| This study is a part of"Study on Psychological Rehabilitation Model of Disabilities Caused by Trauma or War". The aim of this study is to develop and test a psychological intervention model for burn patients at early stage of treatment, based on characteristics of psychological reaction and the positive factors promoting psychological adaptation of burn patients, in order to provide instruction and guide for nurses'providing psychological care and reduce heavy burden on patients, family and society because of psychological disorders of burn patients. This study has three parts.Part one, development of psychological intervention model of burn patients at early stage of treatment. Based on brief review of articles on psychological intervention of trauma and burn patients, with stress theory as theory foundation, combined with Roy's adaptation model, crisis intervention techniques and positive psychology, theoretical structure of psychological intervention was developed. After analyzing various psychological intervention strategies, according to principles of nurse-administered and easily accepted by burn patients, psychological intervention model of burn patients was developed.Part two, qualitative study of burn patients with significant burn injury. The aim was to track the experiences of burn patients in every rehabilitation stage, forward testify the importance of early psychological intervention and provide proof for construction of intervention model. Descriptive phenomenological design was the methodological basis for this part. Eight purposively selected burn survivors were interviewed.Content analysis indicated that severely burned patients experienced loss, adaptation and growth process during the rehabilitation course. Optimistic personality, positive coping styles, and social support contributed to the positive adaptation of Chinese burned patients. Positive coping styles included downward social comparison and positive reappraisal. Social support included emotional support from a significant guy and proper information support. Instruction on coping strategies to patients were needed especially the situation was uncontrollable.Part three, experimental study of clinical intervention on burned patients. A sample of 47 burn patients admitted with TBSA more than 10% was distributed to attend either a 4-week psychological intervention program or no intervention after they were admitted and were assessed pre- and post intervention with HADS and General self-efficacy Scale (GSES). The majority of participants were male, married, and had sudden burn. Demographic statistics revealed that the incident of anxiety and depression were respectively 89.4% and 78.7%. T-test and ANOVA indicated that participants in both groups had no significant differences when admitted and improved significantly over time on overall HADS, anxiety subscale, and depression subscale (P<0.05). Participants in the intervention group showed more improvement than those in no intervention group on overall HADS, anxiety subscale, depression subscale and GSES (P<0.05). Correlation analysis revealed that education level and TBSA was associated with patients'anxiety and depression, which indicated that the psychological intervention model was helpful in enhancing self-efficacy and reducing anxiety and depression of burn patients.Discussion and Conclusion: Burn survivors experience a series of traumatic assaults to the body and mind which present extraordinary challenges to psychological resilience, especially that psychological reaction at early stage was related to the rehabilitation and outcome of the patients. Psychological rehabilitation process tree map developed on qualitative research and psychological intervention model for burn patients based on literature review and clinical tests can help emphasize the importance of early psychological assessment and intervention to promote psychological adaptation and guide them make full use of patients'self-efficacy to achieve better psychological and physical rehabilitation.
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