Persistent pain outcomes and patient satisfaction with pain management after burn injury

Abstract

Objectives: Acute burn pain management has advanced significantly, yet little is known about long-term pain outcomes after severe burn injury. Even less is known about patient satisfaction with pain management after burn injury. This study examined the long-term pain and psychological outcomes of burn survivors who were treated at the Burns Service of Western Australia between 1994 and 2005. Methods: Of 2114 burn survivors who were mailed standardized self-report measures of pain, depressive, and posttraumatic stress symptoms, 492 returned completed questionnaires. Of these, 18% reported persistent burn-related pain, and 27% and 14% reported clinically significant depressive and posttraumatic stress symptoms, respectively. Those with persistent pain reported significantly more severe depressive and posttraumatic stress symptoms compared with those with no pain. Interestingly, respondents with persistent burn-related pain recalled significantly higher levels of procedural and dressing change acute pain than those without pain symptoms. Linear multiple regression analyses revealed that the extent to which pain treatment expectations were met predicted overall satisfaction with pain treatment, beyond the effects of perceived pain improvement, current burn pain intensity, depression and posttraumatic stress symptoms, age, sex, and total burn surface area. Discussion: Collectively, these findings suggest a significant proportion of severely injured burn survivors continue to experience persistent pain and point to the need to identify and treat persistent pain more effectively. Moreover, assessing and managing pain treatment expectations during the early phase of recovery postburn may yield improved levels of patient satisfaction with treatment received. © 2011 by Lippincott Williams & Wilkins.