Moving the lenses of trauma - Trauma-informed care in the burns care setting

Michelle Cleary; Sancia West; Rachel Kornhaber; Denis Visentin; Amanda Neil; Josef Haik; Cathy Kezelman; Loyola McLean

doi:10.1016/j.burns.2020.01.011

Moving the lenses of trauma - Trauma-informed care in the burns care setting

Burns. 2020 Sep;46(6):1365-1372. doi: 10.1016/j.burns.2020.01.011. Epub 2020 Mar 17.

Authors

Michelle Cleary¹, Sancia West², Rachel Kornhaber³, Denis Visentin⁴, Amanda Neil⁵, Josef Haik⁶, Cathy Kezelman⁷, Loyola McLean⁸

Affiliations

¹ School of Nursing, College of Health and Medicine, University of Tasmania, Sydney, NSW, Australia. Electronic address: michelle.cleary@utas.edu.au.
² School of Nursing, College of Health and Medicine, University of Tasmania, Sydney, NSW, Australia.
³ School of Nursing, College of Health and Medicine, University of Tasmania, Sydney, NSW, Australia; Department of Plastic and Reconstructive Surgery, National Burns Center, Sheba Medical Center, Tel Hashomer, Israel.
⁴ School of Health Sciences, College of Health and Medicine, University of Tasmania, Sydney, NSW, Australia.
⁵ Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
⁶ School of Nursing, College of Health and Medicine, University of Tasmania, Sydney, NSW, Australia; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Plastic and Reconstructive Surgery, National Burns Center, Sheba Medical Center, Tel Hashomer, Israel.
⁷ Blue Knot Foundation, Sydney, New South Wales, Australia.
⁸ Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Westmead Psychotherapy Program, Western Sydney Local Health District, Cumberland Hospital, Parramatta, NSW, Australia; Discipline of Psychiatry, Faculty of Medicine and Health, The University of Sydney, Australia; Consultation Liaison Psychiatry, Royal North Shore Hospital, Sydney, NSW, Australia.

PMID: 32192867
DOI: 10.1016/j.burns.2020.01.011

Abstract

Trauma impacts people's coping mechanisms with their ability to function posing risks to their capacity to manage and respond appropriately to stressors, and to recover. Trauma informed care recognises the needs of survivors by focusing on system-wide design and support during recovery, minimising the risk of re-traumatisation, and maximising choice and empowerment for new adaptations and post-traumatic growth. The principles of TIC are currently not being fully utilised in burns practice, including for severe burns, with the nature, extent and impacts of trauma not being fully understood or acknowledged. Those who sustain a burn injury have an increased risk for developing psychosocial issues that can extend to the family unit, and people with pre-existing mental disorders are more likely to sustain a burns injury, experiencing extended hospitalisation and rehabilitation and being less likely to adhere to burns care. With the application of trauma-informed care within the burns setting, along with an understanding and acknowledging the link between trauma, burns injuries and mental health, health care professionals can minimise potential negative psychological impacts. Investing resources is now essential to effectively address the "trauma deficit" in the area of burns recovery.

Keywords: Burns; Mental health; Recovery; Trauma; Trauma-informed care.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Adaptation, Psychological
Burns / psychology
Burns / therapy*
Humans
Mental Health
Posttraumatic Growth, Psychological
Psychological Trauma*
Survivors