Pruritus in burn victims: relationship with anxiety, depression, and post-traumatic stress

Authors

Abstract

Objective: To assess the relationship between pruritus intensity and anxiety, depression, post-traumatic stress, and health-related quality of life scores in burn victims. Methods: A cross-sectional study, carried out in two outpatient clinics of burn hospitals located in municipalities in the countryside of São Paulo. The sample consisted of 60 patients who answered sociodemographic and clinical characterization instruments: the Visual Numerical Scale, to assess pruritus intensity, the Hospital Anxiety and Depression Scale, the Impact of Events Scale, to assess post-traumatic stress, and the Freiburg Life Quality Assessment Wound Module to Brazilian Portuguese. Results: The sample was characterized by a predominance of males (73%). Significant positive correlations were found between pruritus intensity and anxiety (r=0.33), depression (r=0.53), post-traumatic stress (r=0.43), and total Freiburg Life Quality Assessment Wound score (r=0.63). Conclusions: These findings reinforce the importance of assessing pruritus in comprehensive care for burn victims, aiming to reduce the psychological impact and improve health-related quality of life.

Downloads

Download data is not yet available.

References

Tibebu NS, Desie T, Marew C, Wubneh M, Birhanu A, Tigabu A. Health-related quality of life and its associated factors among burn patients at Governmental Referral Hospitals of Amhara Regional State, Northwest Ethiopia, 2020: institutional-based cross-sectional study. Clin Cosmet Investig Dermatol. 2021 Apr 13;14:367-75. https://doi.org/10.2147/CCID.S306211

World Health Organization. Burns [Internet]. 2023 [acesso 2023 maio 23]. Disponível em: https://www.who.int/news-room/fact-sheets/detail/burns

Santos JV, Souza J, Amarante J, Freitas A. Burden of burns in Brazil from 2000 to 2014: a nationwide hospital-based study. World J Surg. 2017 Aug;41(8):2006-12. https://doi.org/10.1007/s00268-017-3988-5

Barrett LW, Fear VS, Waithman JC, Wood FM, Fear MW. Understanding acute burn injury as a chronic disease. Burns Trauma. 2019 Sep 16;7:23. https://doi.org/10.1186/s41038-019-0163-2

Han J, Zhou XP, Liu JE, Yue P, Gao L. The process of developing resilience in patients with burn injuries. J Nurs Res. 2020 Feb;28(1):e71. https://doi.org/10.1097/jnr.0000000000000342

Kelter BM, Holavanahalli R, Suman OE, Ryan CM, Schneider JC. Recognizing the long-term sequelae of burns as a chronic medical condition. Burns. 2020 Mar;46(2):493-6. https://doi.org/10.1016/j.burns.2019.10.017

Thibaut A, Shie VL, Ryan CM, Zafonte R, Ohrtman EA, Schneider JC, Fregni F. A review of burn symptoms and potential novel neural targets for non-invasive brain stimulation for treatment of burn sequelae. Burns. 2021 May;47(3):525-37. https://doi.org/10.1016/j.burns.2020.06.005

Evers AWM, Peerdeman KJ, van Laarhoven AIM. What is new in the psychology of chronic itch? Exp Dermatol. 2019 Dec;28(12):1442-7. https://doi.org/10.1111/exd.13992

Chung BY, Kim HB, Jung MJ, Kang SY, Kwak IS, Park CW, Kim HO. Post-burn pruritus. Int J Mol Sci. 2020 May 29;21(11):3880. https://doi.org/10.3390/ijms21113880

Sanders KM, Akiyama T. The vicious cycle of itch and anxiety. Neurosci Biobehav Rev. 2018 Apr;87:17-26. https://doi.org/10.1016/j.neubiorev.2018.01.009

Reich A, Heisig M, Phan N, Taneda K, Takamori K, Takeuchi S, Furue M, Blome C, Augustin M, Ständer S, Szepietowski JC. Visual analogue scale: evaluation of the instrument for the assessment of pruritus. Acta Derm Venereol. 2012 Sep;92(5):497-501. https://doi.org/10.2340/00015555-1265

Botega NJ, Bio MR, Zomignani MA, Garcia Jr C, Pereira WAB. Transtornos do humor em enfermaria de clínica médica e validação de escala de medida (HAD) de ansiedade e depressão. Rev Saúde Pública. 1995 Out;29(5):359-63. https://doi.org/10.1590/S0034-89101995000500004

Echevarria-Guanilo ME, Dantas RA, Farina JA Jr, Alonso J, Rajmil L, Rossi LA. Reliability and validity of the Impact of Event Scale (IES): version for Brazilian burn victims. J Clin Nurs. 2011 Jun;20(11-12):1588-97. https://doi.org/10.1111/j.1365-2702.2010.03607.x

Kaizer UAO, Alexandre NMC, São-João T, Rodrigues RCM. Psychometric properties of the freiburg life quality assessment for wounds among burned patients. J Nurs Meas. 2018 Apr 1;26(1):90-105. https://doi.org/10.1891/1061-3749.26.1.90

Oliveira RC, Borges KNG, Azevedo CBS, Inocencio MD, Luz MS, Maranhão MGM, Lucena MM, Paula MB, Oliveira RS, Pellizzer LGM. Trauma por queimaduras: uma análise das internações hospitalares no Brasil. REAS. 2020;12(12):e5674. https://doi.org/10.25248/reas.e5674.2020

Lip HTC, Tan JH, Thomas M, Imran FH, Mat TNAT. Survival analysis and mortality predictors of hospitalized severe burn victims in a Malaysian burns intensive care unit. Burns Trauma. 2019 Jan 28;7:3. https://doi.org/10.1186/s41038-018-0140-1

Kwak IS, Park SY, Choi YH, Cho SI, Yang YS, Cho YS, Choi MG, Seo CH, Park CW, Kim HO. Clinical and histopathological features of post burn pruritus. J Burn Care Res. 2016 Nov/Dec;37(6):343-9. https://doi.org/10.1097/BCR.0000000000000392

Reszke R, Szepietowski JC. Itch and psyche: bilateral associations. Acta Derm Venereol. 2020 Jan 7;100(2):adv00026. https://doi.org/10.2340/00015555-3346

Van Loey NEE, de Jong AEE, Hofland HWC, van Laarhoven AIM. Role of burn severity and posttraumatic stress symptoms in the co-occurrence of itch and neuropathic pain after burns: a longitudinal study. Front Med (Lausanne). 2022 Oct 12;9:997183. https://doi.org/10.3389/fmed.2022.997183

Spronk I, Van Loey NEE, Sewalt C, Nieboer D, Renneberg B, Moi AL, Oster C, Orwelius L, van Baar ME, Polinder S; Quality of life study group. Recovery of health-related quality of life after burn injuries: an individual participant data meta-analysis. PLoS One. 2020 Jan 10;15(1):e0226653. https://doi.org/10.1371/journal.pone.0226653

Boersma-van Dam E, van de Schoot R, Hofland HWC, Engelhard IM, Van Loey NEE. Individual recovery of health-related quality of life during 18 months post-burn using a retrospective pre-burn measurement: an exploratory study. Qual Life Res. 2021 Mar 30(3):737-49. https://doi.org/10.1007/s11136-020-02678-0

Tracy LM, Edgar DW, Schrale R, Cleland H, Gabbe BJ; BRANZ Adult Long-Term Outcomes Pilot Project participating sites and working party. Predictors of itch and pain in the 12 months following burn injury: results from the Burns Registry of Australia and New Zealand (BRANZ) Long-Term Outcomes Project. Burns Trauma. 2020 Feb 27;8:tkz004. https://doi.org/10.1093/burnst/tkz004

Samhan AF, Abdelhalim NM. Impacts of low-energy extracorporeal shockwave therapy on pain, pruritus, and health-related quality of life in patients with burn: a randomized placebo-controlled study. Burns. 2019 Aug;45(5):1094-101. https://doi.org/10.1016/j.burns.2019.02.007

Published

2024-06-06

How to Cite

1.
Bispo RR, Gonçalves N, Andrechuk CRS, Rodrigues RCM. Pruritus in burn victims: relationship with anxiety, depression, and post-traumatic stress. ESTIMA [Internet]. 2024 Jun. 6 [cited 2024 Nov. 21];22. Available from: https://www.revistaestima.com.br/estima/article/view/1468

Issue

Section

Original article