pain anxiety of burn patients
Burn is a challenge of today society that causes irreversible damages and other issues in the burn patient and the family (Harorani and Safarabadi, 2016). Burn is a painful form of trauma that mostly creates disability in patients. According to the WHO, 300 thousand individuals die every year because of burn and the consequences. In addition, more than 95% of the death cases caused by burn happen in countries with low-average income (WHO, 2008). Every year, 725 thousand accidents happen in Iran that cause burn in the victims. Given the available statistics, the mortality rate in hospitalized burn patients is higher in Iran compared to the developed countries (Aghakhani et al., 2015). Studies have shown a high level of anxiety in burn patients (Jain et al., 2017, Mohammed and Ramprasad, 2013). Such anxiety is not only due to burn wound but it is also due to psychological issues caused by the burn (Ghezljeh et al., 2017). Anxiety is a common response after physical and emotional trauma and its highly prevalent in burn patients. Several studies have reported that anxiety in patients attenuates physical and emotional performance and increases the severity of pain as well (Chester et al., 2018).
On the other hand, pain and anxiety in burn patients have a reciprocal relationship so that anxiety intensifies pain in burn patients and vice versa (Seyyed-Rasooli et al., 2016). Pain anxiety is a new field of chronic pain, fear, and anxiety studies. The majority of studies have shown that anxiety affects pain and there is a mutual relationship between these two concepts (Gilasi et al., 2014). Pain anxiety has significant effects on pain experiences. The most important effect of anxiety on chronic pain is that patients may develop a specific assessment of pain that makes them alert about the painful or threatening emotions and fear of painful emotions in future (Mazlom et al., 2017a). Burn patients have to undergo painful therapeutic measures that create a high level of anxiety experienced by therapeutic measures (Harorani and Safarabadi, 2016). Expecting pain anxiety increases the patient’s concerns during therapeutic care and attenuates the ability to sustain pain. Pain anxiety is a predictor of behaviors that signal pain and increase hospitalization term and post-trauma stress anxiety. Physical limitations have a role in development and expansion of chronic pains and anxiety disorder (Rafiei et al., 2010). Pain anxiety has a behavioral mechanism in which anxiety about movement and experiencing physical damage plays a role in continuity of pain (Burns-Nader et al., 2017). Studies have supported the major role of pain anxiety in creating disability in individuals with chronic and acute pain even when biological-medical variable and pain severity are controlled (Griggs et al., 2017). If treatment pain anxiety is not controlled, it leads to fear, insomnia, depression, evident disabilities, inefficient mental coping, and uncooperative attitudes in the patient. Therefore, it is important to implement efficient intervention about pain anxiety during and after therapeutic measures (Mazlom et al., 2017a). Anxiety management requires examining and determining the factors .