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Harold B. Crasilneck, Ph.D.; Jerry A. Stirman, M.D.; Ben J. Wilson, M.D.; Erasmus J. McCranie, M.D.; Morris J. Fogelman, M.D.
JAMA. 1955;158(2):103-106. doi:10.1001/jama.1955.02960020009003.
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The definitive and supportive care of the severely burned person during the early phase of injury is difficult as a result of the severe physiological derangements that occur. The prolonged care of the burned patient through the later phases of reconstruction and rehabilitation may be even more difficult, for the injured person frequently makes poor psychological adaptations to his injury, such as becoming withdrawn and passively uncooperative or frankly negativistic toward the treatment that is intended to overcome the structural and functional effects of thermal injury. Thus, a vicious cycle becomes established in which the emotional responses to the injury and to its debilitating sequelae tend to delay recovery. In order that the management of the late phase be definitive then, the patient's hostility or other unacceptable adaptation mechanisms must be overcome and replaced by a willingness to cooperate in the treatment measures. If this aspect of the late management


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