Elsevier

Hand Clinics

Volume 19, Issue 1, February 2003, Pages 41-49
Hand Clinics

Review article
Psychological aspects of mutilating hand injuries

https://doi.org/10.1016/S0749-0712(02)00056-2Get rights and content

Section snippets

Injury-related issues

It is frequently the assumption among health care professionals that severity and extent of injury plays a predominant role in the individual's psychological, social, and occupational adjustment to that injury. There is, however, limited correlation between tissue damage and functional loss and the psychological adjustment to traumatic injury [7], [8], [9], [10], [11]; there is limited correlation between mutilating hand injuries and psychological adjustment as well. Lee et al examined the

Psychological responses to a mutilating hand injury

Individuals experiencing a mutilating hand injury likely experience intense emotional reactions as a result of their injury, subsequent treatment, and immediate or long-term disability. Reactions may be experienced as a wide range of emotions including anxiety, depression, guilt, fear, frustration, sadness, and anger, among others [15]. Such a range of emotions is normal, and strong emotional reactions should not necessarily be viewed as abnormal. Whether the affective response warrants a

Promoting healthy adjustment to injury

The assumption cannot be made that all individual's who have undergone a mutilating hand injury will experience an episode of adjustment-related difficulties. These individuals are not doomed to experience depression, ASD, or PTSD. Although variation in mood and affect undoubtedly occur as the individual comes to terms with the injury, assumptions about the expected course of adjustment should be avoided. The course of adjustment will vary greatly among individuals, as will the factors that

Specific psychological intervention strategies

Fortunately, for the individual who is experiencing significant difficulties in their adjustment to a mutilating hand injury—either immediately or long-term—there are psychological interventions available that have proven efficacy. The sooner the problem is identified and appropriate treatment is initiated, the more likely the individual is to recover and return to normal psychosocial functioning. In the case where a referral for mental health services is indicated, it is important to convey to

Pain in mutilating hand injuries

Pain has been identified as one of the most acutely stressful aspects of traumatic injuries and their treatment—particularly if the pain is perceived as poorly controlled or unavoidable [16]. The problem presented by pain should be addressed in a timely manner in the treatment of a mutilating hand injury, lest it negatively influence the immediate and long-term functional outcome.

Poorly managed pain can lead to maladaptive psychological and emotional reactions such as anger, anxiety, phobic

Summary

The immediate and long-term outcome of a mutilating hand injury can be positively influenced by health care professionals adopting a biopsychosocial perspective toward treatment and management. Such an injury produces a psychological and social impact that should be openly and candidly addressed with the injured individual and with the family. The earlier and the more skillfully these issues are addressed, the more likely it is that psychological factors will not impede functional outcome.

Acknowledgements

The author thanks Dr. Charles Callahan of Memorial Medical Center for his helpful comments and suggestions.

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