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Jawad AM, Kadhum M, Evans J, Cubitt JJ, Martin N. Recovery of functional independence following major burn: A systematic review. Burns 2024; 50:1406-1423. [PMID: 38492981 DOI: 10.1016/j.burns.2024.02.017] [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: 09/29/2023] [Revised: 01/07/2024] [Accepted: 02/21/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Major burn injury, despite advancements in care and prevention, can have a profound impact on long-term morbidity, affecting quality of life and socioeconomic standing. We aim to explore factors predicting recovery of independence, the expected rate and time in majorly burned patients, and the measures of progress used. METHOD A systematic search of four databases (MEDLINE, EMBASE, COCHRANE, CINAHL) was conducted for studies reporting outcomes pertaining to physical ability indicative of independent function in adult (>15 y) cohorts who had suffered a major burn (>20% TBSA) up to 30 years after treatment in a developed specialised burn service. Data extracted included factors affecting rate of and time to achievement of function in five independence domains, as well as the outcome measures used. RESULTS 21 eligible studies were included comprising 1298 major burns survivors with a combined mean age of 39.6 y and a mean TBSA of 25.8%. The most significant recurring factors impacting recovery of independent function were older age, female gender, burn severity, prolonged ICU and hospital admission, preceding mental health conditions, and post-acute psychological issues. Exercise-based rehabilitation conferred benefits on major burn patients even over 2 years following injury. Discharge to independent living from hospital occurred in 27% to 97% of patients, while reported return to work rates varied from 52% to 80%. Burns Specific Health Scale-Brief, Functional Independence Measure, and Physical Composite Score (SF-36) were the most widely used outcome scoring systems. CONCLUSION Major burn survivors have protracted recovery with potential for persistent chronic impairments, remaining consistently below baseline levels of function. Non-modifiable factors such as age and gender, and disease characteristics such as burn size with associated physical, physiological and psychosocial sequelae are contributory. Further research is required to explore achievement of specific milestones of major burn and polytrauma critical care patients, while early targeted rehabilitation addressing physical, psychological, and vocational needs has promising potential benefit.
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Affiliation(s)
- Ali M Jawad
- Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, UK; Welsh Centre for Burns and Plastic Surgery, Swansea, Wales, UK.
| | - Murtaza Kadhum
- Welsh Centre for Burns and Plastic Surgery, Swansea, Wales, UK
| | - Janine Evans
- Welsh Centre for Burns and Plastic Surgery, Swansea, Wales, UK
| | | | - Niall Martin
- Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, UK
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2
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Yang J, Liu J, Ma K, Bai H, Ran M, Tian G, Yang S, Fu X. Analysis of anatomic location of burns inpatients in China from 2009 to 2018. BMC Public Health 2024; 24:1799. [PMID: 38970003 PMCID: PMC11227170 DOI: 10.1186/s12889-024-18910-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 05/21/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND Burns cause serious physical and psychological harm to patients, placing a heavy burden on the global healthcare system. Our previous study detailed the epidemiological characteristics of burn injuries in Chinese inpatients from 2009 to 2018. Interestingly, the anatomic locations of burn injuries vary by gender, age, provinces, and outcomes among different causes. Therefore, this current study aims to analyze the characteristics of burn injuries in inpatients with various burn sites by collecting data in China from 2009 to 2018. This analysis will inform future healthcare system decisions and provide effective strategies. METHODS Burns inpatients from 196 hospitals across 31 provinces in China were included in the study, covering the period from 2009 to 2018. The data collected encompassed information on gender, age, etiology, regions, clinical outcomes, and anatomical locations of the injuries. Data analysis was conducted using Microsoft Excel 2007. RESULTS From 2009 to 2018, a total of 333,995 burns inpatients were recorded. The most vulnerable parts to burns were multiple burn sites (230,090, 68.89%). Women were more susceptible to lower limb burns (15,608, 14%), while men were more prone to eye injuries (8,387, 3.37%) and hand burns (6,119, 2.75%). The age group of 0-10 years was the most vulnerable to burns across all body areas, including internal organs. In China, individuals aged 20-50 years were at a higher risk of head and neck burns compared to other age groups. The Han population showed increased vulnerability to eye injuries (2.12 times higher than minorities), respiratory tract issues (2.09 times higher than minorities), and trunk burns (1.83 times higher than minorities), while being less susceptible to internal organ injuries (0.23 times fewer than minorities) and lower limb burns (0.78 times fewer than minorities). The southwest region had the highest proportion of burns inpatients with burns affecting single body parts, whereas the eastern area had the highest rates of respiratory tract burns (0.85%) and multiple burn sites (80.64%). Scalding was identified as the most common cause of burns, while flame burns (769, 55.81%) and chemical burns (438, 47.35%) were the main causes of respiratory tract and internal organ injuries, respectively. CONCLUSIONS This study provides an initial description of characteristics of burns inpatients with various anatomic locations of burns in China over the past decade. Our findings will contribute to the most up-to-date clinical evidence database for healthcare planning and prevention initiatives in both China and other countries.
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Affiliation(s)
- Jie Yang
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Department, PLA General Hospital and PLA Medical College; PLA Key Laboratory of Tissue Repair and Regenerative Medicine and Beijing Key Research Laboratory of Skin Injury, Repair and Regeneration; Research Unit of Trauma Care, Tissue Repair and Regeneration, Chinese Academy of Medical Sciences, 2019RU051, Beijing, 100048, PR China
- Department of Dermatology, The Fourth Medical Center, PLA General Hospital, Beijing, 100048, PR China
| | - Jianchao Liu
- Institution of Hospital Management, Chinese PLA General Hospital, Beijing, 100853, PR China
| | - Kui Ma
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Department, PLA General Hospital and PLA Medical College; PLA Key Laboratory of Tissue Repair and Regenerative Medicine and Beijing Key Research Laboratory of Skin Injury, Repair and Regeneration; Research Unit of Trauma Care, Tissue Repair and Regeneration, Chinese Academy of Medical Sciences, 2019RU051, Beijing, 100048, PR China
| | - Huajuan Bai
- Institution of Hospital Management, Chinese PLA General Hospital, Beijing, 100853, PR China
| | - Mingzi Ran
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Department, PLA General Hospital and PLA Medical College; PLA Key Laboratory of Tissue Repair and Regenerative Medicine and Beijing Key Research Laboratory of Skin Injury, Repair and Regeneration; Research Unit of Trauma Care, Tissue Repair and Regeneration, Chinese Academy of Medical Sciences, 2019RU051, Beijing, 100048, PR China
- Department of Anesthesiology, The Fourth Medical Center, PLA General Hospital, Beijing, 100048, PR China
| | - Guanglei Tian
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Department, PLA General Hospital and PLA Medical College; PLA Key Laboratory of Tissue Repair and Regenerative Medicine and Beijing Key Research Laboratory of Skin Injury, Repair and Regeneration; Research Unit of Trauma Care, Tissue Repair and Regeneration, Chinese Academy of Medical Sciences, 2019RU051, Beijing, 100048, PR China
| | - Siming Yang
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Department, PLA General Hospital and PLA Medical College; PLA Key Laboratory of Tissue Repair and Regenerative Medicine and Beijing Key Research Laboratory of Skin Injury, Repair and Regeneration; Research Unit of Trauma Care, Tissue Repair and Regeneration, Chinese Academy of Medical Sciences, 2019RU051, Beijing, 100048, PR China.
- Department of Dermatology, The Fourth Medical Center, PLA General Hospital, Beijing, 100048, PR China.
| | - Xiaobing Fu
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Department, PLA General Hospital and PLA Medical College; PLA Key Laboratory of Tissue Repair and Regenerative Medicine and Beijing Key Research Laboratory of Skin Injury, Repair and Regeneration; Research Unit of Trauma Care, Tissue Repair and Regeneration, Chinese Academy of Medical Sciences, 2019RU051, Beijing, 100048, PR China.
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3
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Dewidar O, McHale G, Al Zubaidi A, Bondok M, Abdelrazeq L, Huang J, Jearvis A, Aliyeva K, Alghamyan A, Jahel F, Greer-Smith R, Tufte J, Barker LC, Elmestekawy N, Sharp MK, Horsley T, Prats CJ, Jull J, Wolfenden L, Cuervo LG, Hardy BJ, Roberts JH, Ghogomu E, Obuku E, Owusu-Addo E, Nicholls SG, Mbuagbaw L, Funnell S, Shea B, Rizvi A, Tugwell P, Bhutta Z, Welch V, Melendez-Torres GJ. Motivations for investigating health inequities in observational epidemiology: a content analysis of 320 studies. J Clin Epidemiol 2024; 168:111283. [PMID: 38369078 DOI: 10.1016/j.jclinepi.2024.111283] [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: 11/01/2023] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVES To enhance equity in clinical and epidemiological research, it is crucial to understand researcher motivations for conducting equity-relevant studies. Therefore, we evaluated author motivations in a randomly selected sample of equity-relevant observational studies published during the COVID-19 pandemic. STUDY DESIGN AND SETTING We searched MEDLINE for studies from 2020 to 2022, resulting in 16,828 references. We randomly selected 320 studies purposefully sampled across income setting (high vs low-middle-income), COVID-19 topic (vs non-COVID-19), and focus on populations experiencing inequities. Of those, 206 explicitly mentioned motivations which we analyzed thematically. We used discourse analysis to investigate the reasons behind emerging motivations. RESULTS We identified the following motivations: (1) examining health disparities, (2) tackling social determinants to improve access, and (3) addressing knowledge gaps in health equity. Discourse analysis showed motivations stem from commitments to social justice and recognizing the importance of highlighting it in research. Other discourses included aspiring to improve health-care efficiency, wanting to understand cause-effect relationships, and seeking to contribute to an equitable evidence base. CONCLUSION Understanding researchers' motivations for assessing health equity can aid in developing guidance that tailors to their needs. We will consider these motivations in developing and sharing equity guidance to better meet researchers' needs.
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Affiliation(s)
- Omar Dewidar
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Bruyère Research Institute, University of Ottawa, Ottawa, Canada.
| | - Georgia McHale
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | - Ali Al Zubaidi
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada; School of Medicine, University College Cork, Cork, Ireland
| | - Mostafa Bondok
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada; Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Leenah Abdelrazeq
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada; Department of Health Sciences, Carelton University, Ottawa, Canada
| | - Jimmy Huang
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | - Alyssa Jearvis
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | - Khadija Aliyeva
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | - Amjad Alghamyan
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | - Fatima Jahel
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | | | | | - Lucy C Barker
- Department of Psychiatry, University of Toronto, Toronto, Canada; Women's College Hospital, Toronto, Canada
| | - Nour Elmestekawy
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | - Melissa K Sharp
- Department of General Practice, Health Research Board Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Tanya Horsley
- Royal College of Physicians and Surgeons of Canada, Ottawa, Canada
| | - Clara Juandro Prats
- Applied Health Research Center, St. Michael's Hospital, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Janet Jull
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, Kingston, Canada
| | - Luke Wolfenden
- Cochrane Public Health, School of Medicine and Public Health, The University of Newcastle, New South Wales, Australia
| | - Luis Gabriel Cuervo
- Department of Evidence and Intelligence for Action in Health, Pan American Health Organization (PAHO/WHO), Washington, DC, USA; Department of Paediatrics, Obstetrics & Gynaecology, and Preventive Medicine, Doctoral School, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Billie-Jo Hardy
- Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Janet Hatchet Roberts
- WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity, Ottawa, Canada
| | | | - Ekwaro Obuku
- Africa Centre for Systematic Reviews & Knowledge Translation, Makerere University College of Health Sciences, Kampala, Uganda
| | - Ebenezer Owusu-Addo
- Bureau of Integrated Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Stuart G Nicholls
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Sarah Funnell
- Department of Family Medicine, Queen's University, Kingston, Canada; Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Bev Shea
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Anita Rizvi
- School of Psychology, University of Ottawa, Ottawa, Canada
| | - Peter Tugwell
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Zulfiqar Bhutta
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada; Centre for Excellence in Women and Child Health and Institute of Global Health and Development, The Aga Khan University, Karachi, Pakistan
| | - Vivian Welch
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
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Deng H, Genovese TJ, Schneider JC. A Narrative Review of Outcomes in Burn Rehabilitation Based on the International Classification of Functioning, Disability, and Health. Phys Med Rehabil Clin N Am 2023; 34:867-881. [PMID: 37806703 PMCID: PMC10560762 DOI: 10.1016/j.pmr.2023.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Burn injury commonly causes long-term physical impairments and psychosocial limitations that impact survivorship. This article uses the World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF) framework to summarize burn rehabilitation outcomes related to body functions and structures and how they relate to activities and participation within the social context. This article will contribute to a better understanding of burn recovery, facilitate the identification of specific and meaningful issues common to burn survivorship that may be under-reported in prior investigations and guide future rehabilitation to advance long-term burn outcomes.
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Affiliation(s)
- Huan Deng
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, 300 1st Avenue, Boston, MA 02129, USA
| | - Timothy J Genovese
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, 300 1st Avenue, Boston, MA 02129, USA
| | - Jeffrey C Schneider
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, 300 1st Avenue, Boston, MA 02129, USA; Rehabilitation Outcomes Center at Spaulding, Boston, MA, USA; Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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5
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Bagheri T, Fatemi M, Abdollahi Far S, Rahbar A, Asgari M, Hoveidamanesh S, Momeni M. Investigation Of Common Burn Mechanisms, And Training And Safety Conditions In The Workplace. ANNALS OF BURNS AND FIRE DISASTERS 2022; 35:179-185. [PMID: 37016594 PMCID: PMC10067145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 08/15/2021] [Indexed: 06/19/2023]
Abstract
Workplace burn injuries are associated with significant physical, psychological, and social challenges. This study was designed and conducted to investigate the common burn mechanisms, and training and safety conditions in the workplace. The study is a cross-sectional study that was performed on patients admitted to Shahid Motahari University Hospital in Tehran from August 2016 to October 2017. Samples consisted of patients who suffered burns at work and were able to answer research questions. Data were recorded in tablets by electronic patient registration forms.Of the total burn patients under study, 14.28% were injured in the workplace. The burns were mainly thermal, followed by electrical, chemical, and inhalation burns. 38.2% of patients were not trained for safety measures at work and 27.8% of patients were not given personal protective equipment. 39.0% of workspaces were not safe against the risk of burns. Failure of devices and equipment was the cause of 28.8% of the accidents. Electrical damage, the ignition of flammable materials, gas explosions and contact with molten materials were the most common mechanisms in the occurrence of workplace burns. The lack of awareness by workers, lack of attention to the use of safety equipment at work, and the presence of damaged equipment are the main causes of burn accidents in the workplace. Therefore, the implementation of codified safety training and monitoring the observance of safety measures by workers and employers are recommended.
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Affiliation(s)
- T. Bagheri
- Burn Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - M.J. Fatemi
- Burn Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - S. Abdollahi Far
- Disaster Medicine Management, Iranian Red Crescent Society, Tehran, Iran
| | - A. Rahbar
- International Baccalaureate Student, Ontario, Canada
| | - M. Asgari
- School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S. Hoveidamanesh
- Burn Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - M. Momeni
- Shahid Motahari Hospital, Burn Research Center, Iran University of Medical Sciences, Tehran, Iran
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6
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Ross EE, Colbath RA, Yu J, Munabi N, Gillenwater TJ, Yenikomshian HA. Peer Support Groups: Identifying Disparities to Improve Participation. J Burn Care Res 2022; 43:1019-1023. [PMID: 35781574 PMCID: PMC9435488 DOI: 10.1093/jbcr/irac086] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Disparities in psychosocial outcomes after burn injury exist in patients from racial or ethnic minority groups in the United States. Peer support groups can help patients with many psychosocial aspects of recovery from burns; however, access to such support among patients of racial and ethnic minority or low socioeconomic groups are unknown. The present study examined participation rates in outpatient peer support within this patient population. Patients attending outpatient clinic at an urban safety-net hospital and regional burn center with a majority minority patient population were asked about participation in burn survivor group, interest in joining a group, and given validated survey questions about managing emotions and social interactions since injury. Current or past participation in peer support was low (4.2%), and 30.3% of patients not already in support group were interested in joining. Interest in future participation in peer support was highest among Hispanic patients (37.0%) and lowest among Black patients (0%). Logistic regression models demonstrated that increased total body surface area burned, hospital length of stay, and need for surgical intervention were associated with interest in joining or having joined a peer support group. Effectiveness of management of emotions and social interactions were not associated with interest in joining peer support in the future. These findings demonstrate a considerable difference between levels of interest and participation in peer support within this population. Improving access to and education about benefits of peer support in underresourced communities may help to address the variation in psychosocial outcomes of patients across racial or ethnic minority groups recovering from burns.
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Affiliation(s)
- Erin E Ross
- From the Keck School of Medicine, University of SouthernCalifornia, Los Angeles, CA, USA
| | - Rachel A Colbath
- From the Keck School of Medicine, University of SouthernCalifornia, Los Angeles, CA, USA
| | - Jeremy Yu
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of SouthernCalifornia, Los Angeles, CA, USA
| | - Naikhoba Munabi
- Division of Plastic Surgery, Keck School of Medicine, University of SouthernCalifornia, Los Angeles, CA, USA
| | - T Justin Gillenwater
- Division of Plastic Surgery, Keck School of Medicine, University of SouthernCalifornia, Los Angeles, CA, USA
| | - Haig A Yenikomshian
- Division of Plastic Surgery, Keck School of Medicine, University of SouthernCalifornia, Los Angeles, CA, USA
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Deng H, Abouzeid CA, Shepler LJ, Slavin MD, Taylor JA, Mercier HW, Herrera-Escobar JP, Kazis LE, Ryan CM, Schneider JC. Using digital phenotyping to characterize psychosocial trajectories for people with burn injury. Burns 2022; 48:1262-1266. [PMID: 35504767 PMCID: PMC9357168 DOI: 10.1016/j.burns.2022.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 04/18/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Huan Deng
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Cailin A. Abouzeid
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Lauren J. Shepler
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Mary D. Slavin
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA,Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA
| | - J. Andrew Taylor
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | | | | | - Lewis E. Kazis
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA,Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA
| | - Colleen M. Ryan
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,Shriners Hospitals for Children-Boston®, Boston, MA, USA
| | - Jeffrey C. Schneider
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA,Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,Correspondence to: Spaulding Rehabilitation Hospital, 300 1st Avenue, Boston, MA 02129, USA., (J.C. Schneider)
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8
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Hemmati Maslakpak M, Ajoudani F, Lotfi M, Alinejad V. Society, family, and individual characteristics as double-edged swords in the social reintegration of Iranian female survivors from unintentional severe burns: a qualitative study of enablers and barriers. BMC WOMENS HEALTH 2021; 21:339. [PMID: 34560875 PMCID: PMC8464107 DOI: 10.1186/s12905-021-01481-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/16/2021] [Indexed: 11/24/2022]
Abstract
Background Reintegrating to society is a significant challenge during burn survivors’ rehabilitation. Aim This study aims to describe what Iranian female survivors from unintentional severe burns experience as enablers and barriers of social reintegration (SR). Methods Fourteen adult female burn survivors whose burns were unintentional participated in this qualitative study. Data were gathered through semi-structured face-to-face or telephone interviews and analyzed using inductive content analysis. Results Thirteen subcategories and six categories were emerged. Categories and subcategories of enablers content area were as follows: positive impact of society on SR (normal treatment of society, instrumental support), positive impact of family on SR (magnifying personal abilities assets, empathy and emotional support), and positive impact of personal characteristics on SR (coping with others stares, right to have a normal social life). Categories and subcategories of Barriers content area were as follows: negative impact of society on SR (being questioned in public, incorrect judgment about intent of burns, burns as a contagious disease), negative impact of family on SR (embarrassment of appearing in public with the survivor, family mistrust), and negative impact of intra-personal factors on SR (exaggeration of the post-burn changes, being over-sensitive to the others looks). From the deep interpretation of the data two overarching themes were emerged: “acceptance of the new normal by the society and the individual” and “being encompassed by misconceptions and mistreatments”.
Conclusions Society, family and the individual characteristics have a dual role to play in the success of social reintegration in Iranian female unintentional burn survivors.
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Affiliation(s)
| | - Fardin Ajoudani
- School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran.
| | - Mojgan Lotfi
- Sina Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahid Alinejad
- Patient Safety Research Centre, Urmia University of Medical Sciences, Urmia, Iran
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9
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Zhu Z, Kong W, Wang H, Xiao Y, Shi Y, Gan L, Sun Y, Tang H, Xia Z. Prevalence and predictors of scar contracture-associated re-hospitalisation among burn inpatients in China. Sci Rep 2021; 11:14973. [PMID: 34294790 PMCID: PMC8298512 DOI: 10.1038/s41598-021-94432-w] [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: 04/13/2021] [Accepted: 07/09/2021] [Indexed: 11/16/2022] Open
Abstract
Scar contracture, a common destructive complication causing increased re-hospitalisation rate of burn survivors and aggravated burden on the medical system, may be more seriously in Chinese population because of their higher susceptibility to scar formation. This study aims to evaluate the prevalence and predictors of scar contracture-associated re-hospitalisation among Chinese burn inpatients. This cross-sectional study screened burn inpatients hospitalised during 2013 to 2018 through the Hospital Quality Monitoring System database, among whom re-hospitalised for scar contracture were identified. Variables including sex, age, occupations, burn area, burn site and surgical treatment were analysed. Potential predictors of scar contracture-associated re-hospitalisation among burn inpatients were determined by univariate regression analyses. Of the 220,642 burn inpatients, 2146 (0.97%) were re-hospitalised for scar contracture. The re-hospitalised inpatients were predominantly men and blue-collar workers, showing younger median age at the time of burns, larger burn sizes, and higher percentage of surgical treatment compared other burn inpatients. Significant univariate predictors of scar contracture-associated re-hospitalisation included male sex, age < 50 years, blue-collar work, ≥ 40% total body superficial area burned, inhalation injured, and surgical treatment. Scar contracture is an intractable complication and a significant factor to increase re-hospitalisation rate among Chinese burn inpatients.
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Affiliation(s)
- Zhe Zhu
- Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Burn Institute of PLA, Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai, 200433, China
| | - Weishi Kong
- Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Burn Institute of PLA, Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai, 200433, China
| | - Haibo Wang
- Clinical Trial Unit, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China.,Centre for Data Science in Health and Medicine, Peking University, Beijing, 100191, China
| | - Yongqiang Xiao
- Department of Burn and Plastic Surgery, The 970Th Hospital of People's Liberation Army, Yantai, 264000, Shandong, China
| | - Ying Shi
- China Standard Medical Information Research Center, 288 Haide 2nd road, Shenzhen, 518000, China
| | - Lanxia Gan
- China Standard Medical Information Research Center, 288 Haide 2nd road, Shenzhen, 518000, China
| | - Yu Sun
- Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Burn Institute of PLA, Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai, 200433, China.
| | - Hongtai Tang
- Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Burn Institute of PLA, Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai, 200433, China.
| | - Zhaofan Xia
- Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Burn Institute of PLA, Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai, 200433, China.
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10
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Carrougher GJ, McMullen K, Amtmann D, Wolfe AE, Tenney D, Schneider JC, Yeakley J, Holavanahalli RK, Patterson L, Madison C, Gibran NS. "Living Well" After Burn Injury: Using Case Reports to Illustrate Significant Contributions From the Burn Model System Research Program. J Burn Care Res 2021; 42:398-407. [PMID: 32971531 PMCID: PMC10044562 DOI: 10.1093/jbcr/iraa161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The Burn Model System (BMS) program of research has been funded since 1993 by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR). The overarching aim of this program is to improve outcomes and quality of life for people with burns in the areas of health and function, employment, and community living and participation. This review reports on BMS contributions that have affected the lives of individuals with a significant burn injury using case reports to associate BMS contributions with recovery. In January 2020, current BMS grantee researchers assessed peer-reviewed BMS publications from 1994 to 2020. Using case report methodology, contributions were linked to three individuals treated at one of the four Burn Model System institutions. With over 25 years of NIDILRR funding, unique BMS contributions to patient recovery were identified and categorized into one of several domains: treatment, assessment measures, sequelae, peer support, employment, and long-term functional outcomes. A second review for significant results of BMS research that add to the understanding of burn injury, pathophysiology, and recovery research was identified and categorized as injury recovery research. The case study participants featured in this review identified select NIDILRR research contributions as having direct, personal benefit to their recovery. The knowledge generation and clinical innovation that this research program has contributed to our collective understanding of recovery after burn injury is considerable. Using case study methodology with three adult burn survivors, we highlight the impact and individual significance of program findings and reinforce the recognition that the value of any clinical research must have relevance to the lives of the study population.
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Affiliation(s)
| | - Kara McMullen
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington
| | - Dagmar Amtmann
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington
| | - Audrey E Wolfe
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Jeffrey C Schneider
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts
| | | | | | - Loren Patterson
- University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Nicole S Gibran
- Department of Surgery, University of Washington, Seattle, Washington
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Williams S, Williams J. Traumatic stress sufferers: work as therapy or trigger? MANAGEMENT RESEARCH REVIEW 2021. [DOI: 10.1108/mrr-01-2020-0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
While a return to work following trauma exposure can be therapeutic, this is not always so. As with many topics related to traumatic stress in organizations, several contingency factors complicate the effort to draw an overarching conclusion about whether returning to work is therapeutic. The purpose of this paper is to present important determinants of whether work is therapeutic or triggering for those with traumatic stress conditions. The need for contingency approaches in the study of traumatic stress in organizations is illustrated.
Design/methodology/approach
Literature on traumatic stress in organizations is reviewed.
Findings
Three of the key determinants of whether a return to work is therapeutic or triggering for traumatic stress sufferers are trauma-type contingencies, condition-type contingencies and work-setting contingencies. For instance, human-caused and task-related traumas are more likely than natural disasters to make a return-to-work triggering. Additionally, the time since developing a traumatic stress condition is inversely related to the degree of improvement in that condition through the experience of working. Moreover, managerial actions can affect how therapeutic an employee’s return to work is.
Practical implications
These findings suggest the challenges of reintegrating a traumatized employee to the workplace can be highly situation-specific. Careful consideration of the traumatic event suffered by each traumatic stress victim, their traumatic stress condition, and the work setting to which they would return are recommended.
Social implications
Promoting mental health in organizations can contribute to employers’ social performance.
Originality/value
Examination of the factors that complicate predicting whether work is therapeutic posttrauma demonstrates how contingency approaches can advance research on trauma in organizations.
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Pham TN, Goldstein R, Carrougher GJ, Gibran NS, Goverman J, Esselman PC, Kazis LE, Ryan CM, Schneider JC. The impact of discharge contracture on return to work after burn injury: A Burn Model System investigation. Burns 2020; 46:539-545. [PMID: 32088093 DOI: 10.1016/j.burns.2020.02.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/22/2020] [Accepted: 02/06/2020] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Despite many advances in burn care, the development of extremity contracture remains a common and vexing problem. Extremity contractures have been documented in up to one third of severely burned patients at discharge. However, little is known about the long-term impact of these contractures. The purpose of this study was to examine the association of extremity contractures with employment after burn injury. METHODS We obtained data from the Burn Model System database from 1994 to 2003. We included in the study cohort all adult patients who were working prior to injury and identified those discharged with and without a contracture in one of the major extremity joints (shoulder, elbow, wrist, hip, knee and ankle). We classified contracture severity according to mild, moderate and severe categories. We performed descriptive analyses and predictive modeling to identify injury and patient factors associated with return to work (RTW) at 6, 12, and 24 months. RESULTS A total of 1,203 participant records met criteria for study inclusion. Of these, 415 (35%) had developed a contracture at discharge; 9% mild, 12% moderate, and 14% severe. Among 801 (67%) participants who had complete data at 6 months after discharge, 70% of patients without contracture had returned to work compared to 45% of patients with contractures (p < 0.001). RTW increased at each subsequent follow-up time point for the contracture group, however, it remained significantly lower than in no-contracture group (both p < 0.01). In multivariable analyses, female sex, non-Caucasian ethnicity, larger burn size, alcohol abuse, number of in-hospital operations, amputation, and in-hospital complications were associated with a lower likelihood of employment. In adjusted analyses, discharge contracture was associated with a lower probability of RTW at all 3 time points, although its impact significantly diminished at 24 months. CONCLUSIONS This study indicates an association between discharge contracture and reduced employment 6, 12 and 24 months after burn injury. Among many other identified patient, injury, and hospitalization related factors that are barriers to RTW, the presence of a contracture at discharge adds a significant reintegration burden for working-age burn patients.
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Affiliation(s)
- Tam N Pham
- UW Medicine Regional Burn Center, Department of Surgery, University of Washington, United States.
| | - Richard Goldstein
- Spaulding Rehabilitation Hospital, Department of Physical Medicine and Rehabilitation, Harvard Medical School, United States
| | - Gretchen J Carrougher
- UW Medicine Regional Burn Center, Department of Surgery, University of Washington, United States
| | - Nicole S Gibran
- UW Medicine Regional Burn Center, Department of Surgery, University of Washington, United States
| | - Jeremy Goverman
- Shriners Hospitals for Children-Boston, Department of Surgery, Harvard Medical School, United States
| | - Peter C Esselman
- Department of Rehabilitation Medicine, University of Washington, United States
| | - Lewis E Kazis
- Department of Health Law and Policy and Management, Boston University School of Public Health, United States
| | - Colleen M Ryan
- Shriners Hospitals for Children-Boston, Department of Surgery, Harvard Medical School, United States
| | - Jeffrey C Schneider
- Spaulding Rehabilitation Hospital, Department of Physical Medicine and Rehabilitation, Harvard Medical School, United States
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Neubauer H, Stolle A, Ripper S, Klimitz F, Ziegenthaler H, Strupat M, Kneser U, Harhaus L. Evaluation of an International Classification of Functioning, Disability and Health-based rehabilitation for thermal burn injuries: a prospective non-randomized design. Trials 2019; 20:752. [PMID: 31856888 PMCID: PMC6923835 DOI: 10.1186/s13063-019-3910-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 11/15/2019] [Indexed: 11/15/2022] Open
Abstract
Background Severe burn injuries result in relevant restrictions of physical capacity as well as psychological and social integrity and require a specialized rehabilitation. There is a common agreement, among national as well as international burn associations, that burn rehabilitation is a complex, dynamic process which needs an interdisciplinary and specialized treatment team. There is wide agreement that more research is needed in this field. Methods/design The aim of the study is to examine the effectiveness and efficiency of our new ICF (International Classification of Functioning, Disability and Health)-based rehabilitation for thermal injuries. Because of ethical reasons, we have chosen a prospective non-randomized design, which takes place at two different rehabilitation centers. At center A, a newly developed ICF-based rehabilitation program was established; at rehabilitation center B, a well-established rehabilitation program has existed for 20 years and is used as reference. The primary research question addresses the “Pre-post comparison of the physical and psychological outcome measurements,” secondary question I looks at the “Examination of the non-inferiority of the new treatment concept with the established concept,” and secondary question II is the “Analysis of the rehabilitation process based on the rehabilitation cycle.” Only patients of the two burn rehabilitation centers who are insured by workers’ compensation will be asked to participate in this study to avoid outcome bias by insurance status. A physical examination (physical working capacity testing, grip strength, range of motion, and scar evaluation by Cutometer and Vancouver Scar Scale) and a standardized questionnaire battery (Burn Specific Health Scale-Brief , Short Form 36, Impact of Event Scale-Revised, the German version of the Symptom Checklist, the Freiburg Social Support Questionnaire, Patient/Client Satisfaction Questionnaire, Disabilities of the Arm, Shoulder and Hand, and Lower Extremity Functional Scale ) measure physical and psychological conditions. Data will be taken on admission, during stay, and on discharge of the rehabilitation program and at follow-up 3 and 12 months after discharge. A minimum of 162 participants will be enrolled in this clinical longitudinal, prospective, observational study. Discussion The proof of the effectiveness of the ICF-based rehabilitation program for thermal injuries will give evidence in a comprehensive way for the first time in this field. As result, a standardized rehabilitation concept will be introduced, which can be provided to other rehabilitation institutions treating thermal injuries. Trial registration German Clinical Trials Register, DRKS00017702. Registered on 2 September 2019.
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Affiliation(s)
- Hubert Neubauer
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Plastic- and Hand Surgery, University of Heidelberg, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Germany
| | - Annette Stolle
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Plastic- and Hand Surgery, University of Heidelberg, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Germany
| | - Sabine Ripper
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Plastic- and Hand Surgery, University of Heidelberg, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Germany
| | - Felix Klimitz
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Plastic- and Hand Surgery, University of Heidelberg, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Germany
| | - Hans Ziegenthaler
- Moritz Klinik, Hermann-Sachse-Strasse 46, 07639, Bad Klosterlausnitz, Germany
| | - Mareike Strupat
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Plastic- and Hand Surgery, University of Heidelberg, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Germany
| | - Ulrich Kneser
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Plastic- and Hand Surgery, University of Heidelberg, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Germany
| | - Leila Harhaus
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Plastic- and Hand Surgery, University of Heidelberg, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Germany.
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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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15
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Postacute Care Setting Is Associated With Employment After Burn Injury. Arch Phys Med Rehabil 2019; 100:2015-2021. [DOI: 10.1016/j.apmr.2019.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 06/05/2019] [Accepted: 06/10/2019] [Indexed: 01/29/2023]
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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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Levi B, Kraft CT, Shapiro GD, Trinh NHT, Dore EC, Jeng J, Lee AF, Acton A, Marino M, Jette A, Armstrong EA, Schneider JC, Kazis LE, Ryan CM. The Associations of Gender With Social Participation of Burn Survivors: A Life Impact Burn Recovery Evaluation Profile Study. J Burn Care Res 2018; 39:915-922. [PMID: 29733365 PMCID: PMC6198731 DOI: 10.1093/jbcr/iry007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Burn injury can be debilitating and affect survivors' quality of life in a profound fashion. Burn injury may also lead to serious psychosocial challenges that have not been adequately studied and addressed. Specifically, there has been limited research into the associations of burn injury on community reintegration based on gender. This work analyzed data from 601 burn survivors who completed field testing of a new measure of social participation for burn survivors, the Life Impact Burn Recovery Evaluation (LIBRE) Profile. Differences in item responses between men and women were examined. Scores on the six LIBRE Profile scales were then compared between men and women using analysis of variance and adjusted linear multivariate regression modeling. Overall, men scored significantly better than women on four of the six LIBRE Profile scales: Sexual Relationships, Social Interactions, Work & Employment, and Romantic Relationships. Differences were not substantially reduced after adjustment for demographic characteristics and burn size. Men scored better than women in most of the areas measured by the LIBRE Profile. These gender differences are potentially important for managing burn patients during the post-injury recovery period.
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Affiliation(s)
- Benjamin Levi
- Division of Plastic Surgery, University of Michigan, Ann Arbor
| | - Casey T Kraft
- Department of Plastic Surgery, Ohio State University, Columbus
| | - Gabriel D Shapiro
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University Montreal, Quebec, Canada
| | - Nhi-Ha T Trinh
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Emily C Dore
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - James Jeng
- Mount Sinai Healthcare System, New York, New York
| | - Austin F Lee
- Department of Surgery, Massachusetts General Hospital, Boston
- School of Insurance and Economics, University of International Business and Economics, Beijing, China
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, 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
| | - Alan Jette
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | | | - Jeffrey C Schneider
- Department of Surgery, Massachusetts General Hospital, Spaulding Rehabilitation Hospital, Harvard Medical School, Shriners Hospitals for Children-Boston
| | - Lewis E Kazis
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Colleen M Ryan
- Department of Surgery, Massachusetts General Hospital, Spaulding Rehabilitation Hospital, Harvard Medical School, Shriners Hospitals for Children-Boston
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