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Tróchez-Sanchez JP, Garcia-Perdomo HA. Electrical Burn and Associated Factors That Prolong In-patient Stay in a Level Three Burn Unit. J Burn Care Res 2023; 44:1241-1248. [PMID: 36882105 DOI: 10.1093/jbcr/irad031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Indexed: 03/09/2023]
Abstract
Electrical trauma is associated with significant morbidity and mortality, which have been reduced by improved medical care, as measured by the length of stay (LOS) as a marker for this population's quality of care. This paper will review the clinical and demographic characteristics, LOS in the hospital, and variables related to patients with electrical burns. A retrospective cohort study was conducted at a specialized burn unit in Southwest Colombia. Five hundred seventy-five electrical burn-related admissions from 2000 to 2016 were reviewed for the LOS and variables including patient-related (age, gender, marital status, education, and occupation), location of the accident (domestic vs labor-related), voltage, direct contact, arc, flash, flame, clinical presentation (burn surface area, depth, single or multiple organ injury, secondary infection, and abnormal labs), and treatment (surgical procedures and intensive care unit [ICU] admission). Univariate and bivariate analysis, with its 95% CI (confidence interval). We also performed a multiple logistic regression. LOS was correlated to males, age greater than 20 years, construction workers, high voltage injuries, severe burns by area and depth, infection, ICU admission, and multiple surgical procedures or extremity amputation. LOS due to electrical injury was observed to be significantly associated with the following variables, carpal tunnel release (OR [odds ratio]= 4.25, 95% CI [confidence interval] 1.70-5.20); amputation (OR = 2.81, 95% CI 1.60-5.10); infection (OR = 2.60, 95% CI 1.30-5.20); site of infection, mainly wound (OR = 1.30, 95% CI 1.10-1.44); associated injury (OR = 1.72, 95% CI 1.00-3.24); work or domestic accident (OR = 1.83, 95% CI 1.00-3.32); aged 20-40 years (OR = 1.41, 95% CI 1.00-2.10); CPK (OR = 1.40, 95% CI 1.00-2.00); and third-degree burns (OR = 1.55, 95% CI 1.00-2.80). Risk factors for LOS secondary to electrical injury should be appropriately addressed. Prevention at high-risk workplaces is imperative. Mitigating the injury with appropriate management of infection and timely surgical interventions play an essential role in the successful treatment of these patients.
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Affiliation(s)
| | - Herney Andres Garcia-Perdomo
- Division of Urology/Urooncology, Department of Surgery, School of Medicine, Universidad del Valle. Cali, Colombia
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Won P, Celie KB, Rutter C, Gillenwater TJ, Yenikomshian HA. Burn Patient Perspectives on Disability Weights and the Philosophy of Disability: A Gap in the Literature. EUROPEAN BURN JOURNAL 2023; 4:363-372. [PMID: 38528989 PMCID: PMC10961916 DOI: 10.3390/ebj4040037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Background Disability-adjusted life years (DALY) have a ubiquitous presence in academic global health, including attempts to understand the global burden of burn injuries. Objective The present scoping review aimed to examine whether disability weights (DWs) were informed by burn patient perspectives and secondarily to determine whether literature indicates which of the three most common philosophical models of disability best aligns with burn patient experiences. Methods A review of six databases was conducted and The Critical Appraisal Skills Program (CASP) checklist was utilized. Results Out of a total of 764 articles, zero studies solicited patient perspectives of DWs. Four articles contained data that could be extrapolated to patient perspectives on disability. All articles utilized semi-structured interviews of burn survivors and reported thematic elements including return to work, self-image, and social integration. Patients reported similar themes that burn injuries were disabling injuries and instrumentally detrimental, with modulation based on the patient's social circumstances. Conclusions This scoping review highlights a significant gap in literature. First, no studies were found directly investigating burn patient perspectives on burn DWs. Current DWs have been derived from expert opinions with limited input from patients. Second, the limited primary patient data gleaned from this review suggest patients consider their injuries as instrumentally detrimental, which aligns most closely with the welfarist view of disability. More explicit investigations into the philosophical model of disability best aligning with burn patient experiences are needed to ground the health economics of burns in sound theory.
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Affiliation(s)
- Paul Won
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Karel-Bart Celie
- Uehiro Center for Practical Ethics, University of Oxford, Oxford OX1 1PT, UK
- Division of Plastic and Reconstructive Surgery, University of Southern California, Los Angeles, CA 90033, USA
| | - Cindy Rutter
- Independent Researcher, Los Angeles, CA 90033, USA
| | - T. Justin Gillenwater
- Division of Plastic and Reconstructive Surgery, University of Southern California, Los Angeles, CA 90033, USA
| | - Haig A. Yenikomshian
- Division of Plastic and Reconstructive Surgery, University of Southern California, Los Angeles, CA 90033, USA
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Gandhi G, Parashar A, Sharma RK. Epidemiology of electrical burns and its impact on quality of life - the developing world scenario. World J Crit Care Med 2022; 11:58-69. [PMID: 35433307 PMCID: PMC8788208 DOI: 10.5492/wjccm.v11.i1.58] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 06/11/2021] [Accepted: 12/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Electrical burns are devastating injuries and can cause deep burns with significant morbidity and delayed sequelae. Epidemiological data regarding the etiology, socioeconomic differences and geographic variation are necessary to assess the disease burden and plan an effective preventive strategy. These severe injuries often lead to amputations and thus hamper quality of life in the long term
AIM To identify the population at maximum risk of sustaining electrical burns. We also studied the impact of electrical burns on these patients in terms of quality of life as well as return to work.
METHODS The study was conducted at a tertiary referral teaching hospital over a period of eighteen months. All patients with a history of sustaining electrical burns and satisfying the inclusion criteria were included in the study. All relevant epidemiological parameters and treatment details were recorded. The patients were subsequently followed up at 3 mo, 6 mo and 9 mo. The standardized Brief Version of the Burn Specific Health Scale (BSHS-B) was adopted to assess quality of life. Statistical analysis was conducted using IBM SPSS statistics (version 22.0). A P value of < 0.05 was considered statistically significant.
RESULTS A total of 103 patients were included in the study. The mean age of the patients was 31.83 years (range 18-75 years). A significant majority (91.3%) of patients were male. The mean total body surface area (TBSA) in these patients was 21.1%. In most of the patients (67%), the injury was occupation-related. High voltage injuries were implicated in 72.8% of patients. Among the 75 high voltage burn patients, 31 (41%) required amputation. The mean number of surgeries the patients underwent in hospital was 2.03 (range 1 to 4). The quality of life parameters amongst the patients sustaining high voltage electrical burns were poorer when compared to low voltage injuries at all follow-up intervals across nine domains. In eight of these domains, the difference was statistically significant. Similarly, the scores among the amputees were poorer when compared to non-amputees. The difference was statistically significant in six domains.
CONCLUSION Electrical burns remain a problem in the developing world. Most injuries are occupation-related. The quality of life in patients with high voltage burns and amputees remains poor. Work resumption was almost impossible for amputees. These patients could not regain pre-injury status. Steps should be taken to create awareness and to implement an effective preventive strategy to safeguard against electrical injuries.
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Affiliation(s)
- Giriraj Gandhi
- Department of Plastic Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Atul Parashar
- Department of Plastic Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - Ramesh K Sharma
- Department of Plastic Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
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Al-Shaqsi S, Al-Busaidi S, Al-Kashmiri A, Hashish AM, Mheisin A, Al-Barashdi J. Beyond skin deep: understanding the physical and psychological sufferings of burn survivors in the Sultanate of Oman. EUROPEAN JOURNAL OF PLASTIC SURGERY 2020. [DOI: 10.1007/s00238-019-01604-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mc Kittrick A, Gustafsson L, Marshall K. A systematic review to investigate outcome tools currently in use for those with hand burns, and mapping psychometric properties of outcome measures. Burns 2020; 47:295-314. [PMID: 32826095 DOI: 10.1016/j.burns.2020.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/18/2020] [Accepted: 07/10/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND Severe burn injuries to the hand impact multiple domains of function and participation. Measurement of outcomes after hand burn injuries is multifaceted and is influenced by several variables. OBJECTIVE The aim of this systematic review was to review outcome measures reported in studies used to measure outcomes after severe hand burn injuries; and to critically evaluate the reliability, validity and clinical utility of each hand assessment tool identified from the literature to determine suitability for use with the burn's population. DATA SOURCES A search of the published literature using electronic data bases MEDLINE, CINAHL, PEDro, OT seeker and PubMed was undertaken. Studies were included if they reported assessment tools and outcome measures used to determine hand function after severe burn injuries; were published in English and available in their full-length. Studies were excluded if they were related to a group under 18 years of age. RESULTS Thirty-four papers were included in this systematic review. A total of 25 outcome measures were confirmed for inclusion in this paper and each underwent further evaluation to identify their psychometric properties. LIMITATIONS A factor which could cause bias in this systematic review was the search was restricted to English language journals therefore excluding any primary papers in other languages. Mapping of the outcome measures to the ICF was conducted by the primary author which may give rise to bias however a member checking was conducted in order to remove this bias. CONCLUSIONS This review established that no one outcome measure meets all the psychometric properties of validity, reliability and responsiveness SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO: CRD42018085059.
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Affiliation(s)
- Andrea Mc Kittrick
- Department of Occupational Therapy, Royal Brisbane and Women's Hospital, Herston, 4029, QLD, Australia; School of Health & Rehabilitation Sciences, The University of Queensland, St Lucia, 4072, QLD Australia.
| | - Louise Gustafsson
- Discipline of Occupational Therapy, School of Allied Health Sciences, Griffith University, Nathan, QLD, 4111, Australia; Honorary Associate Professor School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, 4072, QLD Australia
| | - Kathryn Marshall
- Department of Occupational Therapy, Princess Alexandra Hospital, Woolloongabba, 4102, QLD, Australia; School of Health & Rehabilitation Sciences, The University of Queensland, St Lucia, 4072, QLD Australia
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Shakya R, Manandhar M, Dangol R, Shrestha A. Cross cultural adaptation and validation of burn specific health scale- brief in Nepali (BSHS-B-Np). J Patient Rep Outcomes 2020; 4:25. [PMID: 32323083 PMCID: PMC7176760 DOI: 10.1186/s41687-020-00190-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 03/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Burns are a global health problem affecting the survivors and disrupting many aspects of their lives. It is the second most common injury in rural Nepal accounting 5% of disabilities. Burn Specific Health Scale (BSHS) is a valid and most commonly used tool to measure Health Related Quality of Life (HRQoL) of the patient with Burns. BSHS- B (Brief) has been translated, culturally adapted and validated in multiple languages but not in Nepali. Therefore we aim to translate, culturally adapt and validate the BSHS-B in Nepali language (BSHS-B-Np). METHODS Standard guideline was followed to translate the scale into Nepali language. One hundred eleven participants were evaluated to establish the psychometric properties of BSHS-B-Np. Internal consistency, test retest, content validity, discriminant validity and construct validity were assessed using Cronbach's alpha, Interclass correlation coefficient, Factor analysis, Spearman rank test, and Mann- Whitney U test respectively. RESULTS The Cronbach's alpha for BSHS-B-Np was 0.93. Test retest inter-class correlation coefficient was between 0.92 and 0.98. The principal component factor analysis with varimax rotation resulted in separation of nine factors explaining 75.19% of total variance. BSHS-B-Np showed good discriminant validity in 35 out of 36 domain correlations confirming the construct of the scale. Furthermore, the scale was able to discriminate between face, upper limb and lower limb injury (p < 0.05). CONCLUSIONS BSHS-B-Np is a reliable and valid scale for Nepali burns survivors to assess their health related quality of life.
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Affiliation(s)
- Regan Shakya
- Department of Physiotherapy, Kathmandu University School of Medical Sciences/ Dhulikhel Hospital, Dhulikhel, Nepal.
| | - Misu Manandhar
- Department of Physiotherapy, Kathmandu University School of Medical Sciences/ Dhulikhel Hospital, Dhulikhel, Nepal
| | - Roshan Dangol
- Department of Physiotherapy, Sushma Koirala Memorial Hospital, Kathmandu, Nepal
| | - Archana Shrestha
- Department of Community Programs, Kathmandu University School of Medical Sciences/ Dhulikhel Hospital, Dhulikhel, Nepal
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Silva A, Marzo J, García del Castillo J. The adaptation of the Burn Specific Health Scale-Revised (BSHS-R) into the Portuguese context. Burns 2019; 45:1649-1658. [DOI: 10.1016/j.burns.2019.04.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 03/05/2019] [Accepted: 04/30/2019] [Indexed: 10/26/2022]
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Lee SZ, Halim AS. Superior long term functional and scar outcome of Meek micrografting compared to conventional split thickness skin grafting in the management of burns. Burns 2019; 45:1386-1400. [DOI: 10.1016/j.burns.2019.04.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 02/06/2019] [Accepted: 04/08/2019] [Indexed: 02/03/2023]
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Santacreu E, Grossi L, Launois P, López S, Torrent-Bertran ML, Barret JP. The influence of age on quality of life after upper body burn. Burns 2019; 45:554-559. [PMID: 31018911 DOI: 10.1016/j.burns.2018.09.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 07/03/2018] [Accepted: 09/13/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND In Spain, the number of aged persons is increasing. By the year 2066, it is expected that 34.6% of the Spanish population will be over 65 years of age. Elderly people present a higher burning risk owing in part to impaired balance and decreased physical strength, lower cognitive abilities, or socioeconomic context. OBJECTIVE Burns to the upper body body are common and affect both emotional state and physical function, thus leading to reduced quality of life (QoL). Our objective was to determine the influence of age on the QoL of patients who experienced burns to the upper body, with burns with 2 years. METHODS This is an observational study with a sample of 58 patients with burns only on the upper body. Patients were divided into two groups: 29 patients of age over 65 years and 29 patients under 65 years; all of them attended the Vall d'Hebron Burn Center, Barcelona, between 2011 and 2014. From the original sample, 45 patients had survived by the time the information was gathered. The QoL of these individuals was evaluated with the Spanish version of the Burn Specific Health Scale. Demographic data (sex, age, total burn surface area [TBSA], burn mechanism, pathological history, length of hospital stay, and rehabilitation duration) were collected. Statistical analysis included parametric and nonparametric tests as appropriate with R3.3.3. RESULTS There were no differences between groups regarding the mechanism of burn, TBSA, length of hospital stay, and the domains of QoL test. High blood pressure, diabetes, and other comorbidities were significantly more common in the elderly group than in the younger group. Eleven patients died in the elderly group and two in the younger group (p=0.012). CONCLUSION As opposed to what could be expected, in this study, there were no significant differences between surviving patients in both age groups in terms of perceived QoL. Nevertheless, mortality after a burn in the upper side of the body was significantly higher in elderly people than in younger people. The present study results do not support the use of different rehabilitation approaches in elderly patients.
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Affiliation(s)
- Eva Santacreu
- Burn Unit, Vall d'Hebron University Hospital, Barcelona, Spain.
| | - Laura Grossi
- Burn Unit, Vall d'Hebron University Hospital, Barcelona, Spain
| | | | - Silvia López
- Burn Unit, Vall d'Hebron University Hospital, Barcelona, Spain
| | | | - Juan P Barret
- Burn Unit, Vall d'Hebron University Hospital, Barcelona, Spain
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Chin TL, Carrougher GJ, Amtmann D, McMullen K, Herndon DN, Holavanahalli R, Meyer W, Ryan CM, Wong JN, Gibran NS. Trends 10 years after burn injury: A Burn Model System National Database study. Burns 2018; 44:1882-1886. [PMID: 30385060 PMCID: PMC10085112 DOI: 10.1016/j.burns.2018.09.033] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 07/15/2018] [Accepted: 09/28/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND The Burn Specific Health Scale-Brief (BSHS-B) evaluates 9 aspects of health and has been validated globally. Existing reports typically focus on outcomes shortly after injury. The purpose of this study is to determine whether quality of life remains a concern for burn survivors ten years after-injury. METHODS Cross sectional data of survivors admitted from 1994 to 2006 to four US burn centers were collected in the Burn Model System National Database 10 years after injury. Responses to the items in the nine BSHS-B domains range from 0 to 4. Lower scores indicating poorer quality of life. Median scores are reported and differences were compared using Wilcoxon-Mann-Whitney test. RESULTS Ten-year survivor injury characteristics suggest a moderate severity of injury. Survivors scored lower in heat sensitivity, affect, body image, and work (median=3.2, 3.6, 2.8, and 3.6, respectively). Affect, body image, and interpersonal scores were significantly lower for females (median=3.1, 2.8, 3.8, respectively) than males [median=3.6, 3.3, 4, respectively (p=0.008, 0.004, 0.022, respectively)]. CONCLUSIONS Our results suggest certain domains of burn specific health benefit from support at 10 years after injury, and select populations such as females may necessitate additional treatment to restore burn-specific health. These results support that burn injuries represent a chronic condition and long-term medical and psychosocial support may benefit burn survivor recovery.
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Affiliation(s)
- Theresa L Chin
- Department of Surgery, University of California Irvine Medical Center, 333 City Boulevard West, Suite 1600, Orange, CA 92868, United States.
| | - Gretchen J Carrougher
- Department of Surgery, Harborview Medical Center, University of Washington, Box 359796 325 9th Avenue, Seattle, WA, 98104, United States
| | - Dagmar Amtmann
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA 98195-4237, United States
| | - Kara McMullen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA 98195-4237, United States
| | - David N Herndon
- University of Texas Medical Branch, Shriners Hospital for Children-Galveston, 815 Market Street, Galveston, TX 77550, United States
| | - Radha Holavanahalli
- University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9055, United States
| | - Walter Meyer
- University of Texas Medical Branch, Shriners Hospital for Children-Galveston, 815 Market Street, Galveston, TX 77550, United States
| | - Colleen M Ryan
- Massachusetts General Hospital, Spaulding Rehabilitation Hospital, Harvard Medical School, Shriners Hospitals for Children-Boston, 55 Fruit Street, Boston, MA 02114, United States
| | - Joshua N Wong
- Department of Surgery, University of California Irvine Medical Center, 333 City Boulevard West, Suite 1600, Orange, CA 92868, United States
| | - Nicole S Gibran
- Department of Surgery, Harborview Medical Center, University of Washington, Box 359796 325 9th Avenue, Seattle, WA, 98104, United States
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Health-related quality of life in children after burn injuries: A systematic review. J Trauma Acute Care Surg 2018; 85:1110-1118. [DOI: 10.1097/ta.0000000000002072] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Chen L, Lee AF, Shapiro GD, Goverman J, Faoro N, Schneider JC, Kazis LE, Ryan CM. The Development and Validity of the Adult Burn Outcome Questionnaire Short Form. J Burn Care Res 2018; 39:771-779. [PMID: 29931275 PMCID: PMC9834984 DOI: 10.1093/jbcr/irx043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Patient Reported Outcome Measures (PROMs) are useful for understanding the health needs and outcomes of the general public. We aim to develop a burn-specific metric-Adult Burn Outcome Questionnaire (ABOQ)-that is brief and can be administered electronically to all burn survivors over the age of 18. The 14-item ABOQ was developed from the already validated Young Adult Burn Outcome Questionnaire (YABOQ) long form. The ABOQ questionnaire, along with Patient-Reported Outcomes Measurement System-10 (PROMIS-10), was administered to 120 outpatient burn survivors at three hospitals. Clinical validity of the ABOQ was measured by testing associations between ABOQ items and burn size, the PROMIS-10 generic items and composite scales using correlational analysis including multivariate canonical analysis. Nine out of 14 ABOQ items were significantly correlated with burn size (correlations ranging from -0.25 to -0.46, P < .01). The canonical correlation between ABOQ and burn size was 0.68 (P = .0002). The overall canonical correlation between two instruments was also significant (P < .0001). At the item level, at least 25% of the variation in each of the five ABOQ items could be explained by PROMIS-10 items and composite scores, while six other items could only be accounted for by less than 15% of the variation. ABOQ short form assessment can be used to efficiently measure burn outcomes across a range of relevant clinical domains with credible validity. A large proportion of the variation in ABOQ scores was not accounted for by PROMIS-10, suggesting that ABOQ provided additional health-related information specifically for the burn population beyond the generic instrument.
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Affiliation(s)
- Liang Chen
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston,Shriners Hospitals for Children – Boston, Massachusetts,Department of Health Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Austin F. Lee
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston,Shriners Hospitals for Children – Boston, Massachusetts,School of Insurance and Economics, University of International Business and Economics, Beijing, China,Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts
| | - Gabriel D. Shapiro
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Québec, Canada
| | - Jeremy Goverman
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston,Shriners Hospitals for Children – Boston, Massachusetts
| | | | - Jeffrey C. Schneider
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts
| | - 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, Harvard Medical School, Boston,Shriners Hospitals for Children – Boston, Massachusetts
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Predictors of health-related quality of life after burn injuries: a systematic review. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2018; 22:160. [PMID: 29898757 PMCID: PMC6000969 DOI: 10.1186/s13054-018-2071-4] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 05/17/2018] [Indexed: 01/08/2023]
Abstract
Background Identifying predictors of health-related quality of life (HRQL) following burns is essential for optimization of rehabilitation for burn survivors. This study aimed to systematically review predictors of HRQL in burn patients. Methods Medline, Embase, Web of Science, Cochrane, CINAHL, and Google Scholar were reviewed from inception to October 2016 for studies that investigated at least one predictor of HRQL after burns. The Quality in Prognostic Studies tool was used to assess risk of bias of included studies. Results Thirty-two studies were included. Severity of burns, postburn depression, post-traumatic stress symptoms, avoidance coping, less emotional or social support, higher levels of neuroticism, and unemployment postburn were found to predict a poorer HRQL after burns in multivariable analyses. In addition, weaker predictors included female gender, pain, and a postburn substance use disorder. Risk of bias was generally low in outcome measurement and high in study attrition and study confounding. Conclusions HRQL after burns is affected by the severity of burns and the psychological response to the trauma. Both constructs provide unique information and knowledge that are necessary for optimized rehabilitation. Therefore, both physical and psychological problems require attention months to years after the burn trauma. Electronic supplementary material The online version of this article (10.1186/s13054-018-2071-4) contains supplementary material, which is available to authorized users.
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Spronk I, Legemate C, Oen I, van Loey N, Polinder S, van Baar M. Health related quality of life in adults after burn injuries: A systematic review. PLoS One 2018; 13:e0197507. [PMID: 29795616 PMCID: PMC5967732 DOI: 10.1371/journal.pone.0197507] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 05/03/2018] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES Measurement of health-related quality of life (HRQL) is essential to qualify the subjective burden of burns in survivors. We performed a systematic review of HRQL studies in adult burn patients to evaluate study design, instruments used, methodological quality, and recovery patterns. METHODS A systematic review was performed. Relevant databases were searched from the earliest record until October 2016. Studies examining HRQL in adults after burn injuries were included. Risk of bias was scored using the Quality in Prognostic Studies tool. RESULTS Twenty different HRQL instruments were used among the 94 included studies. The Burn Specific Health Scale-Brief (BSHS-B) (46%), the Short Form-36 (SF-36) (42%) and the EuroQol questionnaire (EQ-5D) (9%) were most often applied. Most domains, both mentally and physically orientated, were affected shortly after burns but improved over time. The lowest scores were reported for the domains 'work' and 'heat sensitivity' (BSHS-B), 'bodily pain', 'physical role limitations' (SF-36), and 'pain/discomfort' (EQ-5D) in the short-term and for 'work' and 'heat sensitivity', 'emotional functioning' (SF-36), 'physical functioning' and 'pain/discomfort' in the long-term. Risk of bias was generally low in outcome measurement and high in study attrition. CONCLUSION Consensus on preferred validated methodologies of HRQL measurement in burn patients would facilitate comparability across studies, resulting in improved insights in recovery patterns and better estimates of HRQL after burns. We recommend to develop a guideline on the measurement of HRQL in burns. Five domains representing a variety of topics had low scores in the long-term and require special attention in the aftermath of burns.
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Affiliation(s)
- Inge Spronk
- Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, the Netherlands
- Department of Public Health, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Catherine Legemate
- Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, the Netherlands
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam Movement Sciences, VU University Medical Centre, Amsterdam, the Netherlands
| | - Irma Oen
- Burn Centre, Maasstad Hospital, Rotterdam, the Netherlands
| | - Nancy van Loey
- Association of Dutch Burn Centres, Red Cross Hospital, Beverwijk, the Netherlands
- Utrecht University, Department of Clinical Psychology, Utrecht, The Netherlands
| | - Suzanne Polinder
- Department of Public Health, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Margriet van Baar
- Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, the Netherlands
- Department of Public Health, Erasmus Medical Centre, Rotterdam, the Netherlands
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Three Years After Black Saturday: Long-Term Psychosocial Adjustment of Burns Patients as a Result of a Major Bushfire. J Burn Care Res 2018; 37:e244-53. [PMID: 25501772 DOI: 10.1097/bcr.0000000000000223] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Despite increasing evidence that burn injuries can result in multiple psychological sequelae, little is known about the long-term psychosocial adjustment to burns sustained in a major bushfire. The aim of the present study was to assess long-term psychological distress and health-related quality of life in Australian burns patients as a result of the 2009 Black Saturday bushfires. Eight male and five female burns patients with a mean age of 53.92 (SD = 11.82) years who received treatment at a statewide burns service participated in the study. A battery of standardized questionnaires was administered to assess general psychological distress, burns-specific and generic health-related quality of life, alcohol use, and specific psychological symptoms of posttraumatic stress disorder, depression, and anxiety. The results revealed that more than 3 years after Black Saturday 33% of the burns patients still suffered "high" to "very high" levels of general distress, whereas 58% fulfilled partial or full criteria for posttraumatic stress disorder. Furthermore, participants still experienced significantly impaired physical health functioning as compared to their preinjury status including limitations in work-based activities, increased bodily pain, and lower vitality overall. The trajectory of distress varied for participants. Some individuals experienced little distress overall, whereas others displayed a decline in their stress levels over time. Notwithstanding, some patients maintained high levels of distress throughout or experienced an increase in distress at a later stage of recovery. The results point to the importance of psychosocial screening to identify distress early. Follow-up assessments are crucial to diagnose individuals with chronic or late onset of distress.
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Elsherbiny OE, El Fahar MH, Weheida SM, Shebl AM, Shrief WI. Effect of burn rehabilitation program on improving quality of life (QoL) for hand burns patients: a randomized controlled study. EUROPEAN JOURNAL OF PLASTIC SURGERY 2017. [DOI: 10.1007/s00238-017-1379-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Wasiak J, Tyack Z, Ware R, Goodwin N, Faggion CM. Poor methodological quality and reporting standards of systematic reviews in burn care management. Int Wound J 2017; 14:754-763. [PMID: 27990772 PMCID: PMC7949759 DOI: 10.1111/iwj.12692] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 11/02/2016] [Indexed: 12/18/2022] Open
Abstract
The methodological and reporting quality of burn-specific systematic reviews has not been established. The aim of this study was to evaluate the methodological quality of systematic reviews in burn care management. Computerised searches were performed in Ovid MEDLINE, Ovid EMBASE and The Cochrane Library through to February 2016 for systematic reviews relevant to burn care using medical subject and free-text terms such as 'burn', 'systematic review' or 'meta-analysis'. Additional studies were identified by hand-searching five discipline-specific journals. Two authors independently screened papers, extracted and evaluated methodological quality using the 11-item A Measurement Tool to Assess Systematic Reviews (AMSTAR) tool and reporting quality using the 27-item Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Characteristics of systematic reviews associated with methodological and reporting quality were identified. Descriptive statistics and linear regression identified features associated with improved methodological quality. A total of 60 systematic reviews met the inclusion criteria. Six of the 11 AMSTAR items reporting on 'a priori' design, duplicate study selection, grey literature, included/excluded studies, publication bias and conflict of interest were reported in less than 50% of the systematic reviews. Of the 27 items listed for PRISMA, 13 items reporting on introduction, methods, results and the discussion were addressed in less than 50% of systematic reviews. Multivariable analyses showed that systematic reviews associated with higher methodological or reporting quality incorporated a meta-analysis (AMSTAR regression coefficient 2.1; 95% CI: 1.1, 3.1; PRISMA regression coefficient 6·3; 95% CI: 3·8, 8·7) were published in the Cochrane library (AMSTAR regression coefficient 2·9; 95% CI: 1·6, 4·2; PRISMA regression coefficient 6·1; 95% CI: 3·1, 9·2) and included a randomised control trial (AMSTAR regression coefficient 1·4; 95%CI: 0·4, 2·4; PRISMA regression coefficient 3·4; 95% CI: 0·9, 5·8). The methodological and reporting quality of systematic reviews in burn care requires further improvement with stricter adherence by authors to the PRISMA checklist and AMSTAR tool.
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Affiliation(s)
- Jason Wasiak
- Epworth HealthCareRichmondVAAustralia
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive MedicineMonash UniversityMelbourneVICAustralia
| | - Zephanie Tyack
- Centre for Children's Burns and Trauma Research, Children's Health Research CentreThe University of Queensland & Centre for Functioning and Health Research Metro South HealthBrisbaneQLDAustralia
| | - Robert Ware
- Menzies Health Institute QueenslandGriffith UniversityBrisbaneQLDAustralia
| | | | - Clovis M Faggion
- Department of Periodontology and Restorative Dentistry, Faculty of DentistryUniversity of MunsterMunsterGermany
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Coping styles and quality of life in adults with burn. Burns 2016; 42:1105-1110. [DOI: 10.1016/j.burns.2016.02.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 02/20/2016] [Accepted: 02/23/2016] [Indexed: 11/22/2022]
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Ablort-Morgan C, Allorto NL, Rode H. Rehabilitation of a bilateral upper limb amputee in a resource restricted burn service. Burns 2016; 42:e81-e85. [PMID: 27233676 DOI: 10.1016/j.burns.2016.01.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 01/06/2016] [Accepted: 01/22/2016] [Indexed: 10/21/2022]
Affiliation(s)
- C Ablort-Morgan
- Department of Occupational Therapy, Pietermaritzburg Metropolitan Complex, University of Kwa-Zulu Natal, South Africa
| | - N L Allorto
- Department of Surgery, Pietermaritzburg Metropolitan Complex, University of Kwa-Zulu Natal, South Africa.
| | - H Rode
- Children's Red Cross War Memorial Hospital, Cape Town, South Africa
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Abrams TE, Ogletree RJ, Ratnapradipa D, Neumeister MW. Adult survivors’ lived experience of burns and post-burn health: A qualitative analysis. Burns 2016; 42:152-162. [DOI: 10.1016/j.burns.2015.09.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 09/07/2015] [Accepted: 09/14/2015] [Indexed: 10/22/2022]
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Murphy ME, Holzer CE, Richardson LM, Epperson K, Ojeda S, Martinez EM, Suman OE, Herndon DN, Meyer WJ. Quality of Life of Young Adult Survivors of Pediatric Burns Using World Health Organization Disability Assessment Scale II and Burn Specific Health Scale-Brief: A Comparison. J Burn Care Res 2015; 36:521-33. [PMID: 25167373 PMCID: PMC4362787 DOI: 10.1097/bcr.0000000000000156] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The objective was to determine long-term psychological distress and quality of life (QOL) in young adult survivors of pediatric burns using the World Health Organization Disability Assessment Scale II (WHODAS) and the Burn Specific Health Scale-Brief (BSHS-B). Fifty burn survivors 2.5 to 12.5 years postburn (16-21.5 years old; 56% male, 82% Hispanic) completed the WHODAS and BSHS-B. The WHODAS measures health and disability and the BSHS-B measures psychosocial and physical difficulties. Scores were calculated for each instrument, and then grouped by years postburn, TBSA, sex, burn age, and survey age to compare the effects of each. Next, the instruments were compared with each other. The WHODAS disability score mean was 14.4 ± 2.1. BSHS-B domain scores ranged from 3 to 3.7. In general, as TBSA burned increased, QOL decreased. Female burn survivors, survivors burned prior to school entry, and adolescents who had yet to transition into adulthood reported better QOL than their counterparts. In all domains except Participation, the WHODAS consistently identified more individuals with lower QOL than the BSHS-B. Young adult burn survivors' QOL features more disability than their nonburned counterparts, but score in the upper 25% for QOL on the BSHS-B. This analysis revealed the need for long-term psychosocial intervention for survivors with larger TBSA, males, those burned after school entry, and those transitioning into adulthood. Both instruments are useful tools for assessing burn survivors' QOL and both should be given as they discern different individuals. However, the WHODAS is more sensitive than the BSHS-B in identifying QOL issues.
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Affiliation(s)
- Mary Elizabeth Murphy
- From the Shriners Hospitals for Children and University of Texas Medical Branch, Galveston, and University of Colorado Denver-Anschutz Medical Campus, Aurora
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Finlay V, Phillips M, Allison GT, Wood FM, Ching D, Wicaksono D, Plowman S, Hendrie D, Edgar DW. Towards more efficient burn care: Identifying factors associated with good quality of life post-burn. Burns 2015; 41:1397-404. [PMID: 26233899 DOI: 10.1016/j.burns.2015.06.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 06/04/2015] [Accepted: 06/26/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND As minor burn patients constitute the vast majority of a developed nation case-mix, streamlining care for this group can promote efficiency from a service-wide perspective. This study tested the hypothesis that a predictive nomogram model that estimates likelihood of good long-term quality of life (QoL) post-burn is a valid way to optimise patient selection and risk management when applying a streamlined model of care. METHOD A sample of 224 burn patients managed by the Burn Service of Western Australia who provided both short and long-term outcomes was used to estimate the probability of achieving a good QoL defined as 150 out of a possible 160 points on the Burn Specific Health Scale-Brief (BSHS-B) at least six months from injury. A multivariate logistic regression analysis produced a predictive model provisioned as a nomogram for clinical application. A second, independent cohort of consecutive patients (n=106) was used to validate the predictive merit of the nomogram. RESULTS AND DISCUSSION Male gender (p=0.02), conservative management (p=0.03), upper limb burn (p=0.04) and high BSHS-B score within one month of burn (p<0.001) were significant predictors of good outcome at six months and beyond. A Receiver Operating Curve (ROC) analysis demonstrated excellent (90%) accuracy overall. At 80% probability of good outcome, the false positive risk was 14%. The nomogram was validated by running a second ROC analysis of the model in an independent cohort. The analysis confirmed high (86%) overall accuracy of the model, the risk of false positive was reduced to 10% at a lower (70%) probability. This affirms the stability of the nomogram model in different patient groups over time. An investigation of the effect of missing data on sample selection determined that a greater proportion of younger patients with smaller TBSA burns were excluded due to loss to follow up. CONCLUSION For clinicians managing comparable burn populations, the BSWA burns nomogram is an effective tool to assist the selection of patients to a streamlined care pathway with the aim of improving efficiency of service delivery.
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Affiliation(s)
- V Finlay
- Burn Service of Western Australia at Fiona Stanley Hospital, Australia.
| | - M Phillips
- Burn Service of Western Australia at Fiona Stanley Hospital, Australia
| | - G T Allison
- Burn Service of Western Australia at Fiona Stanley Hospital, Australia
| | - F M Wood
- Burn Service of Western Australia at Fiona Stanley Hospital, Australia
| | - D Ching
- Burn Service of Western Australia at Fiona Stanley Hospital, Australia
| | - D Wicaksono
- Burn Service of Western Australia at Fiona Stanley Hospital, Australia
| | - S Plowman
- Burn Service of Western Australia at Fiona Stanley Hospital, Australia; Fiona Wood Foundation, Perth, Western Australia, Australia
| | - D Hendrie
- Burn Service of Western Australia at Fiona Stanley Hospital, Australia
| | - D W Edgar
- Burn Service of Western Australia at Fiona Stanley Hospital, Australia; Fiona Wood Foundation, Perth, Western Australia, Australia; State Adult Burn Unit, Fiona Stanley Hospital, Murdoch, Western Australia, Australia; Burn Injury Research Node, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
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Piccolo MS, Gragnani A, Daher RP, Scanavino MDT, de Brito MJ, Ferreira LM. Validation of the Brazilian version of the Burn Specific Health Scale-Brief (BSHS-B-Br). Burns 2015; 41:1579-86. [PMID: 26188900 DOI: 10.1016/j.burns.2015.04.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 04/25/2015] [Accepted: 04/28/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Progressive increases in survival rates from burn trauma have shifted attention to patient rehabilitation and posttraumatic quality of life. The assessment of quality of life is strongly dependent on reliable instruments for its measurement. A literature review has revealed that the Burn Specific Health Scale-Brief (BSHS-B) questionnaire is the most commonly used instrument worldwide. OBJECTIVES The aim of this study was to translate the BSHS-B into the Portuguese language, adapt it culturally to the Brazilian population, and test its psychometric properties. METHODS The questionnaire was translated into Portuguese; culturally adapted; and tested for reproducibility, face validity, content validity, and construct validity. The translated version was tested on 92 patients with burns. Internal consistency was tested by means of Cronbach's alpha. Construct validity was performed by correlating the BSHS-B questionnaire with the Burn Specific Health Scale-Revised (BSHS-R), BurnSexQ-Escola Paulista de Medicina (EPM)/Universidade Federal De São Paulo (UNIFESP), the Rosenberg Self-Esteem Scale (RSES), and the Beck Depression Inventory (BDI). RESULTS Cronbach's alpha was 0.85. The Pearson correlation coefficients were significant at three time points of the reliability analysis. A significant correlation was observed between BSHS-B domains and BSHS-R, and between RSES and BDI domains. A significant correlation was also observed between BSHS-B and the BurnSexQ-EPM/UNIFESP social comfort and body image domains. CONCLUSION The BSHS-B questionnaire was translated into Portuguese. It is a reliable tool in this language, showing face, content, and construct validity. The modified instrument has been named BSHS-B-Br.
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Affiliation(s)
- Monica Sarto Piccolo
- Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), Brazil
| | - Alfredo Gragnani
- Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), Brazil.
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Cabulon EAIC, Cardoso JR, Maciel SM, Martins JT, Robazzi MLDCC, Cardelli AAM. Quality of life of individuals treated in an outpatient burn treatment centre: Application of the BSHS-R. Burns 2015; 41:528-35. [DOI: 10.1016/j.burns.2014.08.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 08/25/2014] [Accepted: 08/27/2014] [Indexed: 10/24/2022]
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Validation of the German version of the Burn Specific Health Scale-Brief (BSHS-B). Burns 2015; 41:1333-9. [PMID: 25737271 DOI: 10.1016/j.burns.2015.02.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 01/27/2015] [Accepted: 02/02/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND The Burn Specific Health Scale-Brief (BSHS-B) is recognized as a valid self-rating scale to evaluate quality of life after burn. AIM To validate the translated German version of the BSHS-B. METHOD One hundred and forty one burn survivors (65.2% men) with a mean age of 49.62 years (SD=15.16) and a mean duration after burn of 45.01 months (SD=26.18) answered the BSHS-B. Factor structure was tested by using confirmatory factor analysis, reliability (internal consistency) of the scales was determined by means of Cronbach's α. Construct validity was explored through correlations between the BSHS-B and the Short-Form 8 Health Survey (SF-8). In addition, the know-groups technique was used to determine to which degree the BSHS-B discriminates between patients with low and high burn severity based on the abbreviated burn severity index (ABSI). The Hospital Anxiety and Depression Scale (HADS) was used to examine criterion validity. RESULTS The nine BSHS-B subscales showed good internal consistency. A second-order confirmatory factor analysis revealed the following main components: (1) Affect and Relationship, (2) Function and (3) Skin Involvement. The second-order factors were positively correlated with the SF-8 and negatively correlated with symptoms of anxiety and depression. Patients with low ABSI scored higher on all three BSHS-B domains than those with high ABSI. CONCLUSIONS The results indicate good psychometric properties of the German BSHS-B. Further studies are needed to investigate the utility of the questionnaire in clinical routine practice, evaluation of burn management programs, and burn-specific research.
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Patient experiences living with split thickness skin grafts. Burns 2014; 40:1097-105. [DOI: 10.1016/j.burns.2014.03.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 02/20/2014] [Accepted: 03/10/2014] [Indexed: 11/19/2022]
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Sideli L, Di Pasquale A, Prestifilippo A, Benigno A, Bartolotta A, Cirrincione CR, La Barbera D. Validation of the Italian version of the Burn Specific Health Scale-Brief. Burns 2014; 40:995-1000. [DOI: 10.1016/j.burns.2013.10.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 10/02/2013] [Accepted: 10/04/2013] [Indexed: 11/25/2022]
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Li DW, Liu WQ, Wang HM, Ying-Sun, Cui L, Zhao FF. The Chinese language version of the abbreviated burn specific health scale: a validation study. Burns 2014; 40:1001-6. [PMID: 24439926 DOI: 10.1016/j.burns.2013.10.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 10/21/2013] [Accepted: 10/23/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND The Burn Specific Health Scale (BSHS) is designed to measure burn-specific, health-related quality of life (HRQoL). The aim of the present study was to evaluate the reliability and validity of the Chinese version of the abbreviated BSHS (BSHS-A). METHODS The English version of the BSHS-A was translated into Chinese using a standardised procedure. The participants were 457 patients classified into three severity groups (mild, moderate and severe). All patients completed the Chinese BSHS-A questionnaire, the Short Form-36 (SF-36) and the EuroQol 5-Dimensions (EQ-5D). To evaluate clinical utility of the BSHS-A, we used Cronbach's alpha (internal consistency), intraclass correlation coefficients (ICCs; test-retest reliability) and construct validity (using the SF-36 and EQ-5D). RESULTS Cronbach's alpha for all subscales was >0.80, demonstrating high internal consistency of the BSHS-A (Chinese version). The ICC was >0.70 for each patient group. Strong correlations were observed between the BSHS-A and SF-36 and EQ-5D scales. Neither floor nor ceiling effects were found. CONCLUSION The present study demonstrated that the BSHS-A (Chinese version) has good psychometric properties, showing suitable internal consistency and test-retest reliability. The BSHS-A may, thus, be useful for assessing HRQoL in Chinese burn victims. However, adaptations may be required to reduce its length.
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Affiliation(s)
- Dong-Wen Li
- Department of Nursing, Military General Hospital of Chengdou Region, 270# Rongdou Avenue, Chengdou 610083, China
| | - Wen-Qing Liu
- Department of Nursing, Military General Hospital of Chengdou Region, 270# Rongdou Avenue, Chengdou 610083, China.
| | - Hong-Mei Wang
- Department of Nursing, Military General Hospital of Chengdou Region, 270# Rongdou Avenue, Chengdou 610083, China
| | - Ying-Sun
- Department of Nursing, Military General Hospital of Chengdou Region, 270# Rongdou Avenue, Chengdou 610083, China
| | - Lin Cui
- Department of Nursing, Military General Hospital of Chengdou Region, 270# Rongdou Avenue, Chengdou 610083, China
| | - Fang-Fang Zhao
- Nursing Department of NanTong University, 9# Qixiu Road, Nantong 226001, China
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12-month generic health status and psychological distress outcomes following an Australian natural disaster experience: 2009 Black Saturday Wildfires. Injury 2013; 44:1443-7. [PMID: 23021367 DOI: 10.1016/j.injury.2012.08.060] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Accepted: 08/29/2012] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe the generic health status, health-related quality of life and psychological distress over a 12-month period of burns patients affected by the 2009 Black Saturday Wildfires. DESIGN SETTING AND PARTICIPANTS Cohort study with retrospective assessment of pre-injury status and prospective assessment of physical and psychosocial functioning in the Black Saturday Wildfires burns patients across time. Generic health status and burn specific quality of life using the 36-item Short Form Health Survey (SF-36) and Burn Specific Health Scale (BSHS) were collected at three, six and twelve months post-burn injury. In addition, similar time points were used to measure level of psychological distress and the presence of pain using the Kessler-10 questionnaire (K-10) and the McGill Pain Questionnaire. RESULTS At 12 months post-injury, patients reported a mean 16.4 (standard error, SE: 3.2) reduction in physical health and a 5.3 (SE 2.5) reduction in mental health scores of the SF-36 as compared to their pre-injury scores, with significant decreases observed in the "bodily pain", "physical functioning", "role physical" and "vitality" subscales. High levels of psychological distress and persistent pain were experienced, with no significant changes during the study period to the overall burns specific quality of life. CONCLUSIONS Even 12 months post-burn injury, patients affected by the 2009 Victorian Wildfires still experienced a significant reduction in generic health, increased psychological distress and persistent pain. The need for early and ongoing identification of physical and psychosocial impairments during hospital admission and upon discharge could be helpful to establish systematic interdisciplinary goals for long-term rehabilitation after severe burn injury.
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Ehanire T, Vissoci JRN, Slaughter K, Coêlho R, Bond J, Rodrigues C, Pietrobon R, Levinson H. A systematic review of the psychometric properties of self-reported scales assessing burn contractures reveals the need for a new tool to measure contracture outcomes. Wound Repair Regen 2013; 21:520-9. [PMID: 23758108 DOI: 10.1111/wrr.12058] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2012] [Accepted: 03/25/2013] [Indexed: 12/18/2022]
Abstract
Approximately 40% of burn patients develop scar contractures. It is unknown which scar contracture therapy best optimizes activities of daily living (ADL).The appropriateness of self-reported outcome tools in measuring anti-scar contracture therapies has not been assessed. We conducted a systematic review to determine the quality of existing self-reported scales in measuring ADL among burn patients by analyzing and comparing psychometric properties-factor analysis, validity, reliability, and responsiveness. EMBASE, LILACS, American Psychological Association PsycNET databases were searched for relevant articles. Forty-one articles discussing 10 burn and non-burn-specific scales met eligibility criteria of ADL assessment, and available psychometric analyses. A common strength in most scales was good overall reliability. Common weaknesses were insufficient data on factor analyses, content validity specific to ADL assessment, and responsiveness. The psychometric analyses studies on these scales had poor sample variability. There is insufficient data on the dimensionality and responsiveness of existing scales to support their use for measuring ADL in burn patients. Existing scales do not comprehensively measure ADLs as an isolated parameter. A psychometrically valid, comprehensive self-reported burn contracture scale that measures ADLs among a diverse group of burn patients needs to be developed to optimize burn contracture treatments and develop new therapies.
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Affiliation(s)
- Tosan Ehanire
- Duke University School of Medicine, Durham, NC 27710, USA
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Moi AL, Nilsen RM. Pathways leading to self-perceived general health and overall quality of life in burned adults. Burns 2012; 38:1157-64. [PMID: 22738825 DOI: 10.1016/j.burns.2012.05.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 04/23/2012] [Accepted: 05/06/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE The aim of the study was to explore pathways leading to self-perceived general health and overall quality of life in burn patients. MATERIALS AND METHODS Data on burn-specific health, generic health, overall quality of life, injury characteristics and socio-demographics were obtained from 95 adult burn patients 47.0 (23.8) [mean (SD)] months after injury. A theoretical path model was established based on the concepts of Wilson and Cleary's model on health-related quality of life [1], and the proposed model was examined by structural equation modelling. RESULTS Two main paths were identified, one leading to general health perception and the other leading to overall quality of life. Together, direct and indirect paths explained 63% of the variance of perceived general health and 43% of the variance in overall quality of life. The total effects of the SF-36 domain Vitality on perceived general health and overall quality of life were 0.62 and 0.66, respectively. No statistically significant path could be revealed between general health perception and overall quality of life. CONCLUSION The results indicate that self-perceived general health and overall quality of life are related but distinct constructs. Moreover, vitality seems to be an important factor for the perception of both general health and overall quality of life in burned adults.
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Affiliation(s)
- Asgjerd L Moi
- Faculty of Health and Social Sciences, Bergen University College, Bergen, Norway.
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Pishnamazi Z, Rejeh N, Heravi-Karimooi M, Vaismoradi M. Validation of the Persian version of the Burn Specific Health Scale-Brief. Burns 2012; 39:162-7. [PMID: 22683143 DOI: 10.1016/j.burns.2012.05.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2011] [Revised: 04/23/2012] [Accepted: 05/06/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND The Burns Specific Health Scale-Brief (BSHS-B) is easy to apply, can be self-administered, and is considered a suitable instrument to measure general health and the physical, mental, and social aspects of burn victims' life. AIM The purpose of this study was to translate and culturally adapt the BSHS-B into the Persian language and to investigate its psychometric properties. METHODS The BSHS-B was translated and adapted for Iranian patients. 200 patients (94.34%) filled out the questionnaire. The psychometric properties of the scale, including its internal consistency, test-retest reliability, and construct validity through the known-groups technique were evaluated. RESULTS The Cronbach's alpha coefficient of total scores of the questionnaire was 0.94, demonstrating reasonable internal consistency of the instrument. The test-retest coefficients were reported to be between 0.81 and 0.96. The scale's construct validity was statistically significant. Principal components' factor analysis was used to derive an instrument called the Burn Specific Health Scale-Brief in eight domains. The domains described patients' functions in terms of "Heat sensitivity", "Affect", "Hand function & simple abilities", "Treatment regimens", "Work", "Sexuality", "Interpersonal relationships", and "Body image". CONCLUSIONS The reliability and validity of the adapted version of the BSHS-Brief was shown to be satisfactory. Thus, it can be used to investigate quality of life of Iranian patients suffering from burn.
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Affiliation(s)
- Zahra Pishnamazi
- Department of Nursing, Faculty of Nursing and Midwifery, Shahed University, Tehran, Iran.
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Sexuality after burn in Brazil: survey of burn health-care workers. Burns 2011; 37:1411-8. [DOI: 10.1016/j.burns.2011.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Revised: 03/31/2011] [Accepted: 04/04/2011] [Indexed: 11/18/2022]
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Sheppard NN, Hemington-Gorse S, Shelley OP, Philp B, Dziewulski P. Prognostic scoring systems in burns: a review. Burns 2011; 37:1288-95. [PMID: 21940104 DOI: 10.1016/j.burns.2011.07.017] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2011] [Revised: 06/20/2011] [Accepted: 07/19/2011] [Indexed: 12/16/2022]
Abstract
Survival after burn has steadily improved over the last few decades. Patient mortality is, however, still the primary outcome measure for burn care. Scoring systems aim to use the most predictive premorbid and injury factors to yield an expected likelihood of death for a given patient. Age, burn surface area and inhalational injury remain the mainstays of burn prognostication, but their relative weighting varies between scoring systems. Biochemical markers may hold the key to predicting outcomes in burns. Alternatively, the incorporation of global scales such as those used in the general intensive care unit may have relevance in burn patients. Outcomes other than mortality are increasingly relevant, especially as mortality after burns continues to improve. The evolution of prognostic scoring in burns is reviewed with specific reference to the more widely regarded measures. Alternative approaches to burn prognostication are reviewed along with evidence for the use of outcomes other than mortality. The purpose and utility of prognostic scoring in general is discussed with relevance to its potential uses in audit, research and at the bedside.
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Affiliation(s)
- N N Sheppard
- St. Andrew's Centre for Burns and Reconstructive Surgery, Broomfield, Chelmsford, United Kingdom.
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Psychosocial impact of childhood face burns: A multicenter, prospective, longitudinal study of 390 children and adolescents. Burns 2011; 37:387-94. [DOI: 10.1016/j.burns.2010.12.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Revised: 09/25/2010] [Accepted: 12/16/2010] [Indexed: 10/18/2022]
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