Overcoming a Fear of Hospitalization Post-Burn Injury

For newly injured survivors and loved ones, the most challenging part of recovery is going home. However, once home, they often face new challenges in handling the emotional and mental aspects of recovery. Both survivors and loved ones can overlook or underestimate the toll that the secondary trauma of potential mental health complications can make some people develop nosocomephobia.  

This long word that no one has heard of means fear of admittance to a hospital or feeling anxious and confused about a loved one in the hospital. For many burn survivors and family members, the timing around the fear of hospitalization often doesn’t make sense. Burn survivors and loved ones can feel crushed when the survivor seemed to be doing so well only to have to return for psychiatric concerns or additional burn treatments. 

Factors Contributing to Secondary Trauma in Burn Survivors 

The National Library of Medicine, an official federal government organization, states that burns are physically, psychologically, and economically challenging injuries. A few of the leading causes of psychological distress and secondary trauma after a burn injury are listed below:

Anxiety and Low Self-Esteem 

Having a burn that requires extensive, ongoing treatment can be a source of anxiety for some survivors and their loved ones. Third-degree burns affect the epidermis, fat, and dermis. Second-degree burns affect the epidermis and the dermis, while first-degree burns affect only the top layer of skin. 

The depth of the original burn also impacts whether survivors develop ongoing society. Those with deep burns, which was 63 percent, reported struggling with anxiety and low self-esteem. Just over 41 percent of people with third-degree burns in the government’s 2017 study report feelings of low self-esteem. 

Anxiety can make people fearful of having the same type of injury happen again, especially if someone else’s negligence caused the original injury. People who were normally sociable can become reclusive, only leaving home when necessary. Having low self-esteem makes it challenging for people to advocate for themselves at work, in the medical community, and with their family and friends. 

Depression 

Clinical depression is a common mental health ailment that goes beyond just feeling sad. Everyone feels sad at times, but for burn survivors, depression can hit when they feel like they don’t have as much control of their own lives as they used to. The National Library of Medicine indicated in its 2017 report that up to 95 percent of burn survivors experienced moderate to severe depression after receiving treatment for their original injury. 

As with anxiety and low self-esteem, the type and depth of the original injury produce higher self-reported scores on mental health exams. Typical symptoms include:

• Feeling hopeless or helpless.

• Crying and sadness, anger.

• Losing or gaining weight without trying.

• Losing pleasure in previous hobbies.

• Sleeping too much or not enough. 

Other Common Feelings of Distress for Burn Survivors 

Burn survivors and their loved ones struggle with many complicated emotions due to their injury, treatment, and time spent in the hospital. While anxiety, self-esteem, and depression are all diagnosable conditions, other symptoms are not so easy to identify. We have found the following feelings and frustrations to be common among burn survivors: 

• Contractures and scars cause permanent changes in appearance 

• Disruption of daily responsibilities and roles 

• Disruption of sexual relationship with partner 

• Financial implications of the incident, especially for those who received hospital treatment or those who worry about going back to the hospital 

• Frustration with physical and/or occupational therapy 

• Generalized worry about the future 

• Inability to return to work or school for the time being 

• Limitations in physical activities, resulting in dependence on others 

• Physical pain, including itching and the pain that comes with nerve and skin healing 

• Thinking about the accident or assault over and over, including thinking of or grieving other people involved 

Dealing with these factors on a daily basis would be enough to make anyone feel anxious and depressed. However, those feelings don’t need to be the default. Most doctors recommend acknowledging them and taking steps to increase life satisfaction while decreasing mental health symptoms. Fear of the hospital is often the presenting symptom, but it masks much more troubling symptoms, and medical professionals are available to help.