Mediational Models of Pain, Mental Health, and Functioning in Individuals With Burn Injury.

Purpose/Objective: Despite the increasingly high number of individuals who survive burns and the documented impairments in functioning across psychological, work, sexual, and interpersonal domains, there has been a dearth of research investigating connections between pain and functioning in these domains after burn injury. The purpose of the current study was to investigate the relationships among pain, mental health, and functioning of individuals with burn injury. It was hypothesized that pain after burn would yield direct effects on functioning (work, sexual, and interpersonal), as well as indirect effects on functioning through depression and anxiety. Research Method/Design: Eighty-seven individuals with burn injury completed a questionnaire assessing study constructs in an outpatient burn center setting. Results: Pain was positively related to depression and anxiety and inversely related to all three forms of functioning. In a series of mediational models, depression and anxiety simultaneously and partially mediated the relationship between pain and work functioning. Depression fully mediated the relationship between pain and sexual functioning, as well as partially mediated the relationship between pain and interpersonal functioning. The models explained 39.2% of the variance in work functioning, 28.4% in sexual functioning, and 35.6% in interpersonal functioning. Conclusions/Implications: Although the cross-sectional findings are unable to conclude causality, individuals with burn injury experiencing pain may benefit from a biopsychosocial treatment approach while also addressing symptoms of depression and anxiety. Impact and Implications: Individuals with burn injury often experience pain, which can impair their level of functioning in important life domains. This study found that pain in individuals with burn injury may initiate a cascade of effects on mental health and functioning across work, sexual, and interpersonal domains. Individuals with burn injury experiencing pain may benefit from a biopsychosocial treatment approach that includes a focus on depressive and anxious symptoms. [ABSTRACT FROM AUTHOR]