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Farzan R, Hosseini SJ, Firooz M, Tabarian MS, Jamshidbeigi A, Samidoust P, Sarafi M, Mahdiabadi MZ, Ghorbani Vajargah P, Mollaei A, Karkhah S, Takasi P, Parvizi A, Haddadi S. Perceived stigmatisation and reliability of questionnaire in the survivors with burns wound: A systematic review and meta-analysis. Int Wound J 2023; 20:3391-3403. [PMID: 37016493 PMCID: PMC10502297 DOI: 10.1111/iwj.14176] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 03/18/2023] [Accepted: 03/21/2023] [Indexed: 04/06/2023] Open
Abstract
Perceived stigmatisation (PS) can cause different effects on burns survivors such as depression, low self-esteem, body image disturbance, and social anxiety. Current systematic review and meta-analysis aimed to determine the average PS among the burns survivor population and the average reliability of the PS questionnaire (PSQ). A comprehensive systematic search was conducted in various international electronic databases, such as Scopus, PubMed, Web of Science, and Persian electronic databases such as Iranmedex, and Scientific Information Database (SID) using keywords extracted from Medical Subject Headings such as "Stigmatisation", "Burns", "Reliability", and "Questionnaire" from the earliest to February 1, 2023. The COSMIN and the Joanna Briggs Institute (JBI) checklists were applied to evaluate the risk of bias. Data analysis was performed in STATA V.14 and JAMOVI v 2.3.24 software. The analysis consisted of two sections. Firstly, the overall weighted average of PS was calculated based on mean and standard deviation. Then, the reliability average of PSQ was calculated with the reliability generalisation method based on the alpha coefficient, questionnaire items, and sample size of each study. Finally, eight articles were included in the quantitative analysis. The results showed the weighted average of PS was 2.14 (ES: 2.14, 95%CI: 1.77-2.51, Z = 11.40, I2 :97.8%, P < 0.001). The average of PS in the factors of confused/staring behaviour, absence of friendly behaviour, and hostile behaviour was 2.36 (ES: 2.36, 95%CI: 2.05-2.67, Z = 14.86, I2 :92.7%, P < 0.001), 2.13 (ES: 2.13, 95%CI: 1.87-2.39, Z = 16.22, I2 :93.8%, P < 0.001) and 2.07 (ES: 2.07, 95%CI: 1.67-2.47, Z = 10.05, I2 :96.5%, P < 0.001), respectively. The analysis showed that the overall coefficient alpha of the PSQ was 0.88 (ES: 0.88, 95%CI: 0.851-0.910, Z = 58.7, I2 : 95.04%, P < 0.001). Also, the alpha coefficient of factors including confused/staring behaviour, absence of friendly behaviour, and hostile behaviour were 0.847 (ES: 0.847, 95%CI: 0.770-0.924, Z = 21.6, I2 :99.13%, P < 0.001), 0.860 (ES: 0.860, 95%CI: 0.808-0.912, Z = 32.4, I2 :98.02%, P < 0.001) and 0.899 (ES: 0.899, 95%CI: 0.829-0.968, Z = 21.33, I2 : 0.0%, P < 0.001), respectively. In sum, the current study showed that the average PS was 2.14 out of 5 points. Most survivors and parents reported confused/starring behaviour as a common perceived behaviour from different individuals. Also, the average reliability of PSQ was 0.88, and it had acceptable reliability. More studies are required to better judge the level of PS among different age groups. Also, the psychometric properties of PSQ in different cultures are an essential issue.
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Affiliation(s)
- Ramyar Farzan
- Department of Plastic & Reconstructive Surgery, School of MedicineGuilan University of Medical SciencesRashtIran
| | | | - Mahbobeh Firooz
- Department of NursingEsfarayen Faculty of Medical SciencesEsfarayenIran
| | | | - Amirreza Jamshidbeigi
- Student Research Committee, Faculty of Nursing and MidwiferyMashhad University of Medical SciencesMashhadIran
| | - Pirouz Samidoust
- Razi Clinical Research Development Unit, Razi HospitalGuilan University of Medical SciencesRashtIran
| | - Milad Sarafi
- Department of Vascular Surgery, Rasool‐e‐Akram HospitalIran University of Medical SciencesTehranIran
| | | | - Pooyan Ghorbani Vajargah
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Amirabbas Mollaei
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Samad Karkhah
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Poorya Takasi
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Arman Parvizi
- Anesthesiology Research Center, Department of Anesthesiology, Alzahra HospitalGuilan University of Medical SciencesRashtIran
| | - Soudabeh Haddadi
- Anesthesiology Research Center, Department of Anesthesiology, Alzahra HospitalGuilan University of Medical SciencesRashtIran
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Leung KL, Yang JJ, Chen FR, Kim E, Gosman AA. Psychosocial Burden of Pediatric and Adult Patients With Congenital Versus Traumatic Facial Differences: Assessment of Psychiatric Distress and Healthcare Utilization in the United States From 2004 to 2012. Ann Plast Surg 2023; 90:S305-S311. [PMID: 36921336 DOI: 10.1097/sap.0000000000003401] [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: 03/17/2023]
Abstract
BACKGROUND Psychiatric distress and its effects on healthcare utilization in pediatric patients with congenital and traumatic facial differences remain poorly understood. This study analyzes the psychosocial burden along with mental health and reconstructive surgery services utilization of this patient population in comparison with adult patients with such facial differences. METHODS The 2004-2012 Medical Expenditures Panel Survey was queried for all patients with facial differences. Socioeconomic variables, Patient Health Questionnaire 2 and Kessler 6 scores, responses from validated screening surveys, and utilization of mental health and reconstructive surgery (ie, plastic surgery and otolaryngology) services were compared between pediatric and adult patients with congenital and traumatic facial differences. RESULTS Children ages 5 to 12 years were more likely to be affected by facial trauma, whereas adolescents aged 13 to 17 years were more affected by congenital facial conditions. Pediatric patients with congenital facial conditions had higher rates of medical care, education, and special therapy utilization ( P < 0.0001), although their facial trauma counterparts used mental health services more often ( P < 0.0001). In adults, more facial trauma patients reported poorer perceived mental health status ( P = 0.01). Among patients with any facial difference, distressed adult patients were less likely to see a reconstructive surgeon even when controlling for socioeconomic variables (0.55 [0.31-0.97], P = 0.04). CONCLUSIONS In the pediatric population, psychosocial considerations should include both age and etiology of facial differences to best optimize care. Among adults with facial trauma, poor mental health may contribute to lower rates of surgical follow-up, highlighting a potential benefit for provision of mental health services earlier for these patient populations.
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Affiliation(s)
- Karen L Leung
- From the Division of Plastic Surgery, Department of Surgery, UC San Diego San Diego, CA
| | - Jason J Yang
- From the Division of Plastic Surgery, Department of Surgery, UC San Diego San Diego, CA
| | - Frank R Chen
- Department of Anesthesiology, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Erinn Kim
- From the Division of Plastic Surgery, Department of Surgery, UC San Diego San Diego, CA
| | - Amanda A Gosman
- From the Division of Plastic Surgery, Department of Surgery, UC San Diego San Diego, CA
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Mavragani A, Feragen KJB, Pripp AH, Nordgreen T, Williamson H, Kling J. Predictors of Adolescents' Response to a Web-Based Intervention to Improve Psychosocial Adjustment to Having an Appearance-Affecting Condition (Young Person's Face IT): Prospective Study. JMIR Form Res 2023; 7:e35669. [PMID: 36652281 PMCID: PMC9892986 DOI: 10.2196/35669] [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: 12/13/2021] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Adolescents with a condition affecting their appearance that results in a visible difference can be at risk of psychosocial distress and impaired adjustment. Evidence for the effectiveness of existing interventions in improving psychosocial outcomes is limited, and relevant treatment can be difficult to access. Young Person's Face IT (YPF), a self-guided web-based intervention, has demonstrated potential in reducing social anxiety in adolescents with a visible difference. However, more knowledge is needed about the variables that contribute to variations in intervention effects to identify those who may benefit most from YPF. OBJECTIVE This study aimed to investigate demographic, psychosocial, and intervention-related variables as predictors of overall intervention effects after adolescents' use of YPF. METHODS We used longitudinal data collected as part of a larger, ongoing mixed methods project and randomized controlled trial (ClinicalTrials.gov NCT03165331) investigating the effectiveness of the Norwegian version of YPF. Participants were 71 adolescents (mean age 13.98, SD 1.74 years; range 11-18 years; 43/71, 61% girls) with a wide range of visible differences. The adolescents completed primary (body esteem and social anxiety symptoms) and secondary (perceived stigmatization, life disengagement, and self-rated health satisfaction) outcome measures at baseline and postintervention measurement. The predictor variables were demographic (age and gender), psychosocial (frequency of teasing experiences related to aspects of the body and appearance as well as depressive and anxiety symptoms), and intervention-related (time spent on YPF) variables. RESULTS Two-thirds (47/71, 66%) of the adolescents completed all YPF sessions and spent an average of 265 (SD 125) minutes on the intervention. Backward multiple regression analyses with a 2-tailed P-value threshold of .20 revealed that several variables were retained in the final models and predicted postintervention outcome changes. Body esteem was predicted by age (P=.14) and frequency of teasing experiences (P=.09). Social anxiety symptoms were predicted by gender (P=.12), frequency of teasing experiences (P=.03), depressive and anxiety symptoms (P=.08), and time spent on YPF (P=.06). Perceived stigmatization was predicted by age (P=.09), gender (P=.09), frequency of teasing experiences (P=.19), and depressive and anxiety symptoms (P=.06). Life disengagement was predicted by gender (P=.03), depressive and anxiety symptoms (P=.001), and time spent on YPF (P=.14). Self-rated health satisfaction was predicted by age (P=.008). However, the results were limited by relatively low explained postintervention variance, ranging from 1.6% to 24.1%. CONCLUSIONS This study suggests that adolescent boys, adolescents who experience higher levels of psychosocial distress related to their visible difference, and adolescents who spend sufficient time on YPF may obtain better overall intervention effects.
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Affiliation(s)
| | | | - Are Hugo Pripp
- Oslo Centre of Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Tine Nordgreen
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Heidi Williamson
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| | - Johanna Kling
- Centre for Rare Disorders, Rikshospitalet, Oslo University Hospital, Oslo, Norway
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Rasset P, Mange J, Montalan B, Stutterheim SE. Towards a better understanding of the social stigma of facial difference. Body Image 2022; 43:450-462. [PMID: 36345083 DOI: 10.1016/j.bodyim.2022.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 10/10/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022]
Abstract
Facial difference (FD) is not only an individual experience; it is inherently social, reflecting interactions between social norms and individual attitudes. Often FD is stigmatized. In this paper, we employ a widely used stigma framework, namely the social stigma framework put forth by Pryor and Reeder (2011), to unpack the stigma of FD. This framework posits that there are four forms of stigma: public stigma, self-stigma, stigma by association, and structural stigma. We first discuss the social and psychological literature on FD as it pertains to these various forms of stigma. We then describe coping approaches for FD stigma. Lastly, we delineate evidence-based methods for addressing the various forms of FD stigma, such that future efforts can more effectively tackle the stigma of facial difference.
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Affiliation(s)
- Pauline Rasset
- Laboratoire de Psychologie de Caen Normandie (LPCN EA 7452), Université de Caen Normandie, France.
| | - Jessica Mange
- Laboratoire de Psychologie de Caen Normandie (LPCN EA 7452), Université de Caen Normandie, France
| | - Benoît Montalan
- Centre de Recherche sur les Fonctionnements et Dysfonctionnements Psychologiques (CRFDP EA 7475), Université de Rouen Normandie, France
| | - Sarah E Stutterheim
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
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Connolly BL, Amirabadi A, Goman S, Aloia AA, Fish J, Alexander N, Nathan PC. Exploring the impact of anterior chest wall scars from implantable venous ports in adolescent survivors of cancer. Pediatr Blood Cancer 2022; 69:e29832. [PMID: 35796091 DOI: 10.1002/pbc.29832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/13/2022] [Accepted: 05/16/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND In children with cancer, port-a-caths (ports) are commonly placed in the right anterior chest wall, leaving a visible scar when removed. The psychological impact of port scars on survivors is unknown. It is unclear whether alternative sites should be considered. We assessed the impact of port scars on pediatric cancer survivors to determine whether a change in location is indicated. METHODS We performed a cross-sectional single-center study of pediatric cancer survivors aged 13-18 years. A questionnaire explored participants' perceptions of their port scars. Four additional validated tools were used: Fitzpatrick scale, Patient and Observer Scar Assessment Scale (POSAS), Children's Dermatology Life Quality Index, and a Distress Thermometer. RESULTS Among 100 participants (median age 15.8 years [13-18], median duration since treatment 8 years [1.5-14.8]), 75 'never/occasionally' thought about their port scars, 85 were not bothered by its location and 87 would not have preferred another site. Eleven participants were highly impacted by their scars: six thought about their scar 'everyday/all the time', four were highly bothered by its location, and nine would have preferred a different location. There was an association between the desire for different scar location and how much the location bothered participants (p < 0.0001), female sex (p = 0.03) and Patient POSAS score (p = 0.04). CONCLUSION A port scar on the anterior chest wall was not a major concern for the majority of this cohort. A minority of participants were highly impacted by the scar and its location. Advance identification of those likely to be impacted by their scars may not be possible.
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Affiliation(s)
- Bairbre L Connolly
- Image Guided Therapy, Diagnostic Imaging, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G1X8, Canada.,Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Afsaneh Amirabadi
- Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Simal Goman
- Image Guided Therapy, Diagnostic Imaging, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G1X8, Canada
| | - Adri-Anna Aloia
- Image Guided Therapy, Diagnostic Imaging, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G1X8, Canada
| | - Joel Fish
- Department of Surgery, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Natasha Alexander
- Division of Hematology Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Paul C Nathan
- Division of Hematology Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada
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Sarwer DB, Siminoff LA, Gardiner HM, Spitzer JC. The psychosocial burden of visible disfigurement following traumatic injury. Front Psychol 2022; 13:979574. [PMID: 36110275 PMCID: PMC9468754 DOI: 10.3389/fpsyg.2022.979574] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 07/21/2022] [Indexed: 12/15/2022] Open
Abstract
Hundreds of thousands of individuals experience traumatic injuries each year. Some are mild to moderate in nature and patients experience full functional recovery and little change to their physical appearance. Others result in enduring, if not permanent, changes in physical functioning and appearance. Reconstructive plastic surgical procedures are viable treatments options for many patients who have experienced the spectrum of traumatic injuries. The goal of these procedures is to restore physical functioning and reduce the psychosocial burden of living with an appearance that may be viewed negatively by the patient or by others. Even after receipt of reconstructive procedures, many patients are left with residual disfigurement. In some, disability and disfigurement may be so profound that individuals are candidates for vascularized composite allotransplantation (VCA) procedures, i.e., the transplantation of a vascularized human body part containing multiple tissue types (skin, muscle, bone, nerves, and blood vessels) as an anatomical and/or structural unit. This narrative review paper summarizes the literature on the psychosocial burden experienced by those who have visible disfigurement. While many of these individuals experience stigma and discrimination, relatively few studies have employed a stigma framework to understand the psychosocial sequelea. This paper briefly addresses this framework. Last, particular focus is given to the psychosocial issues of individuals with particularly severe injuries who are potential candidates for VCA procedures.
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Affiliation(s)
- David B. Sarwer
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, United States
- *Correspondence: David B. Sarwer,
| | - Laura A. Siminoff
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, United States
| | - Heather M. Gardiner
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, United States
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7
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Patel KF, Rodríguez-Mercedes SL, Grant GG, Rencken CA, Kinney EM, Austen A, Hou C, Brady KJS, Schneider JC, Kazis LE, Ryan CM. Physical, Psychological, and Social Outcomes in Pediatric Burn Survivors Ages 5 to 18 Years: A Systematic Review. J Burn Care Res 2022; 43:343-352. [PMID: 34922361 PMCID: PMC9272085 DOI: 10.1093/jbcr/irab225] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Acute pediatric burn injuries often result in chronic sequelae that affect physical, psychological, and social outcomes. To date, no review has comprehensively reported on the impact of burn injuries across all three domains in school-aged children. The aim of this systematic review was to identify published literature that focuses on the impact of burn injuries on physical, psychological, or social functioning, and report upon the nature of study characteristics and their outcomes. We included literature published after 1980, focusing on burn outcomes in children aged 5 to 18 years. Each eligible study was systematically reviewed and primary outcomes were classified into outcome domains based on existing frameworks. Fifty-eight studies met inclusion criteria, and reported on physical (n = 24), psychological (n = 47), and social (n = 29) domains. The majority of the studies had sample sizes of <100 participants, burn size of <40%, and findings reported by parents and/or burn survivors. Only eight of 107 different measures were used in three or more studies. Parents and burn survivors generally reported better physical and social outcomes and worse psychological functioning compared to non-burn populations. Physical disabilities were associated with psychological and social functioning in several studies. Follow-up data reported improvements across domains. This review demonstrates the importance of physical, psychological, and social status as long-term outcomes in burn survivors. Mixed findings across three outcome domains warrant long-term research. Findings of this review will guide the foundation of comprehensive burn and age-specific instruments to assess burn recovery.
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Affiliation(s)
- Khushbu F. Patel
- Department of Clinical Research, Shriners Hospitals for Children – Boston®, Massachusetts, Massachusetts, USA
- Department of Surgery, Massachusetts General Hospital, Boston, USA
| | | | | | - Camerin A. Rencken
- Department of Clinical Research, Shriners Hospitals for Children – Boston®, Massachusetts, Massachusetts, USA
- Department of Surgery, Massachusetts General Hospital, Boston, USA
| | - Erin M. Kinney
- Department of Clinical Research, Shriners Hospitals for Children – Boston®, Massachusetts, Massachusetts, USA
| | - Amelia Austen
- Department of Clinical Research, Shriners Hospitals for Children – Boston®, Massachusetts, Massachusetts, USA
| | - Carina Hou
- Department of Clinical Research, Shriners Hospitals for Children – Boston®, Massachusetts, Massachusetts, USA
| | - Keri J. S. Brady
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts, USA
| | - Jeffrey C. Schneider
- Department of Physical Medicine and Rehabilitation, Spaulding Research Institute, Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Lewis E. Kazis
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts, USA
- Department of Physical Medicine and Rehabilitation, Spaulding Research Institute, Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Colleen M. Ryan
- Department of Clinical Research, Shriners Hospitals for Children – Boston®, Massachusetts, Massachusetts, USA
- Department of Surgery, Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Surgery, Shriners Hospitals for Children – Boston®, Massachusetts, USA
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8
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Reducing social anxiety in adolescents distressed by a visible difference: Results from a randomised control trial of a web-based intervention. Body Image 2022; 40:295-309. [PMID: 35121566 DOI: 10.1016/j.bodyim.2022.01.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 01/12/2022] [Accepted: 01/18/2022] [Indexed: 01/28/2023]
Abstract
A visible difference to the face or body may challenge adolescents' adjustment and engagement in life activities, where some require psychosocial support. However, evidence is limited for whether existing interventions for this adolescent group reduce social or appearance-related distress. We therefore conducted a parallel-group, randomised control trial to evaluate the effectiveness of Young Person's Face IT, a self-guided web-based psychosocial intervention developed for adolescents with a visible difference who experience distress. Adolescents (N = 189, aged 11-18) from two countries (Norway and the Netherlands), were randomly allocated to an intervention group or care as usual (CAU). Outcomes were body esteem, social anxiety, perceived stigmatisation, and life disengagement. Compared with CAU, participants who completed Young Person's Face IT showed reductions in social anxiety symptoms (ηp2 = 0.06). No significant improvements were found for the other outcomes. This study endorses web-based psychosocial support in reducing social anxiety in adolescents distressed by a visible difference. Future studies are needed to confirm the effectiveness of Young Person's Face IT and to explore potential long-term effects.
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Krause S, Pritlove C, Abbey S, Jung J. The Meaning Behind the Scar: Anonymous Live Liver Donors' Perceptions of Their Surgical Scars. Transplantation 2021; 105:1039-1043. [PMID: 32467480 DOI: 10.1097/tp.0000000000003333] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Scarring can greatly impact quality of life for individuals (ie, causing depression posttraumatic stress disorder and body image issues). Those who wish to be anonymous live liver donors are warned of the potential negative psychological impacts associated with the large scar left from liver donation surgery. Given the unique degree of autonomy that these patients have over their surgery, we explore whether a sample of 26 anonymous live liver donors experience a unique relationship with their scar. METHODS Anonymous donors participated in a semistructured qualitative interview examining their experience with donation. Interviews were audio-recorded, transcribed, and analyzed using the constant comparison method for themes pertaining, to participants' perception of their scar. RESULTS Five main themes were identified-a marker of satisfaction about the donation experience, a physical reminder of donation, a trigger for recipient-related thoughts, an awareness tool, and a potential threat to anonymity. Donors did not voice any body image or cosmetic concerns due to their scars. Instead, discussions about the negative aspects of scarring centered around the identifying nature of their scar. CONCLUSIONS These findings help underscore the distinctiveness of anonymous living liver donors as a patient population. Preparing anonymous living liver donors for different types of cosmetic issues relating to their scar (ie, as a possible threat to their desired anonymity) may be more appropriate than preparing them in the same way as other donor populations.
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Affiliation(s)
- Sandra Krause
- Centre for Mental Health, University Health Network, Toronto, ON
| | - Cheryl Pritlove
- Multi-Organ Transplant Program, University Health Network, Toronto, ON
| | - Susan Abbey
- Centre for Mental Health, University Health Network, Toronto, ON
- Multi-Organ Transplant Program, University Health Network, Toronto, ON
| | - Judy Jung
- Multi-Organ Transplant Program, University Health Network, Toronto, ON
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Kornhaber R, Visentin D, Thapa DK, West S, McKittrick A, Haik J, Cleary M. Cosmetic camouflage improves quality of life among patients with skin disfigurement: A systematic review. Body Image 2018; 27:98-108. [PMID: 30212716 DOI: 10.1016/j.bodyim.2018.08.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 08/06/2018] [Accepted: 08/06/2018] [Indexed: 01/07/2023]
Abstract
This study systematically reviewed the impact of cosmetic camouflage use on different psychosocial outcomes in patients with disfiguring skin disorders. Electronic databases and reference lists were searched in February 2018 for studies reporting the impact of cosmetic camouflage on different quality of life (QoL) outcomes. Eighteen studies met the inclusion criteria: six randomized controlled trials, two quasi-experimental studies, nine single group 'before and after' interventions, and one comparative study with single post-intervention measurement. Quality appraisal of included studies was undertaken using the Joanna Briggs critical appraisal tools. While the studies varied in design, those included in this review indicated significant improvement in QoL after the use of cosmetic camouflage. The mean reduction in Dermatological Life Quality Index scores ranged from 1.4 to 6.4 signifying improvement in QoL of participants after treatment with cosmetic camouflage. Cosmetic camouflage can be an effective therapy in improving QoL among patients with skin disfigurement.
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Affiliation(s)
- Rachel Kornhaber
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 5052, Alexandria, Sydney, NSW, 2015, Australia; Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Tel Hashomer, Chaim Sheba Medical Derech Sheba 2, Tel-Hashomer, Ramat-Gan, Israel.
| | - Denis Visentin
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 5052, Alexandria, Sydney, NSW, 2015, Australia.
| | - Deependra Kaji Thapa
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 5052, Alexandria, Sydney, NSW, 2015, Australia.
| | - Sancia West
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 5052, Alexandria, Sydney, NSW, 2015, Australia.
| | - Andrea McKittrick
- Department of Occupational Therapy, Royal Brisbane and Women's Hospital, Herston, 4029, Queensland, Australia.
| | - Josef Haik
- Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Tel Hashomer, Chaim Sheba Medical Derech Sheba 2, Tel-Hashomer, Ramat-Gan, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel; Institute for Health Research, University of Notre Dame, Western Australia, Australia.
| | - Michelle Cleary
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 5052, Alexandria, Sydney, NSW, 2015, Australia.
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Nelson S, Conroy C, Logan D. The biopsychosocial model of pain in the context of pediatric burn injuries. Eur J Pain 2018; 23:421-434. [PMID: 30288844 DOI: 10.1002/ejp.1319] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 09/20/2018] [Accepted: 09/28/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND Burns are a common and traumatic source of childhood injury in the United States. The treatment and recovery from burn injuries can be significantly painful and may lead to chronic or persistent pain for years following the initial incident. Further, burn injuries in youth have been found to increase the potential for significant psychosocial (e.g., anxiety, depression, PTSD) and physical (e.g., decreased mobility) impairment. Relatedly, the general experience and processing of pain in youth can also be associated with greater psychosocial (e.g., anxiety, depression) impairment and functional disability over time. However, the phenomenology and associated characteristics of the pain experience following burn injury and, in particular, the potential for combined impact on physical and psychosocial outcomes in youth with severe and/or prolonged pain and a history of burn injury is poorly understood. METHODS A review of the literature was performed in the areas of burn injuries and outcomes associated with both acute and chronic pain with youth and adult populations. RESULTS The current review highlights current gaps in the literature in important areas of function in youth with a history of burn injuries using the biopsychosocial model of pain. Future research and considerations for practice are also outlined. CONCLUSIONS Gaining a greater understanding of the relationship between pain, physical impairment, and psychosocial functioning in these youth is significantly important in order to provide greater preventative and treatment-related intervention going forward. SIGNIFICANCE Using a biopsychosocial framework, this review highlights the need for a greater understanding of pain processing and the long-term potential for persistent pain and pain-related impairment (e.g., functional disability) in youth with a history of burn injuries.
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Affiliation(s)
- Sarah Nelson
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Caitlin Conroy
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.,Mayo Clinic Pediatric Pain Rehabilitation Center, Boston Children's Hospital, Boston, Massachusetts
| | - Deirdre Logan
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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Pan R, Dos Santos BD, Nascimento LC, Rossi LA, Geenen R, Van Loey NE. School reintegration of pediatric burn survivors: An integrative literature review. Burns 2017. [PMID: 28624354 DOI: 10.1016/j.burns.2017.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The school is an essential context for children's social interaction with peers and to develop academic skills. Therefore, a fast reintegration can help children with burns to normalize their life. Thus, school reintegration is an important outcome after burns. The aim of this review was to systematically synthesize the literature addressing school reintegration programs of pediatric burns survivors. METHODS Five electronic databases were searched independently by two reviewers. The search yielded 13 eligible publications. A qualitative content analysis was conducted. RESULTS The two themes identified centered around (1) the roles, obstacles, and support for the different stakeholders (i.e., the child, parents and teacher) and (2) the contents of the school reintegration programs in which subthemes such as purpose, planning, essential elements, team, and effect were distinguished. The results show that return to school should start as soon as the child is admitted to the hospital and the program should acknowledge the different stakeholders' needs and tailor the program to these needs. CONCLUSION The review emphasizes the necessity of an integrated school reintegration program empowering both the child, the parents and the teachers and tailored to the child's specific situation. Furthermore, it offers recommendations for further improvement of the field.
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Affiliation(s)
- Raquel Pan
- Pontifical Catholic University of Minas Gerais at Poços de Caldas, Department of Nursing, Poços de Caldas, MG, Brazil.
| | - Bruna Domingos Dos Santos
- Psychiatric Nursing program, University of São Paulo at Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.
| | - Lucila Castanheira Nascimento
- Maternal-Infant and Public Health Nursing Department, University of São Paulo at Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.
| | - Lídia Aparecida Rossi
- General and Specialized Nursing Department, University of São Paulo at Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.
| | - Rinie Geenen
- Utrecht University, Department of Psychology, Utrecht, The Netherlands.
| | - Nancy E Van Loey
- Association of Dutch Burn Centers, Utrecht University, Department of Clinical & Health Psychology, Beverwijk, Utrecht, The Netherlands.
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Meirte J, Van Daele U, Maertens K, Moortgat P, Deleus R, Van Loey NE. Convergent and discriminant validity of quality of life measures used in burn populations. Burns 2016; 43:84-92. [PMID: 27576927 DOI: 10.1016/j.burns.2016.07.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 07/04/2016] [Accepted: 07/14/2016] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The primary goal of this study was to investigate convergent validity, i.e. overlapping constructs, of the Burn Specific Health Scale-Brief (BSHS-B), the Short Form-36 items Health Survey (SF-36) and the European Quality Of Life Five Dimensions (EQ-5D) within the International Classification of Functioning Disability and Health (ICF) framework. A secondary goal was to examine the discriminant validity of the questionnaires according to burn severity (no surgery versus 1 or more surgeries). METHODS A prospective multi-centre study in adult patients with burns was conducted. At the 9 months assessment, two generic questionnaires, i.e. the SF-36 and EQ-5D, and the BSHS-B were completed. Pearson correlations were used to evaluate convergent validity. Linear discriminant analysis was used to evaluate discriminant validity. RESULTS At 9 months post-burn data from 184 persons were available of which 131 (71%) were male, mean TBSA burned was 11.8% (SD=10.2). Sixty five (34%) patients did not need surgery, 128 (66%) patients required one or more surgeries. Higher convergence was shown between the generic SF-36 and the condition specific BSHS-B whereas the EQ-5D showed lower convergence with the BSHS-B especially in the domain Activity. The generic scales discriminated across all scales whereas not all BSHS-B scales were able to differentiate problem levels across burn severity groups. CONCLUSION This study demonstrates that the ICF is useful to classify scales in order to identify overlapping areas as well as to uncover gaps in relation to patient reported outcomes. Both the SF-36 and EQ-5D showed the ability to distinguish levels of functioning across burn severity groups. As the BSHS-B performed less well and relevant domains of functioning were not addressed, there is room for improvement and modification of this condition specific questionnaire to better capture burn patients' functioning.
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Affiliation(s)
- Jill Meirte
- Oscare, Organisation for Burns, Scar After-Care and Research, Antwerp, Belgium; University of Antwerp, Department of Rehabilitation Sciences and Physiotherapy, Antwerp, Belgium.
| | - Ulrike Van Daele
- University of Antwerp, Department of Rehabilitation Sciences and Physiotherapy, Antwerp, Belgium
| | - Koen Maertens
- Oscare, Organisation for Burns, Scar After-Care and Research, Antwerp, Belgium; Vrije Universiteit Brussel, Department of Clinical and Lifespan Psychology, Brussels, Belgium
| | - Peter Moortgat
- Oscare, Organisation for Burns, Scar After-Care and Research, Antwerp, Belgium
| | | | - Nancy E Van Loey
- Association of Dutch Burn Centers, Department of Behavioural Research, Beverwijk, The Netherlands; Utrecht University, Department of Clinical Psychology, Utrecht, The Netherlands
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14
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The Role of Appearance in Adolescents’ Experiences of Neurofibromatosis Type 1: A Survey of Young People and Parents. J Genet Couns 2016; 25:1054-62. [DOI: 10.1007/s10897-016-9944-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 02/17/2016] [Indexed: 11/25/2022]
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15
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Egberts MR, van de Schoot R, Boekelaar A, Hendrickx H, Geenen R, Van Loey NEE. Child and adolescent internalizing and externalizing problems 12 months postburn: the potential role of preburn functioning, parental posttraumatic stress, and informant bias. Eur Child Adolesc Psychiatry 2016; 25:791-803. [PMID: 26608402 PMCID: PMC4932136 DOI: 10.1007/s00787-015-0788-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 10/22/2015] [Indexed: 11/28/2022]
Abstract
Adjustment after pediatric burn injury may be a challenge for children as well as their parents. This prospective study examined associations of internalizing and externalizing problems in children and adolescents 12 months postburn with preburn functioning, and parental acute and chronic posttraumatic stress symptoms (PTSS) from different perspectives. Child, mother, and father reports of 90 children (9-18 years), collected within the first month and 12 months postburn, were analyzed. Results indicated that overall, child and parental appraisals of pre- and postburn behavioral problems were not significantly different from reference data. Rates of (sub)clinical postburn behavioral problems ranged from 6 to 17 %, depending on the informant. Pre- and postburn behavioral problems were significantly related, but only from the parents' perspective. Path models showed an association between parental PTSS 12 months postburn and parental reports of child internalizing problems, as well as a significant indirect relationship from parental acute stress symptoms via PTSS 12 months postburn. Notably, no associations between parental PTSS and child reports of postburn behavioral problems were found. In conclusion, parental observations of child externalizing problems appear to be influenced by their perspectives on the child's preburn functioning, while parental observations of internalizing problems are also related to long-term parental PTSS. However, these factors seem of no great value in predicting behavioral problems from the child's perspective, suggesting substantial informant deviations. To optimize adjustment, clinical burn practice is recommended to adopt a family perspective including parent perception of preburn functioning and parental PTSS in assessment and intervention.
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Affiliation(s)
- Marthe R. Egberts
- />Association of Dutch Burn Centres, P. O. Box 1015, 1940 EA Beverwijk, The Netherlands , />Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands
| | - Rens van de Schoot
- />Department of Methodology and Statistics, Faculty of Social Sciences, Utrecht University, Utrecht, The Netherlands , />Optentia Research Program, Faculty of Humanities, North-West University, Vanderbijlpark, South Africa
| | - Anita Boekelaar
- />Burn Centre Red Cross Hospital, Beverwijk, The Netherlands
| | | | - Rinie Geenen
- />Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands
| | - Nancy E. E. Van Loey
- />Association of Dutch Burn Centres, P. O. Box 1015, 1940 EA Beverwijk, The Netherlands , />Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands
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16
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Shokrollahi K. Making scars worse to make patients better? The role of surgery in changing the appearance of archetypal stigmatising injuries and the concept of mechanistic stigma in scar management. Scars Burn Heal 2015; 1:2059513115607756. [PMID: 29799569 PMCID: PMC5965319 DOI: 10.1177/2059513115607756] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Kayvan Shokrollahi
- Postgraduate Medical Institute, Edge Hill University, Ormskirk, Lancashire, UK.,Mersey Regional Burns and Plastic Surgery Unit, Whiston Hospital, Liverpool, UK
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17
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Griffiths C, Armstrong-James L, White P, Rumsey N, Pleat J, Harcourt D. A systematic review of patient reported outcome measures (PROMs) used in child and adolescent burn research. Burns 2014; 41:212-24. [PMID: 25300756 DOI: 10.1016/j.burns.2014.07.018] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 07/21/2014] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Patient reported outcome measures (PROMs) can identify important information about patient needs and therapeutic progress. The aim of this review was to identify the PROMs that are being used in child and adolescent burn care and to determine the quality of such scales. METHODS Computerised and manual bibliographic searches of Medline, Social Sciences Index, Cinahl, Psychinfo, Psycharticles, AMED, and HAPI, were used to identify English-language articles using English-language PROMs from January 2001 to March 2013. The psychometric quality of the PROMs was assessed. RESULTS 23 studies met the entry criteria and identified 32 different PROMs (31 generic, 1 burns-specific). Overall, the psychometric quality of the PROMs was low; only two generic scales (the Perceived Stigmatisation Questionnaire and the Social Comfort Scale) and only one burns-specific scale (the Children Burn Outcomes Questionnaire for children aged 5-18) had psychometric evidence relevant to this population. CONCLUSIONS The majority of PROMs did not have psychometric evidence for their use with child or adolescent burn patients. To appropriately identify the needs and treatment progress of child and adolescent burn patients, new burns-specific PROMs need to be developed and validated to reflect issues that are of importance to this population.
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Affiliation(s)
- C Griffiths
- Centre for Appearance Research (CAR), University of the West of England, Bristol, United Kingdom.
| | - L Armstrong-James
- Centre for Appearance Research (CAR), University of the West of England, Bristol, United Kingdom.
| | - P White
- Department of Engineering Design and Mathematics, University of the West of England, Bristol, United Kingdom.
| | - N Rumsey
- Centre for Appearance Research (CAR), University of the West of England, Bristol, United Kingdom.
| | - J Pleat
- Department of Plastic Surgery, Southmead Hospital, Bristol, United Kingdom.
| | - D Harcourt
- Centre for Appearance Research (CAR), University of the West of England, Bristol, United Kingdom.
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18
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Examining perceived stigma of children with newly-diagnosed epilepsy and their caregivers over a two-year period. Epilepsy Behav 2014; 39:38-41. [PMID: 25173098 PMCID: PMC4252721 DOI: 10.1016/j.yebeh.2014.08.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 07/17/2014] [Accepted: 08/02/2014] [Indexed: 11/20/2022]
Abstract
The purpose of this study was to examine the following: 1) the course of perceived epilepsy-related stigma among children newly diagnosed with epilepsy (n=39) and their caregivers (n=97) over a two-year period, 2) the influence of seizure absence/presence on children and caregivers' perception of epilepsy-related stigma, and 3) the congruence of child and caregiver perception of child epilepsy-related stigma. Participants completed a measure of perceived epilepsy-related stigma at three time points, and seizure status was collected at the final time point. Results indicated that both caregivers (t(1,76)=-2.57, p<.01) and children with epilepsy (t(1,29)=-3.37, p<.01) reported decreasing epilepsy-related stigma from diagnosis to two years postdiagnosis. No significant differences were found in caregiver and child reports of perceived stigma for children experiencing seizures compared with children who have been seizure-free for the past year. Results revealed poor caregiver-child agreement of perceived epilepsy-related stigma at all three time points. These data suggest that while children with epilepsy initially perceive epilepsy-related stigma at diagnosis, their perception of stigma decreases over time. Having a better understanding of the course of epilepsy-related stigma provides clinicians with information regarding critical times to support families with stigma reduction interventions.
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Abstract
The transition of pediatric burn survivors into adulthood is accompanied by a reformulation of their self-concept. To anticipate the need for and guide development of appropriate psychosocial interventions, this study examines how young adults who were burned as children perceive themselves and how this perception might affect their self-esteem. Eighty-two young adult burn survivors (45 male, 37 female) were assessed using the Tennessee Self-Concept Scale, 2nd edition (TSCS2) to determine how the participants perceive themselves and their interaction with society. To gain insight into the possible effects of these self-concept scores, relationships were analyzed between self-concept, a behavioral assessment (Young Adult Self-Report [YASR]), and a psychiatric symptom assessment (Structured Clinical Interview for DSM-IV Axis I Disorders [SCID I]). This group of burn survivors scored significantly lower in self-concepts, reflected in TSCS2 subscale scores of physical function, appearance, and sexuality, moral conduct, personal values, academics and work, and identity, than did the reference population. Pearson correlation coefficients showed that as moral, personal, family, and social aspects of self-concept decreased, clinical problems endorsed on the YASR subscales increased, including anxiety, somatic, attention, intrusive, and aggressive. Persons with lower self-concept scores on the TSCS2 personal, family, and social scales were more withdrawn on the YASR. Similarly, those with lower TSCS2 scores on the personal and family scales endorsed significantly more thought problems on the YASR. TSCS2 total self-concept, personal, and all of the supplementary scale scores were significantly lower for the group with an affective disorder. Those whose SCID I scores were consistent with a current anxiety disorder had significantly lower scores for the TSCS2 total self-concept and personal. Lower self-concept was associated with endorsement of SCID symptoms. In summary, the significantly lower self-concept scores on the TSCS2 physical scale are consistent with the physical disfigurement and handicaps common with major burn injuries, and a strong indication of this group's perception of the first impression made when interacting with others. The survivors seem to feel worthwhile within the contexts of family and friends. Although the major limitation of this study using the TSCS2 is the lack of a matched reference population to compare the burn survivors, the TSCS2 does help in gaining insight into the self-esteem issues of the burn survivor population.
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Review of burn research for the year 2011. J Burn Care Res 2013; 34:211-8. [PMID: 23370995 DOI: 10.1097/bcr.0b013e3182839b34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The year 2011 was another robust year for burn research. Over 1100 articles were published on a wide range of burn injury and treatment topics. In this review, we highlight some of the interesting and potentially influential research in the following areas: critical care, infection, inhalation injury, epidemiology, wound characterization and treatment, nutrition and metabolism, pain management, burn reconstruction, psychology, and rehabilitation. As in years past, burn injury research reflects the multidisciplinary and holistic care that is needed to treat this challenging injury condition.
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Masnari O, Schiestl C, Weibel L, Wuttke F, Landolt MA. How children with facial differences are perceived by non-affected children and adolescents: perceiver effects on stereotypical attitudes. Body Image 2013; 10:515-23. [PMID: 23810827 DOI: 10.1016/j.bodyim.2013.05.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Revised: 05/15/2013] [Accepted: 05/26/2013] [Indexed: 10/26/2022]
Abstract
Children with a facial difference are presumed to be at risk of social stigmatization. The purposes of this study were twofold: (1) to assess the effect of facial differences on social perceptions by unaffected children and adolescents; and (2) to identify perceiver characteristics that predict stereotypical attitudes toward facial differences. Participants were 344 non-affected children and adolescents, ages 8-17 years. Participants rated digitally altered images of 12 children depicted either with or without a facial difference. Results show that participants attributed less favorable characteristics to children with a facial difference than to those without. Moreover, participants reported less willingness to interact with or befriend a child with a facial difference. Significant predictors of low discriminative attitudes were older participant age and previous contact with someone with a facial difference. Our data call attention to the need for public education programs targeted at reducing negative attitudes toward facial differences.
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Affiliation(s)
- Ornella Masnari
- Department of Psychosomatics and Psychiatry and Children's Research Center, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland.
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Maskell J, Newcombe P, Martin G, Kimble R. Psychological and psychosocial functioning of children with burn scarring using cosmetic camouflage: a multi-centre prospective randomised controlled trial. Burns 2013; 40:135-49. [PMID: 23770131 DOI: 10.1016/j.burns.2013.04.025] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Revised: 04/18/2013] [Accepted: 04/19/2013] [Indexed: 01/14/2023]
Abstract
BACKGROUND Burns leave patients with long-term physical scarring. Children with scarring are required to face challenges of reintegration into their community, including acceptance of an altered appearance and acceptance by others. This can be difficult given society's preoccupation with physical appearance. Limited research exists investigating validity of cosmetic camouflage as a psychosocial intervention for children with scarring. This study investigated whether using cosmetic camouflage (Microskin™) had a positive impact on health-related quality of life, self-concept and psychopathology for children and adolescents (8-17 years) with burn scarring. METHOD A prospective multi-centre randomised controlled trial was conducted across Australian and New Zealand paediatric hospitals. 63 participants (49 females, mean age 12.7 ± 2.1 years) were enrolled. Data points were baseline (Time 1) and at 8 weeks (Time 2) using reliable and valid psychometric measures. RESULTS Findings indicate there were significant improvements in socialisation, school and appearance scales on the Paediatric Quality of Life Inventory and psychopathology scores particularly peer problems decreased. However self-concept remained stable from baseline throughout intervention use. CONCLUSION Cosmetic camouflage appears to have a positive impact on quality of life particularly socialisation. Cosmetic camouflage is a valid tool to assist children with scarring to actively participate socially within their communities.
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Affiliation(s)
- Jessica Maskell
- The Centre for Children's Burns and Trauma Research, Queensland Children's Medical Research Institute, The University of Queensland, Royal Children's Hospital, Brisbane, QLD 4029, Australia; School of Social Work and Human Services, The University of Queensland, Brisbane, QLD 4072, Australia.
| | - Peter Newcombe
- School of Social Work and Human Services, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Graham Martin
- Department of Child and Adolescent Psychiatry, The University of Queensland, Herston, QLD 4029, Australia
| | - Roy Kimble
- The Centre for Children's Burns and Trauma Research, Queensland Children's Medical Research Institute, The University of Queensland, Royal Children's Hospital, Brisbane, QLD 4029, Australia
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Ravindran V, Rempel GR, Ogilvie L. Embracing survival: A grounded theory study of parenting children who have sustained burns. Burns 2013; 39:589-98. [DOI: 10.1016/j.burns.2012.12.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Revised: 12/09/2012] [Accepted: 12/18/2012] [Indexed: 10/27/2022]
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Psychological consequences of pediatric burns from a child and family perspective: A review of the empirical literature. Clin Psychol Rev 2013; 33:361-71. [DOI: 10.1016/j.cpr.2012.12.006] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Revised: 12/28/2012] [Accepted: 12/31/2012] [Indexed: 10/27/2022]
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Impact of Obesity on Body Image Dissatisfaction and Social Integration Difficulty in Adolescent and Young Adult Burn Injury Survivors. J Burn Care Res 2013; 34:102-8. [DOI: 10.1097/bcr.0b013e3182676cc4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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27
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Masnari O, Landolt MA, Roessler J, Weingaertner SK, Neuhaus K, Meuli M, Schiestl C. Self- and parent-perceived stigmatisation in children and adolescents with congenital or acquired facial differences. J Plast Reconstr Aesthet Surg 2012; 65:1664-70. [DOI: 10.1016/j.bjps.2012.06.004] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Revised: 05/23/2012] [Accepted: 06/10/2012] [Indexed: 11/26/2022]
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Masnari O, Schiestl C, Rossler J, Gutlein SK, Neuhaus K, Weibel L, Meuli M, Landolt MA. Stigmatization Predicts Psychological Adjustment and Quality of Life in Children and Adolescents With a Facial Difference. J Pediatr Psychol 2012; 38:162-72. [DOI: 10.1093/jpepsy/jss106] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
For 2011, approximately 1746 original research articles in burns were published in English in scientific journals. This article reviews those with the most potential impact on for burn therapeutics and outcomes according to the Editor of one of the major journals (Burns) and his colleague. As done previously, articles were found and divided into these topic areas: epidemiology of injury and burn prevention, wound and scar characterisation, acute care and critical care, inhalation injury, infection, psychological considerations, pain and itching management, rehabilitation and long-term outcomes, and burn reconstruction. Each selected article is mentioned briefly with editorial comment.
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Affiliation(s)
- Steven E Wolf
- Division of Burn, Trauma, and Critical Care, Department of Surgery, University of Texas - Southwestern Medical Center, United States.
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