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Wang C, Deng Y, Yao Y, Tan H. Demoralization syndrome in burn patients: A cross-sectional study. Burns 2024; 50:1640-1651. [PMID: 38555238 DOI: 10.1016/j.burns.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/08/2024] [Accepted: 02/21/2024] [Indexed: 04/02/2024]
Abstract
AIMS To investigate the status of demoralization syndrome and the factors affecting demoralization in burn patients. METHODS This study employed a cross-sectional research design and utilized a face-to-face questionnaire to gather data from adult burn patients with burn depths classified as second-degree or higher. The Demoralization Scale Mandarin Version, the Perceived Social Support Scale, the Herth Hope Index, and the Medical Coping Method Questionnaire were used to assess the level of demoralization, perceived social support, sense of hope, and coping strategies, respectively. General information, including socio-demographic data and disease characteristics, were collected. The patients' level of demoralization was categorized as the mean ± 1 standard deviation of the DS-MV scores. The data was analyzed using IBM SPSS 26.0 software to explore the relationship between the variables. RESULTS This study included 381 burn patients with a mean DS-MV score of 34.62 ± 18.319. Of these, 66 (17.3%) had mild demoralization, 241 (63.3%) had moderate demoralization, and 74 (19.4%) had severe demoralization. Cause of burn, total burn area, average monthly income of the individual, occupation, sense of hope, perceived social support, and medical coping strategies were the important factors associated with the severity of demoralization in burn patients. CONCLUSIONS Patients with burn injuries exhibit a notable prevalence and severity of demoralization indicating focused attention. By considering associated risk factors, healthcare professionals can devise and execute tailored intervention strategies aimed at mitigating the occurrence and intensity of demoralization in burn patients.
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Affiliation(s)
- Chang Wang
- School of Nursing, Guizhou Medical University, No. 9 Beijing Road, Yunyan District, Guiyang, China
| | - YunYun Deng
- School of Nursing, Guizhou Medical University, No. 9 Beijing Road, Yunyan District, Guiyang, China
| | - YiMing Yao
- Department of Nursing, Guangzhou Red Cross Hospital, Jinan University, No. 396, Tongfu Middle Road, Haizhu District, Guangzhou, China
| | - HuiYi Tan
- School of Nursing, Guizhou Medical University, No. 9 Beijing Road, Yunyan District, Guiyang, China; Department of Nursing, Guangzhou Red Cross Hospital, Jinan University, No. 396, Tongfu Middle Road, Haizhu District, Guangzhou, China.
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Ahmadi H, Mirza Aghazadeh Attari A, Ajoudani F, Lotfi M. Family-based education and follow-up program for patients with burns: A mixed assessment study. Burns 2024; 50:1671-1681. [PMID: 38604826 DOI: 10.1016/j.burns.2024.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 03/10/2024] [Accepted: 03/31/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Burn injuries are a major cause of morbidity and mortality worldwide, affecting not only the patients but also their families. Family-based education and follow-up program are interventions that aim to improve the quality of life and psychosocial outcomes of patients with burns and their families. However, we find a lack of evidence on the effectiveness and feasibility of these programs in different settings and populations. This study aimed to evaluate the features of the family-based education and follow-up program (FBEFP), a pilot project that was developed and implemented at the Tabriz Sina Teaching Hospital in 2020 to improve its burn care system. DESIGN A mixed-methods approach was used to collect and analyze both quantitative and qualitative data from various sources, such as, questionnaires, medical records, interviews and observation notes, to assess the content, process, and outcome of the program. The study followed the three steps of the CDC's framework for program evaluation: describing the program, measuring its effectiveness, and providing recommendations for improvement. RESULTS The results of this study revealed the positive impacts of the FBEFP on the patients' physical, psychological, and social outcomes and quality of life. 4.8% of the people in the follow-up group were re-admitted, while this amount was 7.2% in the group without follow-up. Although the number of readmissions was less in the non-follow-up group, statistically no significant difference was observed between the two ratios before and after follow-up. In order to evaluate satisfaction rates, In the follow-up group, 72 patients and in the non-follow-up group, 38 patients were reached. After converting these data to normal distribution, using t-tests, it was determined that the difference between the two studied groups was highly significant. In other words, the follow-up process had favorable results on satisfaction of the studied people. However, the study also identified some challenges and barriers in implementing the program, such as lack of resources, staff training, and family involvement. CONCLUSION FBEFP is a promising intervention that enhances the well-being of patients with burns and their families. However, more evidence is needed to support its effectiveness and feasibility in different contexts and populations. The study also provided valuable insights into the benefits and challenges of implementing a Family-Based Education and Follow-up Program for patients with burns in a low-resource setting. The study contributed to the development of guidelines and recommendations for future research and practice in this field.
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Affiliation(s)
- Homa Ahmadi
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Fardin Ajoudani
- School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Mojgan Lotfi
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
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Joshi MV, Bhakne P, Kulkarni CA, Palekar TJ, Phansopkar P. The Power of Movement: A Comprehensive Case Study of Physiotherapeutic Approaches in Electrical Injury Rehabilitation. Cureus 2024; 16:e64615. [PMID: 39149673 PMCID: PMC11324804 DOI: 10.7759/cureus.64615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 07/15/2024] [Indexed: 08/17/2024] Open
Abstract
Electrical injuries are common phenomena in developing countries, due to inadequate safety measures followed during day-to-day electrical repairs. Workplace injuries account for 20% of these. In some severe cases, electrical injuries lead to burns, indirect fracture dislocations, speech impairments, etc. Falls due to electrical injuries leading to secondary complications are very common and, even though not very severe, they do require immediate treatment and adequate rehabilitation. A 53-year-old male suffered a shoulder injury following an electrical shock. The patient also experienced irritation and speech disturbances. Examination revealed a reduced range of shoulder joints and tightness of muscles of the shoulder complex. Physiotherapy intervention included counseling for the patient and his family members, energy conservation methods for ease in daily activities, a rehabilitation protocol, and modified music therapy. Outcome measures used to assess the progression constituted the Shoulder Pain and Disability Index (SPADI), the Tampa Scale for Kinesiophobia (TSK), and the Depression and Anxiety and Stress Scale. Rehabilitation with adjunct therapy is effective in the overall improvement of the patient's condition concerning their mental health as well as physical health by early strength training.
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Affiliation(s)
- Medhavi V Joshi
- Musculoskeletal Physiotherapy, Dr. D. Y. Patil College of Physiotherapy, Dr. D. Y. Patil Vidyapeeth, Pune, IND
| | - Pallavi Bhakne
- Cardiorespiratory Physiotherapy, Dr. D. Y. Patil College of Physiotherapy, Dr. D. Y. Patil Vidyapeeth, Pune, IND
| | - Chaitanya A Kulkarni
- Community-Based Rehabilitation, Dr. D. Y. Patil College of Physiotherapy, Dr. D. Y. Patil Vidyapeeth, Pune, IND
- Public Health, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Tushar J Palekar
- Physical Medicine and Rehabilitation, Dr. D. Y. Patil College of Physiotherapy, Dr. D. Y. Patil Vidyapeeth, Pune, IND
| | - Pratik Phansopkar
- Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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Sinha S, Gabriel VA, Arora RK, Shin W, Scott J, Bharadia SK, Verly M, Rahmani WM, Nickerson DA, Fraulin FO, Chatterjee P, Ahuja RB, Biernaskie JA. Interventions for postburn pruritus. Cochrane Database Syst Rev 2024; 6:CD013468. [PMID: 38837237 PMCID: PMC11152192 DOI: 10.1002/14651858.cd013468.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
BACKGROUND Postburn pruritus (itch) is a common and distressing symptom experienced on healing or healed burn or donor site wounds. Topical, systemic, and physical treatments are available to control postburn pruritus; however, it remains unclear how effective these are. OBJECTIVES To assess the effects of interventions for treating postburn pruritus in any care setting. SEARCH METHODS In September 2022, we searched the Cochrane Wounds Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE (including In-Process & Other Non-Indexed Citations), Ovid Embase, and EBSCO CINAHL Plus. We also searched clinical trials registries and scanned references of relevant publications to identify eligible trials. There were no restrictions with respect to language, publication date, or study setting. SELECTION CRITERIA Randomised controlled trials (RCTs) that enrolled people with postburn pruritus to compare an intervention for postburn pruritus with any other intervention, placebo or sham intervention, or no intervention. DATA COLLECTION AND ANALYSIS We used the standard methodological procedures expected by Cochrane. We used GRADE to assess the certainty of the evidence. MAIN RESULTS We included 25 RCTs assessing 21 interventions with 1166 randomised participants. These 21 interventions can be grouped into six categories: neuromodulatory agents (such as doxepin, gabapentin, pregabalin, ondansetron), topical therapies (such as CQ-01 hydrogel, silicone gel, enalapril ointment, Provase moisturiser, beeswax and herbal oil cream), physical modalities (such as massage therapy, therapeutic touch, extracorporeal shock wave therapy, enhanced education about silicone gel sheeting), laser scar revision (pulsed dye laser, pulsed high-intensity laser, fractional CO2 laser), electrical stimulation (transcutaneous electrical nerve stimulation, transcranial direct current stimulation), and other therapies (cetirizine/cimetidine combination, lemon balm tea). Most RCTs were conducted at academic hospitals and were at a high risk of performance, attrition, and detection bias. While 24 out of 25 included studies reported change in burn-related pruritus, secondary outcomes such as cost-effectiveness, pain, patient perception, wound healing, and participant health-related quality of life were not reported or were reported incompletely. Neuromodulatory agents versus antihistamines or placebo There is low-certainty evidence that doxepin cream may reduce burn-related pruritus compared with oral antihistamine (mean difference (MD) -2.60 on a 0 to 10 visual analogue scale (VAS), 95% confidence interval (CI) -3.79 to -1.42; 2 studies, 49 participants). A change of 2 points represents a minimal clinically important difference (MCID). Due to very low-certainty evidence, it is uncertain whether doxepin cream impacts the incidence of somnolence as an adverse event compared to oral antihistamine (risk ratio (RR) 0.64, 95% CI 0.32 to 1.25; 1 study, 24 participants). No data were reported on pain in the included study. There is low-certainty evidence that gabapentin may reduce burn-related pruritus compared with cetirizine (MD -2.40 VAS, 95% CI -4.14 to -0.66; 1 study, 40 participants). A change of 2 points represents a MCID. There is low-certainty evidence that gabapentin reduces the incidence of somnolence compared to cetirizine (RR 0.02, 95% CI 0.00 to 0.38; 1 study, 40 participants). No data were reported on pain in the included study. There is low-certainty evidence that pregabalin may result in a reduction in burn-related pruritus intensity compared with cetirizine with pheniramine maleate (MD -0.80 VAS, 95% CI -1.24 to -0.36; 1 study, 40 participants). A change of 2 points represents a MCID. There is low-certainty evidence that pregabalin reduces the incidence of somnolence compared to cetirizine (RR 0.04, 95% CI 0.00 to 0.69; 1 study, 40 participants). No data were reported on pain in the included study. There is moderate-certainty evidence that ondansetron probably results in a reduction in burn-related pruritus intensity compared with diphenhydramine (MD -0.76 on a 0 to 10 numeric analogue scale (NAS), 95% CI -1.50 to -0.02; 1 study, 38 participants). A change of 2 points represents a MCID. No data were reported on pain and adverse events in the included study. Topical therapies versus relevant comparators There is moderate-certainty evidence that enalapril ointment probably decreases mean burn-related pruritus compared with placebo control (MD -0.70 on a 0 to 4 scoring table for itching, 95% CI -1.04 to -0.36; 1 study, 60 participants). No data were reported on pain and adverse events in the included study. Physical modalities versus relevant comparators Compared with standard care, there is low-certainty evidence that massage may reduce burn-related pruritus (standardised mean difference (SMD) -0.86, 95% CI -1.45 to -0.27; 2 studies, 166 participants) and pain (SMD -1.32, 95% CI -1.66 to -0.98). These SMDs equate to a 4.60-point reduction in pruritus and a 3.74-point reduction in pain on a 10-point VAS. A change of 2 VAS points in itch represents a MCID. No data were reported on adverse events in the included studies. There is low-certainty evidence that extracorporeal shock wave therapy (ESWT) may reduce burn-related pruritus compared with sham stimulation (SMD -1.20, 95% CI -1.65 to -0.75; 2 studies, 91 participants). This equates to a 5.93-point reduction in pruritus on a 22-point 12-item Pruritus Severity Scale. There is low-certainty evidence that ESWT may reduce pain compared with sham stimulation (MD 2.96 on a 0 to 25 pressure pain threshold (PPT), 95% CI 1.76 to 4.16; 1 study, 45 participants). No data were reported on adverse events in the included studies. Laser scar revision versus untreated or placebo controls There is moderate-certainty evidence that pulsed high-intensity laser probably results in a reduction in burn-related pruritus intensity compared with placebo laser (MD -0.51 on a 0 to 1 Itch Severity Scale (ISS), 95% CI -0.64 to -0.38; 1 study, 49 participants). There is moderate-certainty evidence that pulsed high-intensity laser probably reduces pain compared with placebo laser (MD -3.23 VAS, 95% CI -5.41 to -1.05; 1 study, 49 participants). No data were reported on adverse events in the included studies. AUTHORS' CONCLUSIONS There is moderate to low-certainty evidence on the effects of 21 interventions. Most studies were small and at a high risk of bias related to blinding and incomplete outcome data. Where there is moderate-certainty evidence, practitioners should consider the applicability of the evidence for their patients.
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Affiliation(s)
- Sarthak Sinha
- Department of Comparative Biology and Experimental Medicine, University of Calgary, Calgary, Canada
| | - Vincent A Gabriel
- Departments of Clinical Neurosciences, Pediatrics and Surgery, University of Calgary, Calgary Firefighters' Burn Treatment Centre, Calgary, Canada
| | - Rohit K Arora
- Department of Comparative Biology and Experimental Medicine, University of Calgary, Calgary, Canada
| | - Wisoo Shin
- Department of Comparative Biology and Experimental Medicine, University of Calgary, Calgary, Canada
| | - Janis Scott
- Calgary Firefighters' Burn Treatment Centre, Calgary, Canada
| | - Shyla K Bharadia
- Departments of Clinical Neurosciences, Pediatrics and Surgery, University of Calgary, Calgary Firefighters' Burn Treatment Centre, Calgary, Canada
| | - Myriam Verly
- Division of Plastic and Reconstructive Surgery, University of Calgary, Calgary, Canada
| | - Waleed M Rahmani
- Department of Comparative Biology and Experimental Medicine, University of Calgary, Calgary, Canada
| | - Duncan A Nickerson
- Department of Plastic, Burn and Wound Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Frankie Og Fraulin
- Division of Plastic and Reconstructive Surgery, University of Calgary, Calgary, Canada
- Department of Surgery, Alberta Health Services, Alberta Children's Hospital, Calgary, Canada
| | - Pallab Chatterjee
- Department of Plastic Surgery, Surgical Division, Command Hospital Air Force, Bengaluru, India
| | - Rajeev B Ahuja
- Department of Plastic Surgery, Sir Ganga Ram Hospital, New Delhi, India
| | - Jeff A Biernaskie
- Department of Comparative Biology and Experimental Medicine, University of Calgary, Calgary, Canada
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Peng F, Chung CH, Koh WY, Chien WC, Lin CE. Risks of mental disorders among inpatients with burn injury: A nationwide cohort study. Burns 2024; 50:1315-1329. [PMID: 38519375 DOI: 10.1016/j.burns.2024.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 01/29/2024] [Accepted: 02/26/2024] [Indexed: 03/24/2024]
Abstract
OBJECTIVE This investigation identified the association between burn injuries and the risk of mental disorders in patients with no documented pre-existing psychiatric comorbidities. We also examined the relationship of injury severity and the types of injury with the likelihood of receiving new diagnoses of mental disorders. METHODS This population-based retrospective cohort study used administrative data extracted from the Taiwanese National Health Insurance Research Database (NHIRD) between 2000 and 2013. In total, 10,045 burn survivors were matched with a reference cohort of 40,180 patients without burn injuries and were followed to determine if any mental disorder was diagnosed. Patients diagnosed with mental disorders in the five years before study initiation were excluded to ensure incident diagnoses throughout the research duration. Generalized estimating equations in Cox proportional hazard regression models were used for data analysis. RESULTS In general, burn injury survivors have a 1.21-fold risk of being diagnosed with new mental disorders relative to patients without burn injuries. Total body surface area (TBSA) of ≧ 30% (aHR: 1.49, 95% CI: 1.36-1.63) and third- or fourth-degree burns (aHR: 1.49, 95% CI: 1.37-1.63) had a significantly greater risk of being diagnosed with mental disorders in comparison to the reference cohort. Patients TBSA 10-29% (aHR: 0.85, 95% CI: 0.77-0.93) and first- or second-degree burn victims (aHR: 0.89, 95% CI: 0.81-0.97) had relatively lower risk of mental disorders than the reference cohort. CONCLUSION Burn injuries were associated with an increased risk of mental disorders. Additional research in this field could elucidate this observation, especially if the inherent limitations of the NHIRD can be overcome.
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Affiliation(s)
- Fan Peng
- Department of Psychiatry, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan, ROC; School of Post-baccalaureate Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, Taipei, Taiwan, ROC; School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Wan-Ying Koh
- School of Post-baccalaureate Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Department of General Medicine, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan, ROC
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, Taipei, Taiwan, ROC; School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC; Graduate Institute of Life Science, National Defense Medical Center, Taiwan, ROC.
| | - Ching-En Lin
- Department of Psychiatry, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan, ROC; School of Medicine, Tzu Chi University, Hualien, Taiwan, ROC.
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Freeman CE, Yoo J, Slater JC. Utilizing a Quality Improvement Approach to Improve Positioning of Acute Burn Patients. J Burn Care Res 2024; 45:660-668. [PMID: 38015462 DOI: 10.1093/jbcr/irad189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Indexed: 11/29/2023]
Abstract
Patient positioning, using "anti-deformity positioning," is a standard practice in burn rehabilitation to assist with edema management, scar contracture prevention, and wound healing. Consistently providing proper positioning requires the combined effort of the multidisciplinary burn team. Our primary goal was to increase the frequency that patients were correctly positioned to over 90%. At a medium-sized, academic burn unit, random audits were conducted by burn lead therapists on the compliance of proper patient positioning over 6 months. Using this data as a trigger, a quality improvement project was designed using the Plan-Do-Study-Act (PDSA) cycle. Surveys were distributed to therapy and nursing staff to identify barriers to proper positioning. Effects on positioning compliance postintervention were monitored. In the 6 months prior to intervention, the average correct positioning was 76%. Surveys identified the following barriers to care: nursing needed more education and the approach was too heavily reliant on nursing efforts alone. To address this, therapists provided education to all nurses, communicated daily about positioning expectations, shifted the project to a multidisciplinary approach, and made changes in therapy workflow. The median compliance improved from 79% to 91% (P < .05). Coordinating efforts of the entire burn team improve consistency for positioning in burn patients. Utilizing the PDSA cycle allowed us to identify areas for improvement and develop appropriate interventions to increase education for nursing staff and workflow improvements for therapists. Following the completion of our interventions, we were able to obtain an immediate improvement in our patient positioning compliance.
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Affiliation(s)
- Catherine E Freeman
- University of Cincinnati Medical Center Burn Unit, Cincinnati, OH 45219, USA
| | - Junhwi Yoo
- University of Cincinnati College of Medicine, Cincinnati, OH 45219, USA
| | - Julia C Slater
- University of Cincinnati Medical Center Burn Unit, Cincinnati, OH 45219, USA
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Kittrick AM, Jones A, Morgan LT. Timepoint for return to occupations post-burn injury using the Canadian Occupational Performance Measure (COPM). Aust Occup Ther J 2024. [PMID: 38616179 DOI: 10.1111/1440-1630.12948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 03/03/2024] [Accepted: 03/09/2024] [Indexed: 04/16/2024]
Abstract
INTRODUCTION The Canadian Occupational Performance Measure (COPM) was implemented at a state-wide burns service to ensure compliance with current best evidence as outlined by the Australian and New Zealand Burns Association 'burn trauma rehabilitation: allied health practice guidelines'- Chapter 7 Measuring Post-Burn Recovery, as a standard outcome measure for individuals with an admission time greater than 24 h. The primary aim of this study is to determine if individuals have a minimal important change in performance and satisfaction with activities that were identified as problematic on the COPM prior to their acute discharge. Previous research confirmed the feasibility of using the COPM in the acute burn ward and recommended the most appropriate timepoint for re-measurement be confirmed, which is the secondary objective of this study. The benefits of confirming this timepoint include ensuring efficient use of clinicians' time without compromising the accuracy of the assessment and ensuring effective translation of the guidelines' recommendation. METHODS A prospective longitudinal study was undertaken, where all individuals who previously completed a COPM prior to acute discharge were sought to complete a re-assessment while accessing outpatient services. Time frames for re-assessment were open. Only individuals who were actively receiving occupational therapy outpatient services were included. COPM assessments were completed in person where possible, particularly for participants who required an interpreter, with phone and video calls also used when needed. RESULTS A total of 37 participants were included, with the timeframe between initial and post-COPM assessment ranging from 2 to 643 days. Outcomes plateaued at approximately 12 months (365 days) post-initial measurement (prior to discharge from acute ward). The most common occupational performance goals that participants identified were returning to work, sport, and driving. 86.5% of participants increased their satisfaction with these activities. The results of this study demonstrate improvements across the domains of performance and satisfaction occur for individuals with burns at approximately 3 months and 12 months post-injury. CONCLUSION Based on this study, it is suggested that when using the COPM assessment in a tertiary burn setting, re-measurement be completed no earlier than 3 months and later than 12 months from burn injury, or upon discharge from the service. The findings from this study will be translated into clinical practice at this facility.
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Affiliation(s)
- Andrea Mc Kittrick
- Department of Occupational Therapy, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Amber Jones
- Department of Occupational Therapy, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Lachlan T Morgan
- School of Allied Health, Australian Catholic University, Banyo, Australia
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Ma Y, Barnes SP, Chen YY, Moiemen N, Lord JM, Sardeli AV. Influence of scar age, laser type and laser treatment intervals on paediatric burn scars: a systematic review and meta-analysis. BURNS & TRAUMA 2024; 12:tkad046. [PMID: 38312741 PMCID: PMC10838059 DOI: 10.1093/burnst/tkad046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/24/2023] [Indexed: 02/06/2024]
Abstract
Background Laser therapy has emerged to play a valuable role in the treatment of paediatric burn scars; however, there is heterogeneity in the literature, particularly concerning optimal timing for initiation of laser therapy. This study aims to investigate the effect of factors such as scar age, type of laser and laser treatment interval on burn scar outcomes in children by meta-analysis of previous studies. Methods A literature search was conducted across seven databases in May 2022 to understand the effects of laser therapy on burn scar outcomes in paediatric patients by metanalysis of standardized mean difference (SMD) between pre- and post-laser intervention. Meta-analyses were performed using the Comprehensive Meta-Analysis software version 4.0. Fixed models were selected when there was no significant heterogeneity, and the random effects model was selected for analysis when significant heterogeneity was identified. For all analyses, a p-value < 0.05 was considered significant. Results Seven studies were included in the meta-analysis with a total of 467 patients. Laser therapy significantly improved Vancouver Scar Scale (VSS)/Total Patient and Observer Scar Assessment Scale (Total POSAS), vascularity, pliability, pigmentation and scar height of burn scars. Significant heterogeneity was found between the studies and thus subgroup analyses were performed. Early laser therapy (<12 months post-injury) significantly improved VSS/POSAS scores compared to latent therapy (>12 months post-injury) {SMD -1.97 [95% confidence interval (CI) = -3.08; -0.87], p < 0.001 vs -0.59 [95%CI = -1.10; -0.07], p = 0.03} as well as vascularity {SMD -3.95 [95%CI = -4.38; -3.53], p < 0.001 vs -0.48 [95%CI = -0.66; -0.30], p < 0.001}. Non-ablative laser was most effective, significantly reducing VSS/POSAS, vascularity, pliability and scar height outcomes compared to ablative, pulse dye laser and a combination of ablative and pulse dye laser. Shorter treatment intervals of <4 weeks significantly reduced VSS/POSAS and scar height outcomes compared to intervals of 4 to 6 weeks. Conclusions Efficacy of laser therapy in the paediatric population is influenced by scar age, type of laser and interval between laser therapy application. The result of this study particularly challenges the currently accepted initiation time for laser treatment. Significant heterogeneity was observed within the studies, which suggests the need to explore other confounding factors influencing burn scar outcomes after laser therapy.
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Affiliation(s)
- Yangmyung Ma
- College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom
| | - Sabrina P Barnes
- Hull York Medical School, University Rd, Heslington, York YO10 5DD, United Kingdom
| | - Yung-Yi Chen
- College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom
| | - Naiem Moiemen
- College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom
- Department of Burns and Plastic Surgery, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, United Kingdom
- Scar Free Foundation Centre for Burns Research, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, United Kingdom
| | - Janet M Lord
- College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom
- Scar Free Foundation Centre for Burns Research, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, United Kingdom
- National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, United Kingdom
| | - Amanda V Sardeli
- College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom
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Ergani HM, Yalçın Topçuoğlu E, Yaşar B, Akgün AE, Acicbe O, Akın M, Erkin Ünlü R, Yastı AÇ. Physical Medicine Applications in Hand Burns: Treatment or Rehabilitation. J Burn Care Res 2024; 45:98-103. [PMID: 37638523 DOI: 10.1093/jbcr/irad130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Indexed: 08/29/2023]
Abstract
The aim of this study is to investigate the contribution of concurrent physical therapy to the preservation of hand function in patients with hand burns. This retrospective cohort study included the records of adult patients who presented with hand burns between July 1, 2020, and December 1, 2021. A total of 67 of 1578 burn patients who attended the clinic were included in this study. The patients' age, sex, total BSA with burns, causative agent, depth of burn on the hand, right or left hand, location of the burned area on the hand, treatment applied, healing time of the burn on the hand, limitation of movement, the joint restrictions, contractures, and compliance with physical therapy were assessed and recorded. Among the 67 patients included, 82.1% (n = 55) had no limitation in terms of their joint range of motion, whereas 17.9% (n = 12) had a limitation of movement in their finger joints. When the prevalence of movement limitation was examined by gender, such limitation was found to be more common in females (P = .041). Moreover, contractures were found to occur more frequently in patients with full-thickness burns (P = .032). It was also found that the limitation of movement was more severe in patients with skin grafts (P = .044). In addition, it was observed that the recovery time of the burn area was longer in those patients who had movement limitations (P = .004). In this study, we found that applying early physical therapy to patients after burn injuries facilitated the recovery of hand functions.
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Affiliation(s)
- Hasan Murat Ergani
- Department of Plastic Reconstructive and Aesthetic Surgery, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Elif Yalçın Topçuoğlu
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Burak Yaşar
- Department of Plastic Reconstructive and Aesthetic Surgery, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Ali Emre Akgün
- Department of General Surgery, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Okan Acicbe
- Department of Plastic Reconstructive and Aesthetic Surgery, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Merve Akın
- Department of General Surgery, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Ramazan Erkin Ünlü
- Department of Plastic Reconstructive and Aesthetic Surgery, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Ahmet Çınar Yastı
- Department of General Surgery, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
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Ma Y, Barnes SP, Chen YY, Moiemen NS, Lord JM, Sardeli AV. Influence of scar age, laser type and laser treatment intervals on adult burn scars: A systematic review and meta-analysis. PLoS One 2023; 18:e0292097. [PMID: 37756273 PMCID: PMC10529539 DOI: 10.1371/journal.pone.0292097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
AIM The study aims to identify whether factors such as time to initiation of laser therapy following scar formation, type of laser used, laser treatment interval and presence of complications influence burn scar outcomes in adults, by meta-analysis of previous studies. METHODS A literature search was conducted in May 2022 in seven databases to select studies on the effects of laser therapy in adult hypertrophic burn scars. The study protocol was registered with PROSPERO (CRD42022347836). RESULTS Eleven studies were included in the meta-analysis, with a total of 491 patients. Laser therapy significantly improved overall VSS/POSAS, vascularity, pliability, pigmentation and scar height of burn scars. Vascularity improvement was greater when laser therapy was performed >12 months (-1.50 [95%CI = -2.58;-0.42], p = 0.01) compared to <12 months after injury (-0.39 [95%CI = -0.68; -0.10], p = 0.01), the same was true for scar height ((-1.36 [95%CI = -2.07; -0.66], p<0.001) vs (-0.56 [95%CI = -0.70; -0.42], p<0.001)). Pulse dye laser (-4.35 [95%CI = -6.83; -1.86], p<0.001) gave a greater reduction in VSS/POSAS scores compared to non-ablative (-1.52 [95%CI = -2.24; -0.83], p<0.001) and ablative lasers (-0.95 [95%CI = -1.31; -0.59], p<0.001). CONCLUSION Efficacy of laser therapy is influenced by the time lapse after injury, the type of laser used and the interval between laser treatments. Significant heterogeneity was observed among studies, suggesting the need to explore other factors that may affect scar outcomes.
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Affiliation(s)
- Yangmyung Ma
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
| | | | - Yung-Yi Chen
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
| | - Naiem S. Moiemen
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
- Department of Burns and Plastic Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Scar Free Foundation Centre for Burns Research, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Janet M. Lord
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
- Scar Free Foundation Centre for Burns Research, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Amanda V. Sardeli
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
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11
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Avila-Martinez N, Gansevoort M, Verbakel J, Jayaprakash H, Araujo IM, Vitorino M, Tiscornia G, van Kuppevelt TH, Daamen WF. Matrisomal components involved in regenerative wound healing in axolotl and Acomys: implications for biomaterial development. Biomater Sci 2023; 11:6060-6081. [PMID: 37525590 DOI: 10.1039/d3bm00835e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
Achieving regeneration in humans has been a long-standing goal of many researchers. Whereas amphibians like the axolotl (Ambystoma mexicanum) are capable of regenerating whole organs and even limbs, most mammals heal their wounds via fibrotic scarring. Recently, the African spiny mouse (Acomys sp.) has been shown to be injury resistant and capable of regenerating several tissue types. A major focal point of research with Acomys has been the identification of drivers of regeneration. In this search, the matrisome components related to the extracellular matrix (ECM) are often overlooked. In this review, we compare Acomys and axolotl skin wound healing and blastema-mediated regeneration by examining their wound healing responses and comparing the expression pattern of matrisome genes, including glycosaminoglycan (GAG) related genes. The goal of this review is to identify matrisome genes that are upregulated during regeneration and could be potential candidates for inclusion in pro-regenerative biomaterials. Research papers describing transcriptomic or proteomic coverage of either skin regeneration or blastema formation in Acomys and axolotl were selected. Matrisome and GAG related genes were extracted from each dataset and the resulting lists of genes were compared. In our analysis, we found several genes that were consistently upregulated, suggesting possible involvement in regenerative processes. Most of the components have been implicated in regulation of cell behavior, extracellular matrix remodeling and wound healing. Incorporation of such pro-regenerative factors into biomaterials may help to shift pro-fibrotic processes to regenerative responses in treated wounds.
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Affiliation(s)
- Nancy Avila-Martinez
- Department of Medical BioSciences, Radboud Research Institute, Radboud university medical center, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Merel Gansevoort
- Department of Medical BioSciences, Radboud Research Institute, Radboud university medical center, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Juul Verbakel
- Department of Medical BioSciences, Radboud Research Institute, Radboud university medical center, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Haarshaadri Jayaprakash
- Centre of Marine Sciences (CCMAR), University of Algarve, 8005-139, Faro, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve, 8005-139, Faro, Portugal
| | - Ines Maria Araujo
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve, 8005-139, Faro, Portugal
- Algarve Biomedical Center Research Institute (ABC-RI), University of Algarve, 8005-139, Faro, Portugal
| | - Marta Vitorino
- Centre of Marine Sciences (CCMAR), University of Algarve, 8005-139, Faro, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve, 8005-139, Faro, Portugal
- Algarve Biomedical Center Research Institute (ABC-RI), University of Algarve, 8005-139, Faro, Portugal
| | - Gustavo Tiscornia
- Centre of Marine Sciences (CCMAR), University of Algarve, 8005-139, Faro, Portugal
- Eugin Barcelona, Balmes, 236, 08006 Barcelona, Spain
| | - Toin H van Kuppevelt
- Department of Medical BioSciences, Radboud Research Institute, Radboud university medical center, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Willeke F Daamen
- Department of Medical BioSciences, Radboud Research Institute, Radboud university medical center, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
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12
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Düken ME, Yayan EH, Zengin M, Sevgi T. The effects of the posttraumatic stress and general health status on paediatric burns and their sleep habits. Burns 2023; 49:1321-1327. [PMID: 36566094 DOI: 10.1016/j.burns.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 10/18/2022] [Accepted: 11/15/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Burns are serious injuries that can require hospitalization and have physical and emotional sequelae. Sleep disturbance can occur after trauma as evidenced by posttraumatic stress symptoms such as re-experiencing of a trauma with repetitive dreams, memories and flashbacks. This area has been minimally examined with pediatric burn survivors; therefore, the aim of this study was to investigate the effects of posttraumatic stress and general health on sleep habits of pediatric burn survivors from. METHOD This is a correlational descriptive study. Its sample included 7-18-year-old inpatients at the burn clinic of a university hospital from January to November 2019. This study used the Posttraumatic Stress Disorder Reaction Index, the General Health Questionnaire (12) and the Children's Sleep Habits Questionnaire for data collection. RESULTS Of the participants, 58.6% were male, 46.5% were primary school students, and 62.6% had no diseases other than their burns. 20.2% of the children had epilepsy, 14.2% had diabetes and 3% had pneumonia. Of the child burn victims, 45.5% were brought to the hospital because of contact with fire. All of them had first-degree burns, 59.6% had second-degree burns, and 80.8% had third-degree burns. After their burns, infections developed in 20.2% during trauma and in 43.4% during burn treatment. A structural equation model indicated that the child burn victims' general health perceptions did not significantly affect their sleep habits (p > 0.05). A significant correlation was found between the children's posttraumatic stress disorder and their sleep habits (p < 0.05). Posttraumatic stress disorder explained 7.2% of their sleep habits. A positive and significant correlation was found between the children's general health perceptions and posttraumatic stress disorder (r = 0.74, p < 0.05). CONCLUSION Burns of any kind can cause posttraumatic stress, sleep disorders and impairment of health status in children.
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Affiliation(s)
- Mehmet Emin Düken
- Health Sciences of Facult, Department of Child Health and Diseases Nursing, Harran University, Şanlıurfa 63000, Turkey.
| | - Emriye Hilal Yayan
- Faculty of Nursing, Department of Child Health and Diseases Nursing, Inönü University, Malatya 44280, Turkey.
| | - Mürşide Zengin
- School of Health, Department of Child Health Nursing, Adıyaman University, Adıyaman 02000, Turkey.
| | - Tekcan Sevgi
- Department of Child Health ve Disease of Nursing, Adana Yuregir State Hospital-Child Health and Diseases Service, Adana, Turkey.
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13
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Zhao M, Zhang Y, Zhao H. Identification of ferroptosis-related genes and predicted overall survival in patients with burns. Front Surg 2023; 9:1060036. [PMID: 36700031 PMCID: PMC9869674 DOI: 10.3389/fsurg.2022.1060036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 11/29/2022] [Indexed: 01/11/2023] Open
Abstract
Introduction Burns are a common trauma associated with considerable mortality and morbidity. Although a lot is known regarding burns' pathogenesis, the involvement of ferroptosis is uncertain. Here, we aimed to explore vital ferroptosis-related genes and molecules in burns, through bioinformatics analysis, to uncover new effective therapeutic targets. Methods The FerrDb database was used to acquire ferroptosis-related genes and GSE19743 was downloaded from Gene Expression Omnibus (GEO), a dataset with analysis of control and burned individuals. Hub genes were selected with Cytoscape software, and Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were conducted. Cox proportional hazard function and Kaplan-Meier survival analyses were implemented to screen prognosis-related genes. Additionally, the miRWalk database was used to acquire the miRNAs relevant to our hub genes function and analyzed for enrichment. Result We identified 64 differentially expressed genes and through the intersection with ferroptosis-related genes, 10 were selected as hub genes. GO analysis revealed that the hub genes' most enriched activities were response to oxidative stress, pyridine-containing compound metabolic processes, and reactive oxygen species metabolic processes. KEGG pathways' analysis showed that these overlapped genes were enriched in several pathways, namely, in VEGF signaling. Furthermore, the molecular miRNA functions significantly enriched were signal transduction and cell communication, namely, the biological pathways of the glypican pathway and the ErbB receptor signaling network. SLC40A1 and GPT2 genes were found to be associated with overall survival, suggesting an important role in burn prognosis. Discussion This study may improve our understanding of the underlying burn mechanisms and provide a new direction for the prevention of poor outcomes, advances in burns treatment, and drug development.
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Affiliation(s)
- Mingjian Zhao
- Graduate School, Dalian Medical University, Dalian, China
| | - Yetong Zhang
- Graduate School, Dalian Medical University, Dalian, China
| | - Hongliang Zhao
- Department of Burns and Plastic Surgery, Miyun Hospital, Capital Medical University, Beijing, China,Correspondence: Hongliang Zhao
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14
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Muacevic A, Adler JR, Arora S. Physical Therapy Interventions of an Electrical Burn Injury-Afflicted Patient: A Case Report. Cureus 2022; 14:e31176. [PMID: 36514659 PMCID: PMC9733660 DOI: 10.7759/cureus.31176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/06/2022] [Indexed: 11/09/2022] Open
Abstract
Electrical injuries are uncommon but not completely rare. It is most prevalent in the male population, although females are also affected in the workplace or household-related activities. These injuries usually occur in situations where proper precautions are not taken by the individual and also appropriate safety drills and education for personnel are not carried out. Electrical burns affecting children are very rare, but when they do occur, it is usually due to accidental contact with exposed electrical sources. In this patient, there were severe levels of secondary complications following the burn injury. The patient developed blood infections and also was hampered in doing a variety of activities of daily living. The patient was diagnosed with 45%-50% body surface area (BSA) covered with burns, which suggests its severe nature. Treatment focuses on preventing wound infection, managing the excruciating amount of pain, preventing complications of immobility, promoting mobility as much as the patient can, and also educating the patient and the family members.
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15
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Initial Steps towards Spatiotemporal Signaling through Biomaterials Using Click-to-Release Chemistry. Pharmaceutics 2022; 14:pharmaceutics14101991. [PMID: 36297427 PMCID: PMC9610979 DOI: 10.3390/pharmaceutics14101991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/12/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Abstract
The process of wound healing is a tightly controlled cascade of events, where severe skin wounds are resolved via scar tissue. This fibrotic response may be diminished by applying anti-fibrotic factors to the wound, thereby stimulating regeneration over scarring. The development of tunable biomaterials that enable spatiotemporal control over the release of anti-fibrotics would greatly benefit wound healing. Herein, harnessing the power of click-to-release chemistry for regenerative medicine, we demonstrate the feasibility of such an approach. For this purpose, one side of a bis-N-hydroxysuccinimide-trans-cyclooctene (TCO) linker was functionalized with human epidermal growth factor (hEGF), an important regulator during wound healing, whereas on the other side a carrier protein was conjugated—either type I collagen scaffolds or bovine serum albumin (BSA). Mass spectrometry demonstrated the coupling of hEGF–TCO and indicated a release following exposure to dimethyl-tetrazine. Type I collagen scaffolds could be functionalized with the hEGF–TCO complex as demonstrated by immunofluorescence staining and Western blotting. The hEGF–TCO complex was also successfully ligated to BSA and the partial release of hEGF upon dimethyl-tetrazine exposure was observed through Western blotting. This work establishes the potential of click-to-release chemistry for the development of pro-regenerative biomaterials.
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16
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Lerman SF, Owens MA, Liu T, Puthumana J, Hultman CS, Caffrey JA, Smith MT. Sleep after burn injuries: A systematic review and meta-analysis. Sleep Med Rev 2022; 65:101662. [DOI: 10.1016/j.smrv.2022.101662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/09/2022] [Accepted: 06/06/2022] [Indexed: 11/26/2022]
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Panuccio F, Galeoto G, Valente D, Ioncoli M, Marquez MA, Tofani M, Berardi A. Psychometric properties of the Community Integration Questionnaire - Revised (CIQ-R) in an Italian population with spinal cord injury. Spinal Cord Ser Cases 2022; 8:18. [PMID: 35124691 PMCID: PMC8818046 DOI: 10.1038/s41394-022-00486-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 02/07/2023] Open
Abstract
STUDY DESIGN Psychometric study. OBJECTIVES The aim of this study was to evaluate the internal consistency and validity of the Community Integration Questionnaire - Revised (CIQ-R) in Italian individuals with spinal cord injury (SCI). SETTING Patients' associations, foundations, sport clubs, and federations in Italy. METHODS The psychometric properties were evaluated following international guidelines. Internal consistency was assessed using Cronbach's alpha (α) coefficient, and test-retest reliability was assessed using intraclass correlation coefficient (ICC); concurrent validity was assessed through Pearson's Correlation Coefficient with the Short Form-12 health survey (SF-12). RESULTS The test was administered to 80 people with SCI. Cronbach's α showed a value of 0.825 for the Home Integration subscale, while the other subscales and the total showed values <0.70. 30 of the 80 recruited individuals were submitted to test-retest, which showed ICC values ranging from 0.94 to 1. CIQ-R also showed a correlation between Physical Component Summary (PCS12) of the SF-12, and between Social Integration subscale's score and PCS12 and Mental Component Summary (MCS12). Correlations are also shown between Productivity subscale and PCS12 and MCS12, as well as between the total score and PCS12 and MCS12. CONCLUSION This study provided Italian clinicians and researchers with the first international outcome measure for measuring community integration. The validation of this measurement tool for people with SCI allows to compare outcomes of various studies. It is useful for testing the effectiveness of a treatment in various diseases and define which treatment is more effective than others.
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Affiliation(s)
| | - Giovanni Galeoto
- grid.7841.aDepartment of Human Neurosciences, Sapienza University of Rome, Viale dell’università 30, 00185 Rome, Italy ,IRCSS Neuromed, Via Atinense 18, Rome, 86077 Pozzilli (IS) Italy
| | - Donatella Valente
- grid.7841.aDepartment of Human Neurosciences, Sapienza University of Rome, Viale dell’università 30, 00185 Rome, Italy ,IRCSS Neuromed, Via Atinense 18, Rome, 86077 Pozzilli (IS) Italy
| | - Melissa Ioncoli
- grid.7841.aSapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Maria Auxiliadora Marquez
- grid.512367.4Universidad Fernando Pessoa-Canarias, Las Palmas, Spain ,grid.23520.360000 0000 8569 1592Health Sciences, University of Burgos, Burgos, Spain
| | - Marco Tofani
- grid.7841.aDepartment of Public Health and Infectious Disease, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Anna Berardi
- grid.7841.aDepartment of Human Neurosciences, Sapienza University of Rome, Viale dell’università 30, 00185 Rome, Italy
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Dukes K, Baldwin S, Assimacopoulos E, Grieve B, Hagedorn J, Wibbenmeyer L. Influential Factors in the Recovery Process of Burn Survivors in a Predominately Rural State: A Qualitative Study. J Burn Care Res 2021; 43:374-380. [PMID: 34891162 DOI: 10.1093/jbcr/irab232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Navigating the recovery journey following a burn injury can be challenging. Survivor stories can help define recovery constructs that can be incorporated into support programs. We undertook this study to determine themes of recovery in a predominately rural state. Eleven purposefully selected burn survivors were interviewed using a semi-structured format. Consensus coding of verbatim transcriptions was used to determine themes of successful recovery. Four support-specific themes were identified. These included: using active coping strategies, expressing altruism through helping others, finding meaning and acceptance, and the active seeking and use of support. These themes could be incorporated into support programming and would help guide future survivors through the recovery period.
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Affiliation(s)
- Kimberly Dukes
- University of Iowa Carver College of Medicine, 200 Hawkins Dr, Iowa City, IA 52242, USA.,Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Medical Center, Iowa City, Iowa 52246, USA
| | - Stephanie Baldwin
- Department of Obstetrics and Gynecology, University of Florida/Ascension Sacred Heart 5153 North 9 th Ave. #403 Pensacola, FL 32504, USA
| | - Evangelia Assimacopoulos
- University of Iowa Carver College of Medicine, 200 Hawkins Dr, Iowa City, IA 52242, USA.,Department of Emergency Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA 52242, USA
| | - Brian Grieve
- University of Iowa Carver College of Medicine, 200 Hawkins Dr, Iowa City, IA 52242, USA
| | - Joshua Hagedorn
- University of Iowa Carver College of Medicine, 200 Hawkins Dr, Iowa City, IA 52242, USA
| | - Lucy Wibbenmeyer
- University of Iowa Carver College of Medicine, 200 Hawkins Dr, Iowa City, IA 52242, USA.,Department of Surgery, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA 52242, USA
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Kazis LE, Sager A, Bailey HM, Vasudevan A, Garrity B, Tompkins R. Physical Rehabilitation and Mental Health Care after Burn Injury: A Multi-Nation Study. J Burn Care Res 2021; 43:868-879. [PMID: 34788851 DOI: 10.1093/jbcr/irab214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
While remarkable improvements have been made to acute hospital burn care in recent decades, it is not matched by improvements in post-acute care, including physical rehabilitation and mental health. Progress in acute hospital treatment of burn survivors now highlights the next important step-addressing care once a patient leaves intensive treatment and is discharged to the community. Long-term physical rehabilitation and mental health services are vital to improving quality of life for burn survivors. Using qualitative methods, we apply the adapted Reeve framework to assess and compare post-acute physical rehabilitation and mental health care across thirteen countries on six continents. Twenty semi-structured interviews were conducted with burn surgeons and rehabilitation specialists. One major theme that emerged was the importance of training and resources to the quality of post-acute care. This exploratory study suggests the value of investing scarce resources in a range of low-cost interventions to improve follow-up burn care. One intervention identified here is short-term training in post-acute rehabilitation and mental health to upgrade and standardize best clinical practices to address as-yet unmet post-discharge needs of burn survivors.
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Affiliation(s)
- Lewis E Kazis
- Boston University School of Public Health, Department of Health Law, Policy & Management
| | - Alan Sager
- Boston University School of Public Health, Department of Health Law, Policy & Management
| | - Hannah M Bailey
- Boston University School of Public Health, Department of Health Law, Policy & Management
| | | | - Brigid Garrity
- Boston University School of Public Health, Department of Health Law, Policy & Management
| | - Ron Tompkins
- Massachusetts General Hospital, Center for Engineering in Medicine & Surgery
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Chaudhary FA, Ahmad B, Sinor MZ. The severity of facial burns, dental caries, periodontal disease, and oral hygiene impact oral health-related quality of life of burns victims in Pakistan: a cross-sectional study. BMC Oral Health 2021; 21:570. [PMID: 34749722 PMCID: PMC8573980 DOI: 10.1186/s12903-021-01923-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 10/18/2021] [Indexed: 02/03/2023] Open
Abstract
Background A burn to the face and neck area leaves a visible scar that impacts the victims physically and psychologically. This report was aimed to examine the factors associated with oral health-related quality of life (OHRQoL) in patients with a facial burn injury. Methods Patients with facial burn who attended the Burn Care Centre in Islamabad, Pakistan were systematically and randomly invited to participate in this cross-sectional study. They underwent extra- and intra-oral examinations and, completed self-administered instruments in the Urdu language. The severity of disfigurement, dental caries experience (DMFT), periodontal disease (CPI) and oral hygiene (OHI-S) statuses were assessed. The validated instruments collected information relating to sociodemographic background, oral health behaviours, OHRQoL and satisfaction with appearance (SWAP). Information relating to the time of the incident, cause and severity (type, TBSA) of the burn were obtained from medical records. The OHRQoL prevalence of impact and severity measures were derived and analysed using simple and multiple, logistic and linear regression. Results A total of 271 patients had participated in the study. The OHIP-14 prevalence of impact was 94% with mean severity score = 37 unit (sd = 8.5). The most impacted domains were physical pain (87%), psychological disability (87%), social disability (85%) and physical discomfort (83%). The main determinants of oral health-related quality of life were poor clinical oral conditions - particularly caries, and severity deformity. Other risk factors included poor oral health behaviours, psychological distress and longer time elapsed since the incident, and sex (p < 0.05). Conclusion Dental caries, the severity of the facial deformity, oral health behaviour and time are associated with oral health-related quality of life of patients with facial burns. Oral health behaviour improvement can lower the risk of developing dental problems and oral health-related quality of life impact.
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Affiliation(s)
- Farooq Ahmad Chaudhary
- School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
| | - Basaruddin Ahmad
- School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia.
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Elnaggar RK, Osailan AM, Mahmoud WS, Alqahtani BA, Azab AR. Beyond the acute phase: understanding relationships among cardio-respiratory response to exercises, physical activity levels, and quality of life in children after burn injuries. J Burn Care Res 2021; 43:827-833. [PMID: 34677602 DOI: 10.1093/jbcr/irab203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The long-term cardiorespiratory function in burn-injured children can be jeopardized due to complications brought on by the injury. This study sought to assess the cardio-respiratory responses to maximal exercise in children who sustained a burn injury and explore the relationships among cardio-respiratory response, physical activity levels (PALs), and health-related quality of life (HRQL). Forty-five burn-injured children (age:13.89±2.43 years; duration since burn-injury: 3.13±0.93 years) and 52 age- and gender-matched healthy children (14.15±2.27 years) participated in this study. Both cohorts were evaluated for the maximal exercise capacity [defined by peak oxygen uptake (VO2peak), maximum heart rate (HRmax), minute ventilation (VE), ventilatory equivalent (VEq), respiratory rate (RR), and respiratory exchange ratio (RER)], PALs, and HRQL. The burn-injured children had significantly lower VO2peak (P=.0001) and VE (P=.003) and higher VEq (P<.0001) and RR (P=.007) than their healthy controls, indicating less efficient cardio-respiratory capacity. However, the HRmax (P=.092) and RER (P=.251) were similar. The burn-injured children reported significantly lower PALs (P=.014) and HRQL (P<.0001). The PALs [r (95%CI) = 0.411 (0.132 to 0.624); P = .005] and HRQL [r (95%CI) = 0.536 (0.284 to 0.712); P = .0001] were significantly correlated with the cardio-respiratory capacity represented by VO2peak in burn-injured group. The variations in VO2peak explained ⁓ 17% and 28.7% of the variations in PALs and HRQL, respectively. In conclusion, the cardio-respiratory efficiency of the burn-injured children may remain limited, even up to a few years following the injury. The limited cardio-respiratory capacity account in part for the reduced PALs and HRQL.
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Affiliation(s)
- Ragab K Elnaggar
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia.,Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Ahmad M Osailan
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Waleed S Mahmoud
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia.,Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Bader A Alqahtani
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Alshimaa R Azab
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Angelou IK, van Aswegen H, Wilson M, Grobler R. A profile of adult patients with major burns admitted to a Level 1 Trauma Centre and their functional outcomes at discharge: A retrospective review. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2021. [DOI: 10.4102/sajp.v77i1.1543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Khor D, Liao J, Fleishhacker Z, Schneider JC, Parry I, Kowalske K, Richard R, Wibbenmeyer L. Update on the practice of splinting during acute burn admission from the ACT study. J Burn Care Res 2021; 43:640-645. [PMID: 34490885 DOI: 10.1093/jbcr/irab161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Burn scar contracture (BSC) is a common pathological outcome following burn injuries, leading to limitations in range of motion (ROM) of affected joints and impairment in function. Despite a paucity of research addressing its efficacy, static splinting of affected joints is a common preventative practice. A survey of therapists performed 25 years ago showed a widely divergent practice of splinting during the acute burn injury. We undertook this study to determine the current practice of splinting during the index admission for burn injuries. METHODS This is a review of a subset of patients enrolled in the Burn Patient Acuity Demographics, Scar Contractures and Rehabilitation Treatment Related to Patient Outcome Study (ACT) database. ACT was an observational multicenter study conducted from 2010-2013. The most commonly splinted joints (elbow, wrist, knee and ankle) and their 7 motions were included. Variables included patients' demographics, burn variables, rehabilitation treatment and hospital course details. Univariate and multivariate analysis of factors related to splinting was performed. P< 0.05 was significant. RESULTS Thirty percent of the study population (75 patients) underwent splinting during their hospitalization. Splinting was associated with larger burns and increased injury severity on the patient level and increased involvement with burns requiring grafting in the associated cutaneous functional unit (CFU) on the joint level. The requirement for skin grafting in both analyses remained independently related to splinting, with requirement for grafting in the associated CFU increasing the odds of splinting 6 times (OR =6.0, 95% CI=3.8-9.3, p<0.001). On average splinting was initiated about a third into the hospital length of stay (LOS, 35 ± 21% of LOS) and splints were worn for 50% (50 ± 26%) of the LOS. Joints were splinted for an average 15.1 ± 4.8 hours a day. The wrist was most frequently splinted joint being splinted with one third of wrists splinted ( 30.7%) while the knee was the least frequently splinted joint with 8.2% splinted. However, when splinted, the knee was splinted the most hours per day (17.6 ± 4.8 hours) and the ankle the least (14.4 ± 4.6 hours). Almost one third had splinting continued to discharge (20, 27%). CONCLUSIONS The current practice of splinting, especially the initiation, hours of wear and duration of splinting following acute burn injury remains variable. Splinting is independently related to grafting, grafting in the joint CFU, larger CFU involvement and is more likely to occur around the time of surgery. A future study looking at splinting application and its outcomes is warranted.
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Affiliation(s)
- Desmond Khor
- Department of Surgery, University of Iowa Hospitals and Clinics
| | - Junlin Liao
- Department of Surgery, University of Iowa Hospitals and Clinics
| | | | - Jeffrey C Schneider
- Spaulding Rehabilitation Hospital, Spaulding Research Institute, Department of Physical Medicine and Rehabilitation, Harvard Medical School
| | - Ingrid Parry
- Department of Occupational and Physical Therapy, Shriners Hospital for Children, Northern California, University of California, Davis
| | - Karen Kowalske
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern
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Price K, Moiemen N, Nice L, Mathers J. Patient experience of scar assessment and the use of scar assessment tools during burns rehabilitation: a qualitative study. BURNS & TRAUMA 2021; 9:tkab005. [PMID: 34212058 PMCID: PMC8240530 DOI: 10.1093/burnst/tkab005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/27/2020] [Indexed: 02/03/2023]
Abstract
Background Scar assessment plays a key role during burns aftercare, to monitor scar remodelling and patients’ psychosocial well-being. To aid assessment, subjective scar assessment scales are available that use health-care professionals’ and patients’ opinions to score scar characteristics. The subjective scales are more widely used in clinical practice over objective scar measures. To date, there is no research that considers patients’ views on scar assessment and the role of subjective and objective assessment tools. Therefore, the aim of this qualitative study was to explore patients’ perspectives on scar assessment and the utility of scar assessment tools during burns rehabilitation. Methods Semi-structured interviews were conducted with 10 adult burn patients who were being reviewed in clinic for scarring. Participants were recruited via their clinical care team and research nurses at the Queen Elizabeth Hospital, Birmingham, UK. Topics covered during interview included patient experience of scar assessment, the use of scar assessment tools and discussion surrounding important factors to be addressed when assessing scars. A thematic analysis using the Framework Method was conducted. Results Participants identified key subthemes that contribute towards the overarching theme of patient-centred scar assessment. These are: patient-led care; continuity in care; learning how to self-manage scarring; and psychological assessment. Links were demonstrated between these subthemes and the remaining themes that describe scar assessment strategies, indicating their potential patient-centred contributions. The subjective opinions of clinicians were found to be valued above the use of subjective or objective scar assessment tools. Scar assessment scales were perceived to be a beneficial method for self-reflection in relation to psychosocial functioning. However, minimal feedback and review of completed assessment scales led to uncertainty regarding their purpose. Patients perceived objective tools to be of primary use for health-care professionals, though the measures may aid patients’ understanding of scar properties. Conclusions Scar assessment tools should be used to support, rather than replace, health-care professionals’ subjective judgements of scarring. Adapting the way in which clinicians introduce and use scar assessment tools, according to patient needs, can support a patient-centred approach to scar assessment.
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Affiliation(s)
- Kate Price
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Naiem Moiemen
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.,Scar Free Foundation Centre for Conflict Wound Research, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Laura Nice
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.,NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, UK
| | - Jonathan Mathers
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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El Khatib A, Jeschke MG. Contemporary Aspects of Burn Care. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:386. [PMID: 33923571 PMCID: PMC8073568 DOI: 10.3390/medicina57040386] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/13/2021] [Accepted: 04/15/2021] [Indexed: 02/06/2023]
Abstract
The past one hundred years have seen tremendous improvements in burn care, allowing for decreased morbidity and mortality of this pathology. The more prominent advancements occurred in the period spanning 1930-1980; notably burn resuscitation, early tangential excision, and use of topical antibiotic dressings; and are well documented in burn literature. This article explores the advancements of the past 40 years and the areas of burn management that are presently topics of active discussion and research.
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Affiliation(s)
- Arij El Khatib
- Unité des Grands Brûlés, University of Montreal Medical Centre Sanguinet, 1051, Rue Sanguinet, Montréal, QC H2X 0C1, Canada
| | - Marc G. Jeschke
- Department of Surgery, Division of Plastic Surgery, Department of Immunology, Ross Tilley Burn Centre-Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, 2075 Bayview Avenue, Rm D704, Toronto, ON M4N 3M5, Canada;
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Wongkietkachorn A, Surakunprapha P, Jenwitheesuk K, Eua-angkanakul K, Winaikosol K, Punyavong P, Wongkietkachorn N, Wongkietkachorn S, Salyapongse AN. Indocyanine Green Angiography Precise Marking for Indeterminate Burn Excision: A Prospective, Multi-centered, Double-blinded Study. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3538. [PMID: 33868880 PMCID: PMC8049159 DOI: 10.1097/gox.0000000000003538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 02/10/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND During burn excision, the clinical judgment whether to excise or not excise the area with indeterminate burn depth is difficult. Indocyanine green angiography (ICGA) has been reported to provide high accuracy in diagnosing indeterminate burns. This study aims to evaluate the complete wound closures in both short-term and long-term outcomes after using ICGA precise marking to guide indeterminate burn excision. METHODS This was a prospective, multi-centered, double-blinded, experimental study. The participants were admitted to the hospital with indeterminate burn wounds. ICGA precise marking was performed. The deep second-degree burn was painted, excised, and subsequently covered with skin grafts and measured on day 5. The superficial burns were measured on day 21. All wounds were followed-up at two months. RESULTS Thirty indeterminate burn sites were included in this study. Using ICGA precise marking, the overall rate of short-term complete wound closure, which combined superficial and deep burns, was found to be as high as 96.7% (29/30). The long-term complete wound closures at two months confirmed the short-term result and yielded 100.0% of complete wound closure. The complete wound closures between the short-term and long-term measurements were not significantly different (P > 0.999). CONCLUSIONS Using ICGA precise marking to guide indeterminate burn excision resulted in an excellent rate of complete wound closure and an insignificant difference between short-term and long-term wound outcomes. ICGA is a competent method to aid decision-making in burn surgery of the indeterminate area.
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Affiliation(s)
- Apinut Wongkietkachorn
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Palakorn Surakunprapha
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kamonwan Jenwitheesuk
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kant Eua-angkanakul
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Khon Kaen Hospital, Khon Kaen, Thailand
| | - Kengkart Winaikosol
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Pattama Punyavong
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | - Supawich Wongkietkachorn
- Department of Surgery, Faculty of Medicine, Princess Naradhiwas University, Naradhiwas, Thailand
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Chaudhary FA, Ahmad B. The relationship between psychosocial distress and oral health status in patients with facial burns and mediation by oral health behaviour. BMC Oral Health 2021; 21:172. [PMID: 33794862 PMCID: PMC8017647 DOI: 10.1186/s12903-021-01532-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 03/22/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND There is limited discussion on the influence of psychosocial factors on the oral health of patients with a facial burn injury. This report investigated the relationship between oral health and psychosocial distress in patients with facial burns and the role of oral health behaviour in mediating the relationship. METHODS The data were part of a cross-sectional study that had systematically and randomly selected patients with > 10% total burn surface area from a burn centre in Pakistan. The oral health status (DMFT, CPI, OHI-S) and severity of facial disfigurement were assessed. Validated instruments in the Urdu language were self-administered and information relating to oral health behaviour (brushing and dental visits), oral health-related quality of life (OHIP-14), satisfaction with appearance, self-esteem, anxiety and depression, resilience, and social support were collected. The statistical analyses included simple linear regression, Pearson correlation, t-test, and ANOVA. Mediation analysis was carried out to examine the indirect effect by oral health behaviour. RESULTS From a total of 271 participants, the majority had moderate to severe facial disfigurement (89%), low self-esteem (74.5%), and moderate to high levels of social support (95%). The level of satisfaction with appearance was low, whereas anxiety and depression were high. Disfigurement and satisfaction with appearance were associated with lower self-esteem and social support (p < 0.05). Greater severity of disfigurement, higher levels of anxiety and dissatisfaction with appearance, and lower levels of self-esteem and social support were associated with greater DMFT and OHIP-14 scores, worse periodontal and oral hygiene conditions, and less frequent tooth brushing and dental visits (p < 0.05). The main barriers to oral healthcare utilization were psychological and social issues (p < 0.05). The indirect effect by oral health behaviour was not significant for anxiety but was significant for disfigurement, satisfaction with appearance, self-esteem, and social support. CONCLUSION There is an association between the psychosocial factors and oral health of patients with facial burns through a direct effect and mediation by oral health behaviour.
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Affiliation(s)
- Farooq Ahmad Chaudhary
- School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
| | - Basaruddin Ahmad
- School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
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28
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Katsu A, Tyack Z, Mackey M, Elliott JM, Mackenzie L. Return to employment for working-aged adults after burn injury: a scoping review protocol. BMJ Open 2021; 11:e044145. [PMID: 33408216 PMCID: PMC7789466 DOI: 10.1136/bmjopen-2020-044145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Cutaneous burns can have a catastrophic effect on people's lives and may restrict opportunities for employment due to physical impairment and psychosocial deficits. Failure or delay in return to work can result in loss of income and support for the family unit. It can also negatively affect life role and identity and present difficulties with future opportunities. Current literature indicates multiple discrete influences on return to work as a result of burn injury but an understanding of how working-aged adults resume employment after burn injury is lacking. This scoping review will provide a comprehensive overview of the current literature by mapping and consolidating knowledge in this area of burn recovery and thus provide an informative basis for developing return-to-work programmes for survivors of burn injury. METHODS AND ANALYSIS This scoping review protocol will follow the Arksey and O'Malley's (2005) methodological framework. A comprehensive search strategy has been developed with subject expert librarians. These databases were used: OvidSP: Medline, Embase, PsycINFO, PubMed and Cochrane Central Register of Controlled Trials and EBSCOhost: CINAHL and Scopus. Reference lists of selected full text will be hand searched for additional literature. To enhance consistency and rigour, all reviewers will undertake a calibration exercise before paired reviewers independently screen all records using Rayyan. Full-text articles meeting the study inclusion criteria will be retrieved and examined. Extracted data will be analysed using the International Classification of Functioning, Disability and Health. ETHICS AND DISSEMINATION Ethics approval is generally not required for scoping reviews. Findings of this scoping review will be reported in a peer-reviewed journal and presented at conferences.
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Affiliation(s)
- Akane Katsu
- Discipline of Occupational Therapy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Department of Occupational Therapy, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Zephanie Tyack
- Centre for Children's Burns and Trauma Research, University of Queensland, South Brisbane, Queensland, Australia
| | - Martin Mackey
- Discipline of Physiotherapy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - James M Elliott
- Discipline of Physiotherapy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Kolling Institute, Northern Sydney Local Health District, St Leonards, New South Wales, Australia
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Litchfield I, Moiemen N, Greenfield S. Barriers to Evidence-Based Treatment of Serious Burns: The Impact of Implicit Bias on Clinician Perceptions of Patient Adherence. J Burn Care Res 2020; 41:1297-1300. [PMID: 32645716 DOI: 10.1093/jbcr/iraa114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The underlying assumption of modern evidence-based practice is that treatment decisions made by healthcare providers are based solely on the best available scientific data. However, the connection between evidence informed care guidelines and the provision of care remains ambiguous. In reality, a number of contextual and nonclinical factors can also play a role, among which is the implicit bias that affects the way in which we approach or treat others based on irrelevant, individual characteristics despite conscious efforts to treat everyone equally. Influenced by the social and demographic characteristics of patients, this bias and its associated perceptions have been shown to affect clinical decision making and access to care across multiple conditions and settings. This summary article offers an introduction to how the phenomenon of implicit bias can impact on treatment compliance in multiple care contexts, its potential presence and impact in burns care and describes some of the strategies which offer possible solutions to reducing the disconnect between the conscious attempts to deliver equitable care and the discrepancies in care delivery that remain.
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Affiliation(s)
- Ian Litchfield
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham
| | - Naiem Moiemen
- Plastic & Burns Department, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Medical Centre, Birmingham
| | - Sheila Greenfield
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham
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Ohrtman EA, Shapiro GD, Wolfe AE, Trinh NHT, Ni P, Acton A, Slavin MD, Ryan CM, Kazis LE, Schneider JC. Sexual activity and romantic relationships after burn injury: A Life Impact Burn Recovery Evaluation (LIBRE) study. Burns 2020; 46:1556-1564. [PMID: 32948357 DOI: 10.1016/j.burns.2020.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/10/2020] [Accepted: 01/16/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Engaging in healthy sexual activity and romantic relationships are important but often neglected areas of post-burn rehabilitation. The degree to which persons with burn injuries engage in sexual activity and romantic relationships is not well understood. This study examined demographic and clinical characteristics predicting engagement in sexual activity and romantic relationships in a sample of adult burn survivors compared to a general United States sample. METHODS Data for the adult burn survivor sample were from 601 adult burn survivors who participated in field-testing for the calibration of the Life Impact Burn Recovery Evaluation (LIBRE) Profile, a burn-specific instrument assessing social participation on six scales including sexual activity and romantic relationships. Comparison data were obtained from a general population sample of 2000 adults through sample matching. Demographic predictors of sexual activity and romantic relationship status were examined in each sample using modified Poisson regression analyses. Clinical predictors of engaging in sexual activity and romantic relationships were also examined in the LIBRE sample. RESULTS Participants were slightly more likely to report being sexually active in the adult burn survivor sample than in the general sample (65% vs. 57%, p < 0.01). There was not a significant difference in romantic relationship status between the two samples (64% vs. 62%, p = 0.31). In multivariable regression analyses, men in both samples were more likely to report being in a sexual relationship (RR in LIBRE sample = 1.23, 95% CI 1.08-1.39; RR in general sample = 1.10, 95% CI 1.02-1.18). Participants in both samples who were not working were less likely to report being sexually active or in a romantic relationship (RRs ranging from 0.73 to 0.83, p < 0.05 for all estimates). In the adult burn survivor sample, respondents with hand burns were more likely to report being sexually active and in a romantic relationship (RR = 1.16, 95% CI 1.01-1.33). Time since burn injury, burn size, and burns to other critical areas were not significantly associated with either outcome in adjusted analyses. CONCLUSIONS The likelihood of engaging in sexual activity and romantic relationships is similar among adult burn survivors and the comparison group representing a general United States sample of adults. Further research addressing sexual activity and romantic relationships after burn injuries will help to foster better patient-clinician dialogue, pinpoint barriers, design interventions, and allocate appropriate resources.
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Affiliation(s)
- Emily A Ohrtman
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States
| | - Gabriel D Shapiro
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Audrey E Wolfe
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States
| | - Nhi-Ha T Trinh
- Massachusetts General Hospital, Boston, MA, United States
| | - Pengsheng Ni
- Boston University School of Public Health, Boston, MA, United States
| | - Amy Acton
- The Phoenix Society for Burn Survivors, Grand Rapids, MI, United States
| | - Mary D Slavin
- Boston University School of Public Health, Boston, MA, United States
| | - Colleen M Ryan
- Massachusetts General Hospital, Boston, MA, United States; Shriners Hospital for Children - Boston, Harvard Medical School, Boston, MA, United States
| | - Lewis E Kazis
- Boston University School of Public Health, Boston, MA, United States
| | - Jeffrey C Schneider
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States.
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The development and validation of the CARe Burn Scale: Child Form: a parent-proxy-reported outcome measure assessing quality of life for children aged 8 years and under living with a burn injury. Qual Life Res 2020; 30:239-250. [PMID: 32902793 PMCID: PMC7847857 DOI: 10.1007/s11136-020-02627-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE Patient-reported outcome measures (PROMs) identify patient needs and therapeutic progress. This paper outlines the development and validation of the CARe Burn Scale: Child Form, a parent-proxy-reported outcome measure that assesses quality of life in children aged 8 and under living with a burn injury. METHODS A literature review and interviews with 12 parents of children with a burn and seven health professionals informed the development of a conceptual framework and draft PROM. Cognitive debriefing interviews with 18 parents and eight health professionals provided feedback to ascertain content validity, and 311 parents took part in field testing. Rasch and traditional psychometric analyses were conducted to create a shortened version. Further psychometric analyses with 133 parents tested the shortened CARe Burn Scale in relation to other parent-proxy measures. RESULTS The final conceptual framework included 5 domains: Social and Emotional Difficulties, Social and Emotional Well-Being, Wound/Scar Discomfort, Wound/Scar Treatment and Physical Abilities. Two scales fulfilled Rasch and traditional psychometric analyses, providing evidence of construct validity, acceptability, and reliability. Three scales did not fulfil the Rasch criteria and were retained as checklists. Compared to other parent-proxy measures, individual CARe Burn Scales correlated moderately with similar constructs and had low correlations with dissimilar constructs, indicating evidence of criterion validity (concurrent and discriminant). CONCLUSIONS The CARe Burn Scale: Child Form can be used to measure children's quality of life after having a burn injury which can inform rehabilitation and surgical decision-making.
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Crosscultural Validation of the Community Integration Questionnaire-Revised in an Italian Population. Occup Ther Int 2020; 2020:8916541. [PMID: 32934614 PMCID: PMC7481919 DOI: 10.1155/2020/8916541] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 07/10/2020] [Indexed: 12/14/2022] Open
Abstract
Objective The aims of this study are the translation, cultural adaptation, and validation of the Community Integration Questionnaire–Revised (CIQ-R) in Italian in a group of individuals with no clinical evidence of disability. Methods The test's internal consistency and validity were assessed by following international guidelines. The test's internal consistency was examined using Cronbach's alpha (α) coefficient. Pearson's correlation coefficient was calculated to assess the test's concurrent validity compared with the Short Form-12 (SF-12) health survey. Results The CIQ-R was administrated to 400 people with no clinical evidence of disease, impairment, or disability, aged between 18 and 64. Cronbach's α reported a value of 0.82 in the home integration subscale. The test also showed a good test-retest reliability, with an Intraclass Correlation Coefficient of 0.78, and a significant correlation between the total score of the CIQ-R and the Physical Component Summary (PCS) of the SF-12 (r = 0.118), between the “social integration” subscale's score and PCS12 (r = 0.121) and between the “Electronic Social Networking integration” subscale's score and PCS12 (r = 0.184), with p < 0.05. Conclusion This is the first study to report the results of the translation and validation of the CIQ-R in Italian. The CIQ-R is an important tool for Italian professionals and can be useful in both clinical practice and research for measuring the level of community integration among the healthy population.
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Racial/Ethnic Disparities in Longitudinal Trajectories of Community Integration After Burn Injury. Am J Phys Med Rehabil 2020; 99:602-607. [PMID: 31876543 DOI: 10.1097/phm.0000000000001378] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this study was to examine potential racial/ethnic disparities in community integration for the 2 yrs after burn injury. DESIGN A sample of 1773 adults with burn injury from the Burn Model Systems database was used with data on community integration collected at discharge (preinjury recall), 6, 12, and 24 mos after discharge. METHODS Four sets of hierarchal linear models determined the most appropriate model for understanding racial/ethnic differences in Community Integration Questionnaire trajectories over time. RESULTS Data indicated a decrease in community integration between discharge and 6 mos, a slight increase between 6 mos and 1 yr, and then a plateau between 1 and 2 yrs. White individuals had higher community integration score trajectories over time than black (b = 0.53, P < 0.001) and Hispanic (b = 0.58, P < 0.001) individuals, and community integration scores were similar between black and Hispanic individuals (b = -0.05, P = 0.788). These racial/ethnic disparities remained after accounting for age, sex, total burned surface area, number of days in rehabilitation, and active range of motion deficits. CONCLUSIONS Additional rehabilitation resources should be targeted to helping black and Hispanic individuals integrate back into their communities after burn injury.
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Rencken CA, Allorto N, Harrison AD, McGarvey ST, Aluisio AR. Factors associated with adherence to follow-up care after burn injuries. Burns 2020; 47:240-248. [PMID: 32718731 DOI: 10.1016/j.burns.2020.06.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 06/16/2020] [Accepted: 06/26/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION In South Africa, burns result in excessive morbidity which can be mitigated via follow-up treatments. This study evaluated factors associated with care retention for after burn injuries. METHODS A retrospective chart review was performed for twelve months of care at the public burn facility in Kwazulu-Natal, South Africa. All inpatients were eligible, although those who were transferred or died during care were excluded. The primary outcome was return for initial appointment one-week after discharge. The population was analyzed descriptively, and multivariable logistic regression was employed to yield adjusted odds ratios (aOR) with associated 95% confidence intervals (CIs). RESULTS From 354 patients 310 were analyzed. Of these, 177 (57.47%) were children (<12 years). One third (33.12%) of patients were non-adherent to follow-up (n = 102). In multivariable analysis, children ≤12 years of age were more likely to follow up (aOR = 1.87; 95% CI: 1.07-3.25, p = 0.028), as were those who underwent an operation (aOR = 2.69; 95% CI: 1.47-4.91, p = 0.001). Residing ≥50 km from the health center was associated with lower likelihood of follow up (aOR = 0.52; 95% CI: 0.29-0.93, p = 0.027). CONCLUSION High follow up attrition suggests the need for enhanced engagement in the high-risk burn population studied, and the identified factors could be leveraged in such programming.
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Affiliation(s)
- Camerin A Rencken
- Brown University, 121 South Main Street, Providence, RI, United States.
| | - Nikki Allorto
- Burn Surgeon, University of KwaZulu-Natal, KZN, South Africa
| | - Abigail D Harrison
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, Providence, RI, United States
| | - Stephen T McGarvey
- International Health Institute, Brown University School of Public Health, 121 South Main Street, Providence, RI, United States
| | - Adam R Aluisio
- Department of Emergency Medicine, Brown University, 55 Claverick Street, Providence, RI, United States
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Ohrtman EA, Shapiro GD, Simko LC, Dore E, Slavin MD, Saret C, Amaya F, Lomelin-Gascon J, Ni P, Acton A, Marino M, Kazis LE, Ryan CM, Schneider JC. Social Interactions and Social Activities After Burn Injury: A Life Impact Burn Recovery Evaluation (LIBRE) Study. J Burn Care Res 2020; 39:1022-1028. [PMID: 30016442 DOI: 10.1093/jbcr/iry038] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Social interactions and activities are key components of social recovery following burn injuries. The objective of this study is to determine the predictors of these areas of social recovery. This study provides a secondary analysis of a cross-sectional survey of adult burn survivors. The Life Impact Burn Recovery Evaluation-192 was administered to 601 burn survivors for the field-testing of the Life Impact Burn Recovery Evaluation Profile. Survivors aged 18 years and older with injuries ≥5% total BSA or burns to critical areas (hands, feet, face, or genitals) were eligible to participate. Multivariate linear regression analyses were used to determine predictors of the Social Activities and Social Interactions scale scores. A total of 599 people completed the Social Interactions and Social Activities scales. Of these, 77% identified as White Non-Hispanic, 55% were female, 55% were unmarried, and 80% had burns to critical areas. Participants had a mean age of 45 years, a mean time since burn injury of 15 years, and a mean burn size of 41% total BSA. Younger age (P < .01) and being married/living with a significant other (P ≤ .01) were associated with higher Social Activities and Social Interactions scale scores. Individual item responses reveal that survivors had lower scores on items related to participating in outdoor activities (30.4%) or feeling uncomfortable with their appearance (32.4% report dressing to avoid stares). Social interactions and activities are long-term challenges for burn survivors. It is important for clinicians to identify patients who may struggle with social recovery in order to focus on future community-based interventions.
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Affiliation(s)
- Emily A Ohrtman
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts
| | - Gabriel D Shapiro
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Laura C Simko
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts
| | - Emily Dore
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Mary D Slavin
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Cayla Saret
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Flor Amaya
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - J Lomelin-Gascon
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Pengsheng Ni
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Amy Acton
- Phoenix Society for Burn Survivors, Grand Rapids, Michigan
| | - Molly Marino
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Lewis E Kazis
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Colleen M Ryan
- Massachusetts General Hospital, Shriners Hospitals for Children, Harvard Medical School, Boston
| | - Jeffrey C Schneider
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts
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Amtmann D, Bocell FD, McMullen K, Bamer AM, Johnson KL, Wiechman SA, Schneider JC. Satisfaction With Life Over Time in People With Burn Injury: A National Institute on Disability, Independent Living, and Rehabilitation Research Burn Model System Study. Arch Phys Med Rehabil 2020; 101:S63-S70. [DOI: 10.1016/j.apmr.2017.09.119] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 09/07/2017] [Accepted: 09/25/2017] [Indexed: 01/07/2023]
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Hornsby N, Blom L, Sengoelge M. Psychosocial Interventions Targeting Recovery in Child and Adolescent Burns: A Systematic Review. J Pediatr Psychol 2020; 45:15-33. [PMID: 31697370 DOI: 10.1093/jpepsy/jsz087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 09/19/2019] [Accepted: 10/02/2019] [Indexed: 02/06/2023] Open
Abstract
Children post-burn injury experience a range of psychosocial sequelae that benefit from early provision of psychosocial support. However, no systematic review exists evaluating the full range of psychological interventions. OBJECTIVE To critically evaluate psychosocial interventions for children (<18 years old) with burn injuries in improving psychosocial recovery. STUDY DESIGN All-language studies were identified from inception to March 2018 in six electronic databases and appraised according to PRISMA checklist and Cochrane Risk of Bias Tool for quality. Studies were stratified into three groups: distraction (virtual reality, child life therapy, imagery-based therapy, hypnosis), burn camps, and other (social skills, cognitive behavioral therapy, parent group counseling). RESULTS Out of a total of 5,456 articles identified, 297 underwent full review resulting in 27 included articles published between 1986 and 2018. Sample sizes ranged from 9 to 266, comprising child and adult participants. A range of interventions and psychosocial outcome measures were found. Several studies (n = 21) reported statistically significant improvements in outcome; the majority were distraction interventions to reduce pain and anxiety. A limited number of studies showing effect was found for cognitive behavioral therapy and parent counseling. Risk of bias was high in studies of burn camps and mixed for all other interventions. CONCLUSIONS A range of psychosocial interventions and outcome tools exist in pediatric burns. Distraction interventions prior to and/or during dressing changes or physical therapy were shown to effectively reduce pain and anxiety for a wide range of pediatric ages.
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Affiliation(s)
- Nancy Hornsby
- Violence, Injury and Peace Research Unit, South African Medical Research Council-UNISA
| | - Lisa Blom
- Department of Public Health Sciences, Karolinska Institutet, Global Health
| | - Mathilde Sengoelge
- Department of Public Health Sciences, Karolinska Institutet, Global Health
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Moortgat P, Anthonissen M, Van Daele U, Vanhullebusch T, Maertens K, De Cuyper L, Lafaire C, Meirte J. The effects of shock wave therapy applied on hypertrophic burn scars: a randomised controlled trial. Scars Burn Heal 2020; 6:2059513120975624. [PMID: 33312712 PMCID: PMC7716075 DOI: 10.1177/2059513120975624] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION A wide variety of non-invasive treatments has been proposed for the management of hypertrophic burn scars. Unfortunately, the reported efficacy has not been consistent, and especially in the first three months after wound closure, fragility of the scarred skin limits the treatment options. Extracorporeal shock wave therapy (ESWT) is a new non-invasive type of mechanotherapy to treat wounds and scars. The aim of the present study was to examine the objective and subjective scar-related effects of ESWT on burn scars in the early remodelling phase. MATERIAL AND METHODS Evaluations included the Patient and Observer Scar Assessment Scale (POSAS) for scar quality, tri-stimulus colorimetry for redness, tewametry for trans-epidermal water loss (TEWL) and cutometry for elasticity. Patients were randomly assigned to one of two groups, the low-energy intervention group or the placebo control group, and were tested at baseline, after one, three and six months. All patients were treated with pressure garments, silicone and moisturisers. Both groups received the ESWT treatment (real or placebo) once a week for 10 weeks. RESULTS Results for 20 patients in each group after six months are presented. The objective assessments showed a statistically significant effect of ESWT compared with placebo on elasticity (P = 0.011, η2P=0.107) but revealed no significant effects on redness and TEWL. Results of the clinical assessments showed no significant interactions between intervention and time for the POSAS Patient and Observer scores. CONCLUSION ESWT can give added value to the non-invasive treatment of hypertrophic scars, more specifically to improve elasticity when the treatment was already started in the first three months after wound closure. LAY SUMMARY Pathological scarring is a common problem after a burn injury. A wide variety of non-invasive treatments has been proposed for the management of these scars. Unfortunately, the reported efficacy of these interventions has not been consistent, and especially in the first three months after wound closure, fragility of the scarred skin limits the treatment options. Extracorporeal shock wave therapy (ESWT) is a relatively new non-invasive therapy to treat both wounds and scars. The aim of the present study was to examine the scar-related effects of ESWT on burn scars in the early phase of healing.The scars were subjectively assessed for scar quality by the patient and an observer using the Patient and Observer Scar Assessment Scale (POSAS). Objective assessments included measurements to assess redness, water loss and elasticity. Forty patients were randomly assigned to one of two groups, the low-energy intervention group or the placebo control group (the device simulated the sound of an ESWT treatment but no real shocks were applied), and were tested at four timepoints up to six months. All patients were treated with pressure garments, silicone and moisturisers. Both groups received the ESWT treatment (real or placebo) once a week for 10 weeks.The objective assessments showed a significant improvement of elasticity in the intervention group when compared with placebo but revealed no significant effects on redness and water loss. Results of the clinical assessments showed no differences between the groups for the POSAS Patient and Observer scores.ESWT can give added value to the non-invasive treatment of pathological scars more specifically to improve elasticity in the early phase of healing.
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Affiliation(s)
| | - Mieke Anthonissen
- OSCARE, Antwerp, Belgium
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Ulrike Van Daele
- OSCARE, Antwerp, Belgium
- University of Antwerp, Rehabilitation Sciences and Physiotherapy, Antwerp, Belgium
| | - Tine Vanhullebusch
- OSCARE, Antwerp, Belgium
- University of Antwerp, Rehabilitation Sciences and Physiotherapy, Antwerp, Belgium
| | - Koen Maertens
- OSCARE, Antwerp, Belgium
- Department of Clinical and Lifespan Psychology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Lieve De Cuyper
- OSCARE, Antwerp, Belgium
- ZNA Stuivenberg, Burns Center, Antwerp, Belgium
| | - Cynthia Lafaire
- OSCARE, Antwerp, Belgium
- ZNA Stuivenberg, Burns Center, Antwerp, Belgium
| | - Jill Meirte
- OSCARE, Antwerp, Belgium
- University of Antwerp, Rehabilitation Sciences and Physiotherapy, REVAKI-MOVANT, Antwerp, Belgium
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Sinha S, Gabriel VA, Nickerson DA, Fraulin FOG, Shin W, Rahmani WM, Chatterjee P, Ahuja RB, Biernaskie JA. Interventions for postburn pruritus. Hippokratia 2019. [DOI: 10.1002/14651858.cd013468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Sarthak Sinha
- University of Calgary; Skin Regeneration Team, Department of Comparative Biology and Experimental Medicine; Rm 403, Heritage Medical Research Building 3300 Hospital Dr NW Calgary AB Canada T2N 4N1
| | - Vincent A Gabriel
- University of Calgary, Calgary Firefighters’ Burn Treatment Centre; Departments of Clinical Neurosciences, Pediatrics and Surgery; Room AC 144 Special Services Building 1403 29 Street NW Calgary AB Canada T2N 2T9
| | - Duncan A Nickerson
- Alberta Health Services, Calgary Firefighters’ Burn Treatment Centre, Foothills Medical Centre; Department of Surgery; 200, 2004 14th Street NW Calgary AB Canada
| | - Frankie OG Fraulin
- Alberta Health Services, Alberta Children's Hospital; Department of Surgery; 2888 Shaganappi Trail NW Calgary AB Canada T3B 6A8
| | - Wisoo Shin
- University of Calgary; Department of Comparative Biology and Experimental Medicine; 3330 Hospital Dr. NW Calgary AB Canada T2N 4N1
| | - Waleed M Rahmani
- University of Calgary; Department of Comparative Biology and Experimental Medicine; 3330 Hospital Dr. NW Calgary AB Canada T2N 4N1
| | - Pallab Chatterjee
- Command Hospital Air Force; Department of Plastic Surgery, Surgical Division; Old Airport Road Bengaluru Karnataka India 560007
| | - Rajeev B Ahuja
- Sir Ganga Ram Hospital; Department of Plastic Surgery; Rajinder Nagar New Delhi Delhi India 110060
| | - Jeff A Biernaskie
- University of Calgary; Department of Comparative Biology and Experimental Medicine; 3330 Hospital Dr. NW Calgary AB Canada T2N 4N1
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Holavanahalli RK, Schneider JC, Miller AC. Introduction to the NIDILRR Burn Model System (BMS) Program: Selected Findings II. Arch Phys Med Rehabil 2019; 101:S0003-9993(19)31369-3. [PMID: 31733193 DOI: 10.1016/j.apmr.2019.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 11/26/2022]
Abstract
A special supplement to the Archives of Physical Medicine and Rehabilitation in 2007 reported selected findings of research from the first 13 years of the BMS Centers and Database Coordinating Center. This special supplement is the second such effort and reports on the growth of the BMS National Longitudinal Database (BMS NDB) since that time and select new research findings from the BMS centers.
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Affiliation(s)
| | | | - A Cate Miller
- National Institute on Disability, Independent Living, and Rehabilitation Research, Washington, DC
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41
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Saret CJ, Ni P, Marino M, Dore E, Ryan CM, Schneider JC, Kazis LE. Social Participation of Burn Survivors and the General Population in Work and Employment: A Life Impact Burn Recovery Evaluation (LIBRE) Profile Study. J Burn Care Res 2019; 40:669-677. [PMID: 31069384 DOI: 10.1093/jbcr/irz076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Work integration and retention after burn injury is a key outcome. Little is known about how burn survivors reintegrate into the workplace. This article compares scores on the Life Impact Burn Recovery Evaluation (LIBRE) Profile, a burn-specific measure of social participation, between burn survivors and general population samples, focusing on the Work and Employment domain. METHODS Convenience samples of burn survivors and the U.S. population were obtained. Differences in demographic and clinical characteristics and LIBRE Profile scores were assessed. To examine work and employment, we compared family and friends, social activities, and social interactions scores among working vs nonworking burn survivors. RESULTS Six hundred and one burn survivors (320 employed) and 2000 U.S. residents (1101 employed) were surveyed. The mean age (P = .06), distributions of sex (P = .35), and Hispanic ethnicity (P = .07) did not differ significantly. Distributions of race (P < .01) and education (P = .01) differed significantly. The burn survivor sample had higher scores, demonstrating higher participation, for work and employment (mean = 49.5, SD = 9.42) than the general sample (mean = 46.94, SD = 8.94; P < .0001), which persisted after adjusting for demographic characteristics. Scores on the three domains administered to all respondents were higher (P < .001) for working than nonworking burn survivors. CONCLUSION Distributions indicated higher social participation in the burn survivor sample than the general sample. Possible explanations include sample bias; resilience, posttraumatic growth, or response-shift of survivors; and limitations of using items in the general sample. Working burn survivors scored higher than those not working. Future work can explore factors that mediate higher scores and develop interventions.
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Affiliation(s)
- Cayla J Saret
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Pengsheng Ni
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Molly Marino
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Emily Dore
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Colleen M Ryan
- Department of Surgery, Massachusetts General Hospital, Boston.,Harvard Medical School, Boston, Massachusetts.,Shriners Hospitals for Children-Boston®, Massachusetts
| | - Jeffrey C Schneider
- Harvard Medical School, Boston, Massachusetts.,Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts
| | - Lewis E Kazis
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
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Robinson LR, Godleski M, Rehou S, Jeschke M. The Impact of Introducing a Physical Medicine and Rehabilitation Consultation Service to an Academic Burn Center. J Burn Care Res 2019; 40:648-651. [PMID: 31120130 DOI: 10.1093/jbcr/irz079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Prior retrospective studies suggest that physical medicine and rehabilitation (PM&R) acute care consultation improves outcome and reduces acute care length of stay (ACLOS) in trauma patients. There have not been prospective studies to evaluate this impact in burn patients. This cohort study compared outcomes before and after the introduction of a PM&R consultation service to the acute burn program, and the inpatient rehabilitation program, at a large academic hospital. The primary outcome measures were length of stay (LOS) in acute care and during subsequent inpatient rehabilitation. For the acute care phase, there were 194 patients in the preconsultation group and 114 who received a consultation. There was no difference in age, Baux score, or LOS in these patients. For the rehabilitation phase, there were 109 patients in the prephysiatrist group and 104 who received PM&R care. The LOS was significantly shorter in the latter group (24 days vs 30 days, P = .002). Functional independence measure (FIM) change, unexpected readmission, and discharge destination were not significantly different. The addition of a burn physiatrist did not influence ACLOS. However, there was a significant reduction in inpatient rehabilitation LOS.
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Affiliation(s)
- Lawrence R Robinson
- Division of Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Medicine, University of Toronto, Canada.,St. John's Rehab Program, Sunnybrook Health Sciences Centre and University of Toronto, Canada
| | - Matthew Godleski
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Ontario, Canada
| | - Sarah Rehou
- Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Marc Jeschke
- Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Institute of Medical Science, Faculty of Medicine, University of Toronto, Canada.,Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, University of Toronto, Canada.,Department of Immunology, Faculty of Medicine, University of Toronto, Ontario, Canada
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Men SY, Huo QL, Shi L, Yan Y, Yang CC, Yu W, Liu BQ. Panax notoginseng saponins promotes cutaneous wound healing and suppresses scar formation in mice. J Cosmet Dermatol 2019; 19:529-534. [PMID: 31267657 DOI: 10.1111/jocd.13042] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/16/2019] [Accepted: 05/20/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND & AIM Panax notoginseng saponins are believed to promote wound healing due to its anti-proliferative effect on fibroblasts. The present work was therefore aimed to examine the beneficial effect of PNS on wound healing in vitro and in a murine model of cutaneous wound. METHODS The in vitro effects of Panax notoginseng saponins on the proliferation of and nitric oxide (NO) synthesis in human fibroblast 3T3 cells were studied. The in vivo effects of Panax notoginseng saponins were examined in C57 mice with dorsal cutaneous wound. The healing rate and scar formation were followed after treatment with Panax notoginseng saponins. The histology and fibroblast accumulation in the wounds were studied using hematoxylin and eosin (H&E) staining. Expression of α-smooth muscle actin (α-SMA) was examined by immunohistochemistry. RESULTS Panax notoginseng saponins inhibited the proliferation of human fibroblast 3T3 with an EC50 of 1.825 mM Panax notoginseng saponins (0.1 mM) significantly promoted NO production (P < 0.01) and NO synthase activity (P < 0.01) of 3T3. In C57 mice with dorsal cutaneous wounds, 0.1 mM Panax notoginseng saponins significant expedited wound healing by reducing the size of lesions and suppressing the formation of scar. H&E staining revealed that treatment with Panax notoginseng saponins suppressed fibroblast accumulation in wound areas, while immunohistochemistry showed a significant reduction in α-SMA expression by 0.1 mM Panax notoginseng saponins. CONCLUSION Panax notoginseng saponins are a promising drug candidate that can accelerate wound healing and reduce scar formation.
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Affiliation(s)
- Si-Ye Men
- Department of General Surgery, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, PR China
| | - Qiao-Ling Huo
- Clinical Surgery of Integrated Traditional Chinese and Western Medicine, Beijing University of Chinese Medicine, Beijing, PR China
| | - Lei Shi
- Department of Scientific Research, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, PR China
| | - Yan Yan
- Department of Experimental Center, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, PR China
| | - Cheng-Cheng Yang
- Department of General Surgery, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, PR China
| | - Wen Yu
- Department of General Surgery, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, PR China
| | - Bao-Qing Liu
- Department of General Surgery, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, PR China
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Elrod J, Schiestl CM, Mohr C, Landolt MA. Incidence, severity and pattern of burns in children and adolescents: An epidemiological study among immigrant and Swiss patients in Switzerland. Burns 2019; 45:1231-1241. [PMID: 31097353 DOI: 10.1016/j.burns.2019.02.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 01/11/2019] [Accepted: 02/07/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Despite advances in surgical management and critical care for burn surgery, morbidity and mortality of patients with severe burns remains high. Especially in the pediatric population, burns often lead to devastating consequences such as the necessity of corrective surgery until adulthood. Worldwide, 80%-90% of all severe burns occur in low to middle income countries. But also in high income countries, burns are distributed inequitably. Risk factors include age, sex, socioeconomic status, and ethnicity. AIM The objective of this study was to determine the typical demographics and injury-related data of pediatric burn patients in order to contribute to preventive measures. Special interest was paid to the question of whether the incidence of severe burns is higher among patients with an immigration background. PATIENTS AND METHODS Patient records of the 4373 patients admitted to the Pediatric Burn Unit of the University Children's Hospital of Zurich from 2006 to 2018 were analyzed. Demographic data and injury patterns are presented descriptively. Temporal trends concerning duration of hospitalization and setting (inpatient versus outpatient), differences in relative incidence and in burn mechanism in distinct cohorts (by nation and Human Development Index (HDI)) and seasonal trends were analyzed. Furthermore, risk factors for large burns and for (prolonged) inpatient treatment were examined using a multivariate approach. RESULTS Temporal resolution shows considerable variation between inpatient and outpatient treatment (p>0.001) and with shorter hospital stays (p=0.004). Swiss citizens and patients with an immigration background from very highly developed countries sustain a significantly lower incidence of heat-related injuries than all others (p<0.001). The most common burn causes among all children, independent of their country of citizenship, are related to kitchen items or hot tea and coffee (35.57%±4.01% resp. 32.39%±5.95%). Logistic regression revealed that migration background from a low HDI country is significantly associated with larger burns (>5% TBSA) and with a need for inpatient treatment. CONCLUSION The study emphasizes the need for highly specific measures of burn prevention and indicates the necessity of focusing on certain target groups who are especially vulnerable to burns, such as immigrants from less developed countries.
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Affiliation(s)
- Julia Elrod
- Pediatric Burn Center, Division of Plastic and Reconstructive Surgery, University Children's Hospital Zurich, Steinwiesstrasse 75 8032, Zurich, Switzerland.
| | - Clemens M Schiestl
- Pediatric Burn Center, Division of Plastic and Reconstructive Surgery, University Children's Hospital Zurich, Steinwiesstrasse 75 8032, Zurich, Switzerland
| | - Christoph Mohr
- Pediatric Burn Center, Division of Plastic and Reconstructive Surgery, University Children's Hospital Zurich, Steinwiesstrasse 75 8032, Zurich, Switzerland
| | - Markus A Landolt
- Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Steinwiesstrasse, 75 8032, Zurich, Switzerland; Division of Child and Adolescence Health Psychology, Department of Psychology, University of Zurich, Steinwiesstrasse, 75 8032, Zurich, Switzerland
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45
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Litchfield I, Jones LL, Moiemen N, Andrews N, Greenfield S, Mathers J. The role of self-management in burns aftercare: a qualitative research study. Burns 2018; 45:825-834. [PMID: 30545694 DOI: 10.1016/j.burns.2018.10.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 10/17/2018] [Accepted: 10/23/2018] [Indexed: 11/15/2022]
Abstract
INTRODUCTION For severe burns patient care presents a considerable challenge, necessitating an integrated multi-disciplinary approach that utilises a range of treatments. The period of care post-discharge can be lengthy and complex, and include scar management, occupational and physiotherapies, psychological support, and further surgery. How successfully the patient negotiates this complex care regimen is critical to their long-term recovery and in doing so they would appear to employ approaches recognised as "self-management" in other chronic conditions. However their exact nature and how they are used has yet to be explicitly explored amongst chronic burn patients. METHODS Semi-structured interviews were conducted with 24 patients to discuss their experiences of long-term burn treatment as part of a broader mixed- methods feasibility study of the use of pressure garment therapy in preventing hypertrophic scarring after burn injury. The topic guide included questions on the patient experience of their care post discharge, including pressure garment therapy and other scar management techniques; and their expectations and experiences of treatment and recovery. The data were analysed using an established framework of self-management processes. RESULTS Burns patients employ many of the same processes of self-management as those experiencing more widely recognised chronic diseases or illnesses. This is despite the prospect of gradual improvement amongst burns patients absent in those with incurable chronic conditions. The key processes of self-management they share are the ability to focus on their illness needs, activate the appropriate resources and coming to terms with the consequences of living with either the physical or psychological consequences of their condition. CONCLUSION Modern burn care is technologically advanced and delivered by a highly trained, multi-disciplinary team, yet the level of its success relies on the ability of the patient to independently fulfil a number of health-related tasks and activities once leaving hospital. Considering the potential cost-savings to health services and the prospect of improved outcomes for patients capable of self-management our work is an important first step in more precisely understanding the use of self-management amongst burns patients, and the level of implicit or explicit support currently offered by their care providers.
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Affiliation(s)
- Ian Litchfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
| | - Laura L Jones
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
| | - Naiem Moiemen
- The Scar Free Foundation Centre for Burns Research, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
| | - Nicole Andrews
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
| | - Sheila Greenfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
| | - Jonathan Mathers
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
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Pham TN, Wong JN, Terken T, Gibran NS, Carrougher GJ, Bunnell A. Feasibility of a Kinect®-based rehabilitation strategy after burn injury. Burns 2018; 44:2080-2086. [DOI: 10.1016/j.burns.2018.08.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 07/27/2018] [Accepted: 08/30/2018] [Indexed: 01/22/2023]
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Elrashid NAA, Sanad DA, Mahmoud NF, Hamada HA, Abdelmoety AM, Kenawy AM. Effect of orange polarized light on post burn pediatric scar: a single blind randomized clinical trial. J Phys Ther Sci 2018; 30:1227-1231. [PMID: 30349154 PMCID: PMC6181673 DOI: 10.1589/jpts.30.1227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 07/10/2017] [Indexed: 12/03/2022] Open
Abstract
[Purpose] This study was carried out to investigate the effect of orange filtered
polarized polychromatic light on post burn pediatric scar. [Participants and Methods]
Thirty children with post burn scar in wrist and hands participated in this study. They
were between 3 to 7 years old, having hypertrophic burn scar ≥2 months post healing, free
from concomitant skin disease and keloids. They were randomly assigned into two groups.
The control group (A) (n=15) received Scar Standard Management (SSM) protocol and the
study group (B) (n=15) received SSM protocol along with 15 min/area polarized light with
medical range filter followed by 15 min/area orange filtered polarized light. All children
received the study protocol once a day, 3 times/week for one month. Scar assessment was
done before and after the study protocol by using Vancouver Scar Scale (VSS). [Results]
All participated children were analyzed. Comparison of post treatment results between
groups revealed significant improvement of post burn scar for both groups with significant
difference in favor to the study group. [Conclusion] Ultimately it was revealed that
Orange filtered polarized light has a special and beneficial effect on decreasing post
burn pediatric scar.
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Affiliation(s)
| | - Doaa A Sanad
- Department of Pediatric Physical Therapy, Faculty of Physical Therapy, Cairo University, Egypt
| | - Noha F Mahmoud
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, October 6 University, Egypt.,Department of Rehabilitation, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Saudi Arabia
| | - Hamada A Hamada
- Lecture of Biomechanics, Faculty of Physical Therapy, Cairo University: Giza, Egypt
| | - Alshaimaa M Abdelmoety
- Department of Public Health and Community Medicine, Faculty of Medicine, Cairo University, Egypt
| | - Ahmed M Kenawy
- Department of Plastic Surgery, Faculty of Medicine, Cairo University, Egypt
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Duke JM, Randall SM, Boyd JH, Wood FM, Fear MW, Rea S. A population-based retrospective cohort study to assess the mental health of patients after a non-intentional burn compared with uninjured people. Burns 2018; 44:1417-1426. [DOI: 10.1016/j.burns.2018.05.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 04/23/2018] [Accepted: 05/16/2018] [Indexed: 12/14/2022]
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Dore EC, Marino M, Ni P, Lomelin-Gascon J, Sonis L, Amaya F, Ryan CM, Schneider JC, Jette AM, Kazis LE. Reliability & validity of the LIBRE Profile. Burns 2018; 44:1750-1758. [PMID: 30075970 DOI: 10.1016/j.burns.2018.04.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 03/20/2018] [Accepted: 04/04/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND The Life Impact Burn Recovery Evaluation (LIBRE) Profile© was developed using Item Response Theory methods to assess social participation after a burn injury. The LIBRE Profile measures six areas of social participation: Relationships with Family & Friends, Social Interactions, Social Activities, Work & Employment, Romantic Relationships, and Sexual Relationships. It can be administered through a computerized adaptive test or through fixed short forms. The goal of this study was to further examine the psychometric properties of the LIBRE Profile, including reliability and validity. METHODS We examined the validity of the LIBRE Profile by administering the six LIBRE Profile scales as well as legacy measures that assessed similar constructs. We calculated the Pearson correlations between the LIBRE Profile scales and the scores on the same-domain and cross-domain legacy measures to evaluate convergent and divergent validity. We then administered the LIBRE Profile scales a second time, seven to ten days after the first administration, to a sample of adult burn survivors to evaluate test-retest reliability. We calculated repeatability coefficients, standard error of measurement, and minimal detectable change to establish the threshold beyond which the amount of change observed across an episode of care cannot be explained as measurement error. RESULTS For reliability, the repeatability coefficients ranged from 7.31 to 9.27 and SEMs ranged from 2.62 to 3.39 for all six scales. MDC90 values ranged from 6.08 to 7.86 points, and MDC95 values ranged from 7.26 to 9.40 points. All correlations between the LIBRE Profile scales and legacy measures are significant (p<0.05) and in the expected directions for both convergent and divergent validity. CONCLUSIONS This study provided evidence for the reliability and validity of the LIBRE Profile, one of the first tools that measures exclusively the social participation after a burn injury.
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Affiliation(s)
- Emily C Dore
- Boston University School of Public Health, Department of Health Law, Policy, and Management, United States
| | - Molly Marino
- Boston University School of Public Health, Department of Health Law, Policy, and Management, United States
| | - Pengsheng Ni
- Boston University School of Public Health, Department of Health Law, Policy, and Management, United States
| | - Julieta Lomelin-Gascon
- Boston University School of Public Health, Department of Health Law, Policy, and Management, United States
| | - Lily Sonis
- Boston University School of Public Health, Department of Health Law, Policy, and Management, United States
| | - Flor Amaya
- Boston University School of Public Health, Department of Health Law, Policy, and Management, United States
| | - Colleen M Ryan
- Department of Surgery, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States; Shriners Hospitals for Children - Boston(®), Boston, MA, United States
| | - Jeffrey C Schneider
- Harvard Medical School, Boston, MA, United States; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Alan M Jette
- MGH Institute of Health Professions, United States
| | - Lewis E Kazis
- Boston University School of Public Health, Department of Health Law, Policy, and Management, United States.
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Lotfi M, Ghahremaneian A, Aghazadeh A, Jamshidi F. The Effect of Pre-Discharge Training on the Quality of Life of Burn Patients. J Caring Sci 2018; 7:107-112. [PMID: 29977882 PMCID: PMC6029655 DOI: 10.15171/jcs.2018.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 09/27/2017] [Indexed: 11/09/2022] Open
Abstract
Introduction: Many physical, psychological, social and economic complications have been reported after discharge, which have a negative impact on the quality of life of burn patients. The present research examines the effect of pre-discharge training program on the life quality of patients with burns.
Methods: This is a pre and post-experimental study with control group that was conducted in 2015 in teaching hospital Sina. The control group received the typical instructions upon being discharged from hospital while the experimental group received in-person training in the form of question-answer, pamphlets and a researcher-made instruction booklet. The patients’ life quality was evaluated when they were being discharged, a month and then three months after they were discharged.
Results: The result showed that the quality of life has a significant statistical difference across the three time points. And these differences are compared using Bonferroni’s adjustment multiple comparisons indicating that pre-discharge training affects the quality of life scores and this effect continues over time.
Conclusion: The results show that the pre-discharge training has significantly improved the life quality among the burns patients. The improvement of life quality is also correlated with the quantitative variable of total body surface area percent (TBSA %). Thus, planning and designing in-discharge training programs based on the existing context, combined with training packages focusing on the patients’ needs could be a very significant step in more successful implementation of the follow-up programs on the burn patients and improving their quality of life.
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Affiliation(s)
- Mojgan Lotfi
- Departement of Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Akram Ghahremaneian
- Departement of Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Aghazadeh
- Departement of Basic sciences, Paramedical Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Jamshidi
- Departement of Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
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