guided imagery on the quality and severity of pain and pain anxiety caused by dressing change in burn patients
Burn is an injury caused by the heat generated by biological, chemical, electrical, and physical agents that causes local and systemic responses [1]. A burn accident is considered as one of the worse possible tragedies in modern society [2] and it can happen in all age, social, and economic groups [3]. The high prevalence of burns and the damages lead to a high mortality rate caused by burn and social and economic costs to the society. This means that burn victims needs special attention [4].
Every year, 500 thousand individuals suffer a burn injury in the USA and 40 thousand of them need hospitalization. The annual expenses of treatment and cares for them is about 1US$ billion [5]. Individuals who suffer burn injuries experience physical, psychological, and economic problems and pain is one of the physical problems [6]. Burn pain is one of the major problems for burn patients [7]. However, the most severe experience of pain is experienced during therapeutic procedures such as dressing change and if not attenuated, it leads to prolonged stress responses after burn, unrest, dissatisfaction, delayed rehabilitation, prolonged hospitalization, and a decrease in the quality of life in patients [8-9]. In addition, pain increases the body metabolism, which intensifies malnutrition, the immunity system failure, and infection susceptibility [10]. Sever pain during dressing change causes side-effects like peptic ulcer and spiritual-mental side-effects. In some cases, patients might experience faint, blood pressure decrease, urinary incontinence, fecal incontinence, and shock [11]. Therefore, pain management in patients with burn injuries should a priority in care decisions [12].
Among the other side-effects of burin are spiritual-mental side-effects and anxiety is the most severe of them [13]. Through increasing pain severity, anxiety degrades physical performance of the burn patient. In fact, anxiety is a common response after a physical and emotional trauma that is very common in burn victims. Anxiety constitutes a major part of pain experience in burn patients [14].
The main form of anxiety in burn patient is the pain-caused anxiety that is increased by a sense of fear and expecting painful procedures. In many cases, anxiety appears before, during, and after painful procedures like dressing change. If not treated, the anxiety leads to fear, sleep deprivation, depression, disability, inefficient mental coping, and reluctance to adhere treatment plant. In light of this, managing pain-caused anxiety before, during, and after therapeutic interventions such as dressing change is imperative [15].
Pain and anxiety control methods include pharmaceutical and non-pharmaceutical methods and among the latter methods are benzodiazepines and narcotics that are prescribed for burn patients [16]. However, due to the side-effects caused by using high doses of narcotics and sedatives in long-run, many researchers are looking for non-pharmaceutical methods to control pain and anxiety in burn patients. Complementary medicine is one of the approaches to alleviate pain and unrest in patients [9, 17].