The first broad, long-term objective of this project is to improve pain control in adults and children who are hospitalized for the care of severe burn injuries. This will be accomplished by determining the optimal doses of opioid drugs (e.g., morphine and its derivatives), and the types of adjunctive interventions (pharmacological, psychological) which have the greatest analgesic effect for particular patients. A second broad objective is to improve knowledge regarding the long-term psychological adjustment of people surviving severe burn injuries.
The specific aims of the project with adult burn patients include testing 1) whether scores on psychometric tests predict response to lorazepam (i.e., the tranquilizer Ativan) and hypnosis, and 2) which variables predict long-term psychological adjustment.
The specific aims for the pediatric burn population are 1) to gather better information about drug dosing for infants and toddlers and determine whether regular schedules of dosing are superior to as needed medication application, and 2) to compare psychological and pharmacological adjuncts for children aged 3-12. The implications of this project for health care include reducing unnecessary suffering from trauma, improving treatment outcome of burn injuries through reducing pain mediated stress, minimizing the financial burden of untreated pain, using burn pain as a model for other acute etiologies of pain,and improving quality of life after disability. To accomplish these objectives, four studies have been proposed involving adult and pediatric patients hospitalized for care at a regional, university based burn center. The first study is a continuation of current research and involves determining what psychometric measures best predict the analgesic response of adults who are randomly assigned to lorazepam or hypnosis treatment conditions. The second study will involve comparing whether infants and toddlers (ages birth - 3 years) randomized to groups which receive regular schedules of medication or """"""""as needed"""""""" plans, show differences in observed behaviors indicative of pain. In the third study, burned children (aged 3-12 years) will be randomly assigned to conditions in which they receive psychological interventions or lorazepam for dressing change pain. Finally, the fourth study will involve a continuation of current research. Measures that predict long-term psychological outcome after burn injuries will be tested.
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