Клинический разбор в общей медицине №08 2026

Консультативная психиатрическая помощь семье, пострадавшей от острой ожоговой травмы 

Д.Ф. Рахма, А. Карима, Х. Сарасвати, П. Аризона

1 Университетская больница общего профиля им. доктора Соетомо, Сурабая, Индонезия;
2 Университет Айрлангга, Сурабая, Индонезия

azimatul.karimah@fk.unair.ac.id

Аннотация
Ожоговые травмы часто сопровождаются значительным психологическим дистрессом, особенно если они случаются внезапно у нескольких членов семьи. Эмоциональные реакции, такие как тревога, страх и чувство неопределенности, могут влиять на восприятие боли, приверженность лечению и процесс выздоровления. Консультативная психиатрия важна для распознавания таких реакций на ранней стадии и поддержки как пациентов, так и осуществляющего лечение коллектива врачей. Мы рассмотрим случай семьи, которая получила острые ожоговые травмы в результате несчастного случая бытового характера, состоящей из отца, матери и младенца. Все трое были госпитализированы для лечения ожогов, им понадобилась консультация психиатра, чтобы преодолеть тревогу, связанный с болью дистресс, а также решить семейные проблемы. Психодиагностика выявила высокие показатели стресса, связанного со страхом инвалидизации, финансовыми трудностями и беспокойством родителей за ребенка. Поддерживающая психотерапия, обучение психологической самопомощи и короткий курс лечения анксиолитиками были применены параллельно со скоординированным взаимодействием с бригадой специалистов по лечению ожогов. Вмешательства помогли уменьшить стресс, улучшить эмоциональную регуляцию и повысить приверженность лечению. Представленный случай показывает, как вмешательство психиатра на раннем этапе может помочь пациентам и семьям, столкнувшимся с острой ожоговой травмой, особенно если травмированы несколько членов семьи. Включение психологической помощи в схему лечения ожогов может улучшить эмоциональную адаптацию, повысить качество общения и укрепить сотрудничество в процессе лечения.
Ключевые слова: ожоги, консультативная психиатрия, психологический стресс, восприятие боли, семейные отношения.
Для цитирования: Рахма Д.Ф., Карима А., Сарасвати Х., Аризона П. Консультативная психиатрическая помощь семье, пострадавшей от острой ожоговой травмы. Клинический разбор в общей медицине. 2026; 7 (8): 52–54. DOI: 10.47407/kr2026.7.8.00900

Introduction
Burn injury is a physically and emotionally distressing experience that often leads to anxiety, fear, and heightened pain perception during treatment [1]. These reactions may influence coping, cooperation with care, and overall recovery. When more than one family member is affected, the psychological burden may be greater due to shared concern and uncertainty [2, 3]. Liaison psychiatry can play an important role in recognizing these difficulties early and supporting both the patient and the treating team [4, 5]. This case report describes a family who sustained acute burn injuries and required psychiatric consultation during hospitalization, illustrating the importance of integrating psychological care into burn management.

Case presentation
A family of three, consisting of a 29-year-old father, a 25-year-old mother, and their 10-month-old daughter, was admitted to the burn unit following an explosion of liquefied petroleum gas in their single room boarding house. The incident occurred in the early morning while the mother was cooking breakfast, with the father and infant asleep at the time. All three sustained partial thickness burn injuries and were initially treated at a nearby hospital before being referred to the regional hospital approximately 16 hours later for definitive care. Emergency debridement was performed for all patients upon arrival, and they were subsequently managed together in a single room in the burn unit. During hospitalization, the maternal grandmother assisted with the infant’s daily care and remained present as a key source of support for the family.
Case 1. The father sustained partial thickness burns involving the extremities and required repeated wound care procedures. Although he remained medically stable, he reported severe procedural pain, persistent sleep disturbance, and ongoing worry about his physical recovery and ability to return to work as the family’s primary provider. He appeared tense and withdrawn during interactions and described intrusive recollections of the explosion, frequent nightmares, hypervigilance, and avoidance of reminders related to the incident. He also expressed marked guilt and self-blame, particularly regarding his perceived failure to protect his wife and child.
Case 2. The mother sustained burns of moderate severity and did not develop medical complications. Psychologically, she appeared increasingly anxious and emotionally overwhelmed during the course of treatment, particularly during wound care and when witnessing her child’s procedures. She reported poor sleep, reduced appetite, and persistent worry about her child’s recovery, alongside feelings of guilt related to the accident. Although she attempted to remain composed, she demonstrated heightened vigilance and difficulty calming herself following painful procedures, often suppressing her own distress in order to focus on her child.
Case 3. The 10-month-old infant sustained partial thickness burns requiring inpatient wound care and remained hemodynamically stable throughout admission. She became visibly distressed during medical procedures, crying and showing signs of fear when approached by healthcare staff. These episodes significantly heightened parental anxiety and frustration, as both parents felt emotionally compelled to comfort her but were often physically unable to do so. The grandmother described the incident as catastrophic for the family and assumed a stabilizing role, providing practical assistance with childcare while also attempting to contain her own emotional response.
Given the degree of emotional distress observed across family members, liaison psychiatry was consulted to assist with psychological assessment and support. Evaluation identified acute stress reactions related to pain, fear of disability, parental guilt, and disruption of family roles. Interventions included supportive psychotherapy, psychoeducation regarding normal stress responses to trauma, relaxation techniques, and close collaboration with the burn care team to promote consistent communication and reassurance. Short term anxiolytic medication was prescribed when clinically appropriate. Over the course of hospitalization, the family demonstrated improved emotional regulation, reduced anxiety during procedures, and better engagement with ongoing burn treatment.

Discussion
Burn injury is not only a physical trauma but also a psychological crisis that often produces anxiety, fear, and distress, especially during painful procedures such as dressing changes and debridement. These emotional reactions may heighten the perception of pain, interfere with sleep, and influence cooperation with treatment [6, 7]. When more than one family member is affected, the psychological impact is multiplied by shared worry, guilt, and uncertainty about recovery [2, 3]. In this family, the parents experienced significant anxiety related to pain, potential disability, and concern for their infant’s wellbeing. These responses are consistent with the understanding that burn trauma affects identity, roles, security, and long-term expectations, not only physical health.
Liaison psychiatry plays an important role in supporting patients and medical teams in acute burn care [4, 5]. Early psychiatric involvement allows anxiety and maladaptive coping to be identified before they evolve into persistent psychological problems. Simple interventions such as psychoeducation, emotional support, reassurance, and structured communication can reduce distress and strengthen patients’ ability to cope with treatment demands. Collaboration between psychiatry and surgical teams also helps ensure that both physical and emotional needs are addressed together, rather than separately [2, 8]. In this case, psychiatric support helped the parents regulate anxiety, understand their stress responses, and remain engaged with care. This highlights the value of integrating psychological assessment and support into routine burn management, particularly when a traumatic event affects the entire family.

Conclusion
This family case highlights the importance of routine psychological assessment in acute burn care, particularly when multiple family members are injured. Severe anxiety, guilt, and distress may amplify pain perception and interfere with procedural tolerance and recovery, even in the absence of major psychiatric illness. Early liaison psychiatry involvement can assist burn teams in identifying acute stress reactions, guiding communication, and implementing timely supportive interventions that improve patient cooperation and emotional stability. Incorporating psychiatric consultation into standard burn management may help prevent escalation of distress, support family coping, and facilitate continuity of care during prolonged and painful treatment courses.

Conflict of interests. The authors declare that there is not conflict of interests.
Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

Funding. This research received no external funding.
Финансирование. Исследование проведено без финансовой поддержки.

Ethical considerations and consent. Informed consent for publication of clinical details was obtained from the patient and her family. All efforts were made to protect patient confidentiality and anonymity throughout the reporting process.
Соблюдение этических стандартов и согласие. От пациентки и ее семьи получено добровольное информированное согласие на публикацию клинических данных. Были предприняты все усилия для защиты конфиденциальности и анонимности пациентов на протяжении всего процесса подготовки публикации.

Список литературы доступен на сайте журнала https://klin-razbor.ru/
The list of references is available on the journal‘s website https://klin-razbor.ru/

Information about the authors
Информация об авторах

Dina Faizatur Rahmah – MD, Department of Psychiatry, Dr Soetomo General Academic Hospital; Department of Psychiatry, Faculty of Medicine, Universitas Airlangga

Дина Файзатур Рахма – доктор медицины, отд-ние психиатрии, Университетская больница общего профиля им. доктора Соетомо; каф. психиатрии, медицинский фак-т, Университет Айрлангга

Azimatul Karimah – MD, Department of Psychiatry, Dr Soetomo General Academic Hospital; Department of Psychiatry, Faculty of Medicine, Universitas Airlangga. E-mail: azimatul.karimah@fk.unair.ac.id; ORCID: 0000-0002-0261-7878

Азиматуль Карима – доктор медицины, отд-ние психиатрии, Университетская больница общего профиля им. доктора Соетомо; каф. психиатрии, медицинский фак-т, Университет Айрлангга. E-mail: azimatul.karimah@fk.unair.ac.id; ORCID: 0000-0002-0261-7878

Hastika Saraswati – MD, Department of Plastic Surgery, Dr Soetomo General Academic Hospital; Department of Plastic Surgery, Faculty of Medicine, Universitas Airlangga

Хастика Сарасвати – доктор медицины, отд-ние пластической хирургии, Университетская больница общего профиля им. доктора Соетомо; каф. пластической хирургии, медицинский фак-т, Университет Айрлангга

Popy Arizona – MD, Department of Psychiatry, Dr Soetomo General Academic Hospital; Department of Psychiatry, Faculty of Medicine, Universitas Airlangga

Попи Аризона – доктор медицины, отд-ние психиатрии, Университетская больница общего профиля им. доктора Соетомо; каф. психиатрии, медицинский фак-т, Университет Айрлангга

Поступила в редакцию: 27.01.2026
Поступила после рецензирования: 10.02.2026
Принята к публикации: 12.02.2026

Received: 27.01.2026
Revised: 10.02.2026
Accepted: 12.02.2026