and intervention groups in the preintervention stage. During and after the intervention, the rate of anxiety in the subjects of the intervention group was significantly decreased (p=0.0001). Also the rate of wound healing in the intervention group was significantly increased during (p=0.018) and after (p=0.001) the intervention, comparing to the control group. The average rate of wound healing after the intervention in the subjects of control and intervention groups showed a significant difference (p=0.009).
Conclusion The therapeutic communication between the nurse and patients positively influences the reduction of anxiety and the process of wound healing.
Materials & Methods This quasi-experimental research was conducted in a period of ten months in 2005 in the women’s burn ward of Imam Reza hospital in Mashhad. The sample included 60patients, who were selected non-randomly and were divided into two groups of 30 women,half in intervention and half in control group. The data collection tools were self-report checklist to determine pain anxiety and the observation checklist to observe the extentof burn wound healing. The Therapeutic Communication plan was implemented for the intervention group. Data were analyzed by SPSS 12 software using Chi-square, independent T and Variance Analysis tests.
Findings No significant statistical difference regarding the rate of anxiety (P=0.63) and wound healing (p=0.73) was observed between control and intervention groups in the preintervention stage. During and after the intervention, the rate of anxiety in the subjects of the intervention group was significantly decreased (p=0.0001). Also the rate of wound healing in the intervention group was significantly increased during (p=0.018) and after (p=0.001) the intervention, comparing to the control group. The average rate of wound healing after the intervention in the subjects of control and intervention groups showed a significant difference (p=0.009).
Conclusion The therapeutic communication between the nurse and patients positively influences the reduction of anxiety and the process of wound healing.
CITATION LINKS
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[15] Hall B. Care of the patient with burns in the trauma rehabilitation setting. Crit Care Nurs Q. 2012;35(3):272-80. 16- Rhonda R, Villarreal C, Walter J. Anxiety: Current practices in assessment and treatment of anxiety of burn patients. Burns. 2000;26(6):459-552.
[16] Wisely J, Tarrier N. A survey of the need for psychological input in a follow up service for adult burn injured patients. Burns. 2001;27(8):801-7.
[17] Fernay C, Faymonville E, Devlieger S. Psychological approaches during dressing changes of burned patients: A prospective randomized study comparing hypnosis against stress reducing strategy. Burns. 2001;27(1):793-9.
[18] Wiechman SA. The management of self-inflicted burn injuries and disruptive behavior for patients with borderline personality disorder. J Burn Care Rehabil. 2000;21(4):307- 17.
[19] Stewar M, Boon H. Patient-physician communication assessment instruments. Patient Educ Couns. 1998;35(3):161-76.
[20] Wachtel Paul. Therapeutic communication: Principles and effective practice. J Adv Nurs. 2003;108(30):1073-9.
[21] Stephen G. Henry SG, Fuhrel-Forbis A, Rogers MA, Eggly S. Association between nonverbal communication during clinical interactions and outcomes: A systematic review and meta-analysis. Patient Educ Couns. 2012;86(3):297-315.
[22] Zambelli Pinto R, Ferreira ML, Vinicius CO, Franco MR, Adams R, Maher CG, et al. Patient-centred communication is associated with positive therapeutic alliance: A systematic review. J Physiother. 2012;58(2):77- 87.
[23] Crawford P, Brown B. Fast healthcare: Brief communication, traps and opportunities. Patient Educ Couns. 2011;82(1):3-10.
[24] Selig HF, Lumenta DB, Giretzlehner M, Jeschke MG, Upton D, Kamolz LP. The properties of an ‘‘ideal’’ burn wound dressing: What do we need in daily clinical practice? Results of a worldwide online survey among burn care specialists. Burns. 2012;38(7):960-6.
[25] Weinberg K, Birdsall C, Vail D, Marano MA, Petrone SJ, Mansour EH. Pain and anxiety with burn dressing changes: Patient self-report. J Burn Care Rehabil. 2000;21(2):155-61.
[26] Solowiej K, Mason V, Upton D. Review of the relationship between stress and wound healing. J Wound Care. 2010;19(3):1-6.
[27]Moser D, Misok L. Critical care nursing practice regarding patient anxiety assessment. Intensive Crit Care Nurs. 2003;19(3):276-80.
[28] Wiechman S, Patterson D. Psychosocial aspects of burn injuries. Burn. 2004;329(2):391-3.
[29] Garg A, Chren MM, Sands LP. Psychological stress perturbs epidermal permeability barrier homeostasis: Implications for the pathogenesis of stress-associated skin disorders. Arch Dermatol. 2001;137(1):53-9.
[30] Moore CL, Schmidt PMA. Burn progressive care unit: Customized care from admission through discharge. Perioperat Nurs Clin. 2012;7(1):99-105.
[31] Kiecolt-Glaser JK, Marucha PT, Malarkey WB, Mercado AM, Glaser R. Slowing of wound healing by psychological stress. Lancet. 1995;346(8984):1194-6.
[32] Barth J, Lannen P. Efficacy of communication skills training courses in oncology: A systematic review and metaanalysis. Ann Oncol. 2011;22(5):1030-40.
[33] Langewitz W, Heydrich L, Nuebling M, Szirt L, Weber H, Grossman P. Swiss cancer league communication skills training programme for oncology nurses: An evaluation. J Adv Nurs. 2010;66:2266-77.
[34] Marlies DEJ, Rianne D, Vandam F. A pain monitoring program for nurses, effect on communication, assessment and documentation of patient. Pain. 2000;20(6):428-39.
[35] Moser D, Misok L. Critical care nursing practice regarding patient anxiety assessment. Intensive Crit Care Nurs. 2003;19(3):276-88.
[36] Woo KY. Wound-related pain: Anxiety, stress and wound healing. Wounds. 2010;6(4):91-8.
[37] Ebrecht M, Hextall J, Kirtley LG, Taylor A, Dyson M, Weinman J. Perceived stress and cortisol levels predict speed of wound healing in healthy male adults. Psychoneuroendocrinology. 2004;29(6):798-809.
[2] Kumar S, Wong F, Ieaper D. What is new in wound healing? Turk J Med Sci. 2004;34:147-60.
[3] Harding KG, Morris HL, Patel GK. Healing chronic wounds. BMJ. 2002;324(7330):160-3.
[4] Gouin J-P, Kiecolt-Glaser JK. The impact of psychological stress on wound healing: Methods and mechanisms. Immunol Allergy Clin North Am. 2011;31(1):81-93.
[5] Glaser R, Kiecolt-Glaser JK. Stress-induced immune dysfunction: Implications for health. Nat Rev Immunol. 2005;5(3):243-51.
[6] Robert R, Blakeney P, Villarreal C, Meyer WJ. Anxiety: Current practices in assessment and treatment of anxiety of burn patients. Burns. 2000;26(6):459-552.
[7] Walburn J, Vedhara K, Hankins M. Psychological stress and wound healing in humans: A systematic review and meta-analysis. J Psychosom Res. 2009;67(3):253-71.
[8]Taal LA, Faber AW. The burn specific pain anxiety scale: Introduction of a reliable and valid measure. Burns. 1997;23(2):147-50.
[9] Taal LA, Faber AW, Vanloey NE, Rwynders CL. The abbreviated burn specific pain anxiety scale: A multicenter study. Burns. 1999;25(6):493-7
[10] Aaron LA, Patterson DR, Finch C. The utility of a burn specific measure of pain anxiety to prospective predict pain and function: A comparative analysis. Burns. 2001;27(4):329-34
[11] Guo S, DiPietro LA. Factor affecting wound healing. J Dent Res. 2010;89(3):219-29.
[12] Gottschlich MM, Jenkins M, Mayes T, Khoury J, Kagan R, Warden GD. Lack of effect of sleep on energy expenditure and physiologic measure in critically ill burn patient. J Am Diet Assoc. 1997;97(2):131-9.
[13] Raymond I, Nielsen TA, Lavigne G, Manzini C, Choinière M. Quality of sleep and its daily relationship to pain intensity in hospitalized adult burn patient. Pain. 2001;22(3):381-8.
[14] Horn W, Bartolucci AW. Factors associated with patient participation in rehabilitation services: A comparative analysis 12 month post discharge. Disabil Rehabil. 2000;22(8):358-62.
[15] Hall B. Care of the patient with burns in the trauma rehabilitation setting. Crit Care Nurs Q. 2012;35(3):272-80. 16- Rhonda R, Villarreal C, Walter J. Anxiety: Current practices in assessment and treatment of anxiety of burn patients. Burns. 2000;26(6):459-552.
[16] Wisely J, Tarrier N. A survey of the need for psychological input in a follow up service for adult burn injured patients. Burns. 2001;27(8):801-7.
[17] Fernay C, Faymonville E, Devlieger S. Psychological approaches during dressing changes of burned patients: A prospective randomized study comparing hypnosis against stress reducing strategy. Burns. 2001;27(1):793-9.
[18] Wiechman SA. The management of self-inflicted burn injuries and disruptive behavior for patients with borderline personality disorder. J Burn Care Rehabil. 2000;21(4):307- 17.
[19] Stewar M, Boon H. Patient-physician communication assessment instruments. Patient Educ Couns. 1998;35(3):161-76.
[20] Wachtel Paul. Therapeutic communication: Principles and effective practice. J Adv Nurs. 2003;108(30):1073-9.
[21] Stephen G. Henry SG, Fuhrel-Forbis A, Rogers MA, Eggly S. Association between nonverbal communication during clinical interactions and outcomes: A systematic review and meta-analysis. Patient Educ Couns. 2012;86(3):297-315.
[22] Zambelli Pinto R, Ferreira ML, Vinicius CO, Franco MR, Adams R, Maher CG, et al. Patient-centred communication is associated with positive therapeutic alliance: A systematic review. J Physiother. 2012;58(2):77- 87.
[23] Crawford P, Brown B. Fast healthcare: Brief communication, traps and opportunities. Patient Educ Couns. 2011;82(1):3-10.
[24] Selig HF, Lumenta DB, Giretzlehner M, Jeschke MG, Upton D, Kamolz LP. The properties of an ‘‘ideal’’ burn wound dressing: What do we need in daily clinical practice? Results of a worldwide online survey among burn care specialists. Burns. 2012;38(7):960-6.
[25] Weinberg K, Birdsall C, Vail D, Marano MA, Petrone SJ, Mansour EH. Pain and anxiety with burn dressing changes: Patient self-report. J Burn Care Rehabil. 2000;21(2):155-61.
[26] Solowiej K, Mason V, Upton D. Review of the relationship between stress and wound healing. J Wound Care. 2010;19(3):1-6.
[27]Moser D, Misok L. Critical care nursing practice regarding patient anxiety assessment. Intensive Crit Care Nurs. 2003;19(3):276-80.
[28] Wiechman S, Patterson D. Psychosocial aspects of burn injuries. Burn. 2004;329(2):391-3.
[29] Garg A, Chren MM, Sands LP. Psychological stress perturbs epidermal permeability barrier homeostasis: Implications for the pathogenesis of stress-associated skin disorders. Arch Dermatol. 2001;137(1):53-9.
[30] Moore CL, Schmidt PMA. Burn progressive care unit: Customized care from admission through discharge. Perioperat Nurs Clin. 2012;7(1):99-105.
[31] Kiecolt-Glaser JK, Marucha PT, Malarkey WB, Mercado AM, Glaser R. Slowing of wound healing by psychological stress. Lancet. 1995;346(8984):1194-6.
[32] Barth J, Lannen P. Efficacy of communication skills training courses in oncology: A systematic review and metaanalysis. Ann Oncol. 2011;22(5):1030-40.
[33] Langewitz W, Heydrich L, Nuebling M, Szirt L, Weber H, Grossman P. Swiss cancer league communication skills training programme for oncology nurses: An evaluation. J Adv Nurs. 2010;66:2266-77.
[34] Marlies DEJ, Rianne D, Vandam F. A pain monitoring program for nurses, effect on communication, assessment and documentation of patient. Pain. 2000;20(6):428-39.
[35] Moser D, Misok L. Critical care nursing practice regarding patient anxiety assessment. Intensive Crit Care Nurs. 2003;19(3):276-88.
[36] Woo KY. Wound-related pain: Anxiety, stress and wound healing. Wounds. 2010;6(4):91-8.
[37] Ebrecht M, Hextall J, Kirtley LG, Taylor A, Dyson M, Weinman J. Perceived stress and cortisol levels predict speed of wound healing in healthy male adults. Psychoneuroendocrinology. 2004;29(6):798-809.