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Deng H, Abouzeid CA, Shepler LJ, Ni P, Slavin MD, Barron DS, Herrera-Escobar JP, Kazis LE, Ryan CM, Schneider JC. Moderation Effects of Daily Behavior on Associations Between Symptoms and Social Participation Outcomes After Burn Injury: A 6-Month Digital Phenotyping Study. Arch Phys Med Rehabil 2024:S0003-9993(24)01000-1. [PMID: 38754720 DOI: 10.1016/j.apmr.2024.05.011] [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: 01/19/2024] [Revised: 04/30/2024] [Accepted: 05/07/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVE To examine the moderation effects of daily behavior on the associations between symptoms and social participation outcomes after burn injury. DESIGN A 6-month prospective cohort study. SETTING Community. PARTICIPANTS Twenty-four adult burn survivors. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Symptoms and social participation outcomes were assessed weekly using smartphone surveys, including symptoms of pain (Patient-Reported Outcomes Measurement Information System [PROMIS] Pain Intensity and Pain Interference), anxiety (PROMIS Anxiety), and depression (Patient Health Questionnaire), as well as outcomes of social interactions and social activities (Life Impact Burn Recovery Evaluation [LIBRE] Social Interactions and Social Activities). Daily behaviors were automatically recorded by a smartphone application and smartphone logs, including physical activity (steps, travel miles, and activity minutes), sleep (sleep hours), and social contact (number of phone calls and message contacts). RESULTS Multilevel models controlling for demographic and burn injury variables examined the associations between symptoms and social participation outcomes and the moderation effects of daily behaviors. Lower (worse) LIBRE Social Interactions and LIBRE Social Activities scores were significantly associated with higher (worse) PROMIS Pain Intensity, PROMIS Pain Interference, PROMIS Anxiety, and Patient Health Questionnaire-8 scores (P<.05). Additionally, daily steps and activity minutes were associated with LIBRE Social Interactions and LIBRE Social Activities (P<.05), and significantly moderated the association between PROMIS Anxiety and LIBRE Social Activities (P<.001). CONCLUSIONS Social participation outcomes are associated with pain, anxiety, and depression symptoms after burn injury, and are buffered by daily physical activity. Future intervention studies should examine physical activity promotion to improve social recovery after burns.
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Affiliation(s)
- Huan Deng
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA
| | - Cailin A Abouzeid
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA
| | - Lauren J Shepler
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA
| | - Pengsheng Ni
- Boston University School of Public Health, Boston, MA
| | - Mary D Slavin
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA; Boston University School of Public Health, Boston, MA; Rehabilitation Outcomes Center at Spaulding, Boston, MA
| | - Daniel S Barron
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | | | - Lewis E Kazis
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA; Boston University School of Public Health, Boston, MA; Rehabilitation Outcomes Center at Spaulding, Boston, MA
| | - Colleen M Ryan
- Massachusetts General Hospital, Harvard Medical School, Boston, MA; Shriners Hospitals for Children-Boston®, Boston, MA, USA
| | - Jeffrey C Schneider
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA; Rehabilitation Outcomes Center at Spaulding, Boston, MA; Massachusetts General Hospital, Harvard Medical School, Boston, MA.
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Li C, Solish M, Rogers AD. Evaluation of patient-reported outcome measures in burn-specific tools: A systematic review. Burns 2024; 50:1-12. [PMID: 38040617 DOI: 10.1016/j.burns.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/15/2023] [Accepted: 10/17/2023] [Indexed: 12/03/2023]
Abstract
INTRODUCTION Patient-reported outcome measures (PROMs) are now well-established tools to evaluate the quality of patient-centred care. Due to the multi-faceted and multi-disciplinary nature of the practice of burn care, as well as the range of significant potential sequelae, PROM's should form a fundamental component of burn quality improvement programs. We aim to 1. Explore biological, psychological, and social considerations that are currently listed in burn-specific PROM tools, as well as their efficacy, 2. Evaluate biological, psychological, and social factors that are considered in new burn-specific PROM tools or those under development, and 3. Identify any opportunities with respect to burn-specific PROM tools, in order to inform future investigation in this area. METHODS A search was performed of MEDLINE (Ovid), EMBASE, CINAHL, and the Cochrane Library databases. Two independent reviewers screened article titles/abstracts and then the full texts using Covidence. All studies were graded independently according to the Quality Rating Scheme for Studies and Other Evidences. RESULTS The initial search yielded 552 references. Based on ab initio inclusion and exclusion criteria, 133 full-text studies were assessed for eligibility, and 21 articles were ultimately included in the systematic review. Due to study heterogeneity, a qualitative synthesis was conducted. Existing burn-specific PROMs covered a range of biological, psychological, and social factors affecting adult and paediatric patients with burn injury, but several studies required additional PROMs for a thorough evaluation. Burn-specific PROM tools under development are poised to fill this deficit. CONCLUSION Major burn injuries are a unique form of trauma, requiring coordinated management that considers numerous factors not relevant to other patient populations. Further research is necessary to validate existing burn-specific PROM tools and to develop more comprehensive burn-specific PROM measures that more comprehensively incorporate the bio-psycho-social model of health.
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Affiliation(s)
- Calandra Li
- Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Max Solish
- Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Alan D Rogers
- Temerty Faculty of Medicine, University of Toronto, Ontario, Canada; Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Ontario, Canada; Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, University of Toronto, Ontario, Canada.
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3
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Deng H, Shepler LJ, Chacon KL, Tenney D, Ni P, Stewart BT, Carrougher GJ, Kowalske K, Wolf SE, Slavin MD, Kazis LE, Ryan CM, Schneider JC. Predictors at 6 and 12 Months for Social Participation Outcome at 24 Months in the Adult Burn Injury Population: A Burn Model System National Database Study. Arch Phys Med Rehabil 2024; 105:235-242. [PMID: 37392780 PMCID: PMC10756920 DOI: 10.1016/j.apmr.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 06/15/2023] [Accepted: 06/21/2023] [Indexed: 07/03/2023]
Abstract
OBJECTIVE To identify clinical factors (physical and psychological symptoms and post-traumatic growth) that predict social participation outcome at 24-month after burn injury. DESIGN A prospective cohort study based on Burn Model System National Database. SETTING Burn Model System centers. PARTICIPANTS 181 adult participants less than 2 years after burn injury (N=181). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Demographic and injury variables were collected at discharge. Predictor variables were assessed at 6 and 12 months: Post-Traumatic Growth Inventory Short Form (PTGI-SF), Post-Traumatic Stress Disorder Checklist Civilian Version (PCL-C), Patient-Reported Outcomes Measurement Information System (PROMIS-29) Depression, Anxiety, Sleep Disturbance, Fatigue, and Pain Interference short forms, and self-reported Heat Intolerance. Social participation was measured at 24 months using the Life Impact Burn Recovery Evaluation (LIBRE) Social Interactions and Social Activities short forms. RESULTS Linear and multivariable regression models were used to examine predictor variables for social participation outcomes, controlling for demographic and injury variables. For LIBRE Social Interactions, significant predictors included the PCL-C total score at 6 months (β=-0.27, P<.001) and 12 months (β=-0.39, P<.001), and PROMIS-29 Pain Interference at 6 months (β=-0.20, P<.01). For LIBRE Social Activities, significant predictors consisted of the PROMIS-29 Depression at 6 months (β=-0.37, P<.001) and 12 months (β=-0.37, P<.001), PROMIS-29 Pain Interference at 6 months (β=-0.40, P<.001) and 12 months (β=-0.37, P<.001), and Heat Intolerance at 12 months (β=-4.55, P<.01). CONCLUSIONS Post-traumatic stress and pain predicted social interactions outcomes, while depression, pain and heat intolerance predicted social activities outcomes in people with burn injury.
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Affiliation(s)
- Huan Deng
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA
| | - Lauren J Shepler
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA
| | - Kaitlyn L Chacon
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA
| | | | - Pengsheng Ni
- Boston University School of Public Health, Boston, MA
| | - Barclay T Stewart
- The University of Washington, Seattle, WA; Harborview Injury Prevention and Research Center, Seattle, WA
| | | | - Karen Kowalske
- The University of Texas Southwestern Medical Center, Dallas, TX
| | | | - Mary D Slavin
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA; Boston University School of Public Health, Boston, MA; Rehabilitation Outcomes Center at Spaulding, Boston, MA
| | - Lewis E Kazis
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA; Boston University School of Public Health, Boston, MA; Rehabilitation Outcomes Center at Spaulding, Boston, MA
| | - Colleen M Ryan
- Massachusetts General Hospital, Harvard Medical School, Boston, MA; Shriners Hospitals for Children-Boston, Boston, MA
| | - Jeffrey C Schneider
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA; Rehabilitation Outcomes Center at Spaulding, Boston, MA; Massachusetts General Hospital, Harvard Medical School, Boston, MA.
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Kelter BM, Wolfe AE, Kazis LE, Ryan CM, Acton A, Slavin MD, Schneider JC. Trajectory Curves for Purposes of Benchmarking and Predicting Clinical Outcomes: A Scoping Review. J Burn Care Res 2022; 43:1095-1104. [PMID: 34986488 PMCID: PMC9255662 DOI: 10.1093/jbcr/irab245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Trajectory curves are valuable tools to benchmark patient health status and predict future outcomes. A longitudinal study is underway to examine social participation after burn injury using the Life Impact Burn Recovery Evaluation (LIBRE) Profile with the goal of developing trajectory curves for specific domains that focus on social reintegration. We conducted a scoping review to inform and understand trajectory curves applied in clinical settings to compare outcomes for an individual to a matched cohort of comparable patients or predicted expected outcomes over time. This scoping review utilized a PubMed search from January 2014 to August 2019 for the following terms: "trajectory curves" or "trajectory models" and "clinic" or "clinical." Only articles that specifically referenced longitudinal and clinical research designs were included in the scoping review. Articles were assessed using standard scoping review methods and categorized based on clinical application of trajectory curves for either benchmarking or prediction. The initial literature review identified 141 manuscripts and 34 met initial inclusion criteria. The reviewed articles support the clinical use of trajectory curves. Findings provide insight into several key determinants involved with the successful development and implementation of trajectory curves in clinical settings. These findings will inform efforts to use the LIBRE Profile to model social participation recovery and assist in developing effective strategies using trajectory curves to promote social reintegration after burn injury.
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Affiliation(s)
- Brian M Kelter
- Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts, USA,Department of Physical Medicine & Rehabilitation, Spaulding Research Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Audrey E Wolfe
- Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts, USA,Department of Physical Medicine & Rehabilitation, Spaulding Research Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Lewis E Kazis
- Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts, USA,Department of Physical Medicine & Rehabilitation, Spaulding Research Institute, Harvard Medical School, Boston, Massachusetts, USA,Department of Health Law, Policy and Management, Boston University School of Public Health, Massachusetts, USA
| | - Colleen M Ryan
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA,Department of Surgery, Shriners Hospitals for Children—Boston®, Massachusetts, USA
| | - Amy Acton
- Phoenix Society for Burn Survivors, Grand Rapids, Michigan, USA
| | | | - Jeffrey C Schneider
- Address correspondence to Jeffrey C. Schneider, MD, 300 1st Avenue, Boston, MA 02129, USA.
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Slavin MD, Ryan CM, Schneider JC, Acton A, Amaya F, Saret C, Ohrtman E, Wolfe A, Ni P, Kazis LE. Interpreting Life Impact Burn Recovery Evaluation Profile Scores for Use by Clinicians, Burn Survivors, and Researchers. J Burn Care Res 2021; 42:23-31. [PMID: 32556266 PMCID: PMC8265741 DOI: 10.1093/jbcr/iraa100] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The Life Impact Burn Recovery Evaluation (LIBRE) Profile is a patient-reported outcome measure developed to assess social participation in adult burn survivors. This study identified numeric score cut-points that define different levels of social participation ability and described each level. An expert panel identified numeric score cut-points that distinguish different levels of social participation for the six LIBRE Profile domains. Methods employed an iterative, modified-Delphi approach, and bookmarking to review calibrated item banks. Analyses (using calibration sample data and repeated in a validation sample) examined means, SDs, and sample distributions for each level. Analyses of variance examined score differences between levels. The panel developed descriptions for each established level. Initial cut-points resulted in four levels for five domains (Social Activities, Social Interactions, Romantic Relationships, Sexual Relationships, and Work & Employment) and five levels for the sixth domain (Relationships with Family & Friends). Comparisons demonstrated significant differences between level mean scores for all domains (P < .05) except Relationships with Family & Friends. Based on follow-up surveys, Relationships with Family & Friends score cut-points were adjusted to identify four levels with significant score differences between all levels. Panelists reached consensus for level descriptions. Score cut-points and descriptions identify different levels of social participation, providing a relevant context for interpreting LIBRE Profile numeric scores. LIBRE Profile Social Participation levels will help clinicians and persons with burn injury interpret LIBRE Profile numeric scores and promote use of this important new assessment.
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Affiliation(s)
- Mary D. Slavin
- Boston University School of Public Health, Department of Health Law, Policy and Management, Boston, Massachusetts, Massachusetts
| | - Colleen M. Ryan
- Sumner Redstone Burn Center, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Shriners Hospitals for Children-Boston®
| | - Jeffrey C. Schneider
- Spaulding Rehabilitation Hospital, Boston, Massachusetts
- Spaulding Research Institute, Boston, Massachusetts
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts
| | - Amy Acton
- Phoenix Society for Burn Survivors, Grand Rapids, Michigan
| | - Flor Amaya
- Boston University School of Public Health, Department of Health Law, Policy and Management, Boston, Massachusetts, Massachusetts
| | - Cayla Saret
- Boston University School of Public Health, Department of Health Law, Policy and Management, Boston, Massachusetts, Massachusetts
| | - Emily Ohrtman
- Spaulding Rehabilitation Hospital, Boston, Massachusetts
| | - Audrey Wolfe
- Spaulding Rehabilitation Hospital, Boston, Massachusetts
| | - Pengsheng Ni
- Boston University School of Public Health, Department of Health Law, Policy and Management, Boston, Massachusetts, Massachusetts
| | - Lewis E. Kazis
- Boston University School of Public Health, Department of Health Law, Policy and Management, Boston, Massachusetts, Massachusetts
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Ohrtman EA, Shapiro GD, Wolfe AE, Trinh NHT, Ni P, Acton A, Slavin MD, Ryan CM, Kazis LE, Schneider JC. Sexual activity and romantic relationships after burn injury: A Life Impact Burn Recovery Evaluation (LIBRE) study. Burns 2020; 46:1556-1564. [PMID: 32948357 DOI: 10.1016/j.burns.2020.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/10/2020] [Accepted: 01/16/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Engaging in healthy sexual activity and romantic relationships are important but often neglected areas of post-burn rehabilitation. The degree to which persons with burn injuries engage in sexual activity and romantic relationships is not well understood. This study examined demographic and clinical characteristics predicting engagement in sexual activity and romantic relationships in a sample of adult burn survivors compared to a general United States sample. METHODS Data for the adult burn survivor sample were from 601 adult burn survivors who participated in field-testing for the calibration of the Life Impact Burn Recovery Evaluation (LIBRE) Profile, a burn-specific instrument assessing social participation on six scales including sexual activity and romantic relationships. Comparison data were obtained from a general population sample of 2000 adults through sample matching. Demographic predictors of sexual activity and romantic relationship status were examined in each sample using modified Poisson regression analyses. Clinical predictors of engaging in sexual activity and romantic relationships were also examined in the LIBRE sample. RESULTS Participants were slightly more likely to report being sexually active in the adult burn survivor sample than in the general sample (65% vs. 57%, p < 0.01). There was not a significant difference in romantic relationship status between the two samples (64% vs. 62%, p = 0.31). In multivariable regression analyses, men in both samples were more likely to report being in a sexual relationship (RR in LIBRE sample = 1.23, 95% CI 1.08-1.39; RR in general sample = 1.10, 95% CI 1.02-1.18). Participants in both samples who were not working were less likely to report being sexually active or in a romantic relationship (RRs ranging from 0.73 to 0.83, p < 0.05 for all estimates). In the adult burn survivor sample, respondents with hand burns were more likely to report being sexually active and in a romantic relationship (RR = 1.16, 95% CI 1.01-1.33). Time since burn injury, burn size, and burns to other critical areas were not significantly associated with either outcome in adjusted analyses. CONCLUSIONS The likelihood of engaging in sexual activity and romantic relationships is similar among adult burn survivors and the comparison group representing a general United States sample of adults. Further research addressing sexual activity and romantic relationships after burn injuries will help to foster better patient-clinician dialogue, pinpoint barriers, design interventions, and allocate appropriate resources.
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Affiliation(s)
- Emily A Ohrtman
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States
| | - Gabriel D Shapiro
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Audrey E Wolfe
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States
| | - Nhi-Ha T Trinh
- Massachusetts General Hospital, Boston, MA, United States
| | - Pengsheng Ni
- Boston University School of Public Health, Boston, MA, United States
| | - Amy Acton
- The Phoenix Society for Burn Survivors, Grand Rapids, MI, United States
| | - Mary D Slavin
- Boston University School of Public Health, Boston, MA, United States
| | - Colleen M Ryan
- Massachusetts General Hospital, Boston, MA, United States; Shriners Hospital for Children - Boston, Harvard Medical School, Boston, MA, United States
| | - Lewis E Kazis
- Boston University School of Public Health, Boston, MA, United States
| | - Jeffrey C Schneider
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States.
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Edgar DW, Van Daele U, Spronk I, van Baar M, van Loey N, Wood FM, Kazis LB, Meirte J. Seeding the value based health care and standardised measurement of quality of life after burn debate. Burns 2020; 46:1721-1723. [PMID: 32571608 PMCID: PMC7260548 DOI: 10.1016/j.burns.2020.05.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 05/21/2020] [Indexed: 11/29/2022]
Affiliation(s)
- D W Edgar
- State Adult Burn Unit, Fiona Stanley Hospital, Murdoch, Australia; Burn Injury Research Node, The Institute for Health Research, The University of Notre Dame Australia, Fremantle, Australia; Fiona Wood Foundation, Fiona Stanley Hospital, Murdoch, Australia.
| | - U Van Daele
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI-MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Oscare, Organisation for Burns, Scar After-Care and Research, Antwerp, Belgium
| | - I Spronk
- Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, The Netherlands; Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, The Netherlands
| | - M van Baar
- Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, The Netherlands; Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, The Netherlands
| | - N van Loey
- Association of Dutch Burn Centres, Department Psychological and Nursing Research, Beverwijk, The Netherlands; Utrecht University, Department of Clinical Psychology, Utrecht, The Netherlands
| | - F M Wood
- Fiona Wood Foundation, Fiona Stanley Hospital, Murdoch, Australia; Burn Service of Western Australia, Fiona Stanley Hospital and Perth Children's Hospital, Perth, Australia; Burn Injury Research Unit, University of Western Australia, Crawley, Australia
| | - L B Kazis
- Health Outcomes Unit and Center for the Assessment of Pharmaceutical Practices (CAPP), Department of Health Law, Policy and Management; Boston University School of Public Health, Boston, Massachusetts
| | - J Meirte
- Oscare, Organisation for Burns, Scar After-Care and Research, Antwerp, Belgium; Department of Rehabilitation Sciences and Physiotherapy (REVAKI-MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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8
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Ryan CM, Schneider JC, Jeng JC. Beyond lessons learned: Establishing longitudinal data collection to improve burn disaster response. Burns 2019; 46:17-18. [PMID: 31732219 DOI: 10.1016/j.burns.2019.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 10/26/2019] [Indexed: 11/25/2022]
Affiliation(s)
- Colleen M Ryan
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Shriners' Hospitals for Children-Boston, Boston, MA, USA; American Burn Association Organization and Delivery of Burn Care Committee, USA.
| | - Jeffrey C Schneider
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, USA; Harvard Medical School, USA; American Burn Association Rehabilitation Committee, USA
| | - James C Jeng
- Nathan Speare Regional Burn Treatment Center, Crozer-Chester Medical Center, Upland, PA, USA; Clinical Professor of Surgery, Icahn School of Medicine, Mount Sinai Healthcare System, New York, NY, USA; American Burn Association Organization and Delivery of Burn Care Disaster Subcommittee, USA
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9
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Saret CJ, Ni P, Marino M, Dore E, Ryan CM, Schneider JC, Kazis LE. Social Participation of Burn Survivors and the General Population in Work and Employment: A Life Impact Burn Recovery Evaluation (LIBRE) Profile Study. J Burn Care Res 2019; 40:669-677. [PMID: 31069384 DOI: 10.1093/jbcr/irz076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Work integration and retention after burn injury is a key outcome. Little is known about how burn survivors reintegrate into the workplace. This article compares scores on the Life Impact Burn Recovery Evaluation (LIBRE) Profile, a burn-specific measure of social participation, between burn survivors and general population samples, focusing on the Work and Employment domain. METHODS Convenience samples of burn survivors and the U.S. population were obtained. Differences in demographic and clinical characteristics and LIBRE Profile scores were assessed. To examine work and employment, we compared family and friends, social activities, and social interactions scores among working vs nonworking burn survivors. RESULTS Six hundred and one burn survivors (320 employed) and 2000 U.S. residents (1101 employed) were surveyed. The mean age (P = .06), distributions of sex (P = .35), and Hispanic ethnicity (P = .07) did not differ significantly. Distributions of race (P < .01) and education (P = .01) differed significantly. The burn survivor sample had higher scores, demonstrating higher participation, for work and employment (mean = 49.5, SD = 9.42) than the general sample (mean = 46.94, SD = 8.94; P < .0001), which persisted after adjusting for demographic characteristics. Scores on the three domains administered to all respondents were higher (P < .001) for working than nonworking burn survivors. CONCLUSION Distributions indicated higher social participation in the burn survivor sample than the general sample. Possible explanations include sample bias; resilience, posttraumatic growth, or response-shift of survivors; and limitations of using items in the general sample. Working burn survivors scored higher than those not working. Future work can explore factors that mediate higher scores and develop interventions.
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Affiliation(s)
- Cayla J Saret
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Pengsheng Ni
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Molly Marino
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Emily Dore
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Colleen M Ryan
- Department of Surgery, Massachusetts General Hospital, Boston.,Harvard Medical School, Boston, Massachusetts.,Shriners Hospitals for Children-Boston®, Massachusetts
| | - Jeffrey C Schneider
- Harvard Medical School, Boston, Massachusetts.,Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts
| | - Lewis E Kazis
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
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10
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Ni P, Marino M, Dore E, Sonis L, Ryan CM, Schneider JC, Jette AM, Kazis LE. Extreme response style bias in burn survivors. PLoS One 2019; 14:e0215898. [PMID: 31059527 PMCID: PMC6502351 DOI: 10.1371/journal.pone.0215898] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 04/10/2019] [Indexed: 11/29/2022] Open
Abstract
This paper explores extreme response style to the Life Impact Burn Recovery Evaluation (LIBRE) Profile, a measure of social participation in burn survivors. We fit a Multidimensional Generalized Partial Credit Model (MGPCM) with a positive extreme response style (PERS) factor and compared this model with the original MGPCM, estimated the impact that PERS has on scores, and examined the personal characteristics that may result in an individual more likely to respond in a fashion that would inflate their true low scores. The average impact of the PERS, based upon the root mean squared bias, ranged from 0.27 to 0.50 of a standard deviation of the scale. Individuals who were older, had participated in a burn survivor support group, and had selected to self-administer the measure were less likely to have a high PERS bias that masks low scores. Future work can consider PERS when measuring the psychosocial impacts of burn injuries and other health conditions.
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Affiliation(s)
- Pengsheng Ni
- Boston University School of Public Health, Department of Health Law, Policy, and Management, Boston, Massachusetts, United States of America
- * E-mail:
| | - Molly Marino
- Boston University School of Public Health, Department of Health Law, Policy, and Management, Boston, Massachusetts, United States of America
| | - Emily Dore
- Boston University School of Public Health, Department of Health Law, Policy, and Management, Boston, Massachusetts, United States of America
| | - Lily Sonis
- Boston University School of Public Health, Department of Health Law, Policy, and Management, Boston, Massachusetts, United States of America
| | - Colleen M. Ryan
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- Shriners Hospitals for Children–Boston, Boston, Massachusetts, United States of America
| | - Jeffrey C. Schneider
- Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts, United States of America
| | - Alan M. Jette
- MGH Institute of Health Professions, Boston, Massachusetts, United States of America
| | - Lewis E. Kazis
- Boston University School of Public Health, Department of Health Law, Policy, and Management, Boston, Massachusetts, United States of America
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11
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Carmean M, Grigorian A, Stefan J, Godes N, Burton K, Joe VC. What Happens After a Positive Screen for Depression and Posttraumatic Stress Disorder in the Outpatient Burn Clinic? J Burn Care Res 2019; 40:590-594. [DOI: 10.1093/jbcr/irz051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 03/29/2019] [Indexed: 12/18/2022]
Abstract
Abstract
Multiple reports have demonstrated a wide prevalence of both depression and posttraumatic stress disorder (PTSD) within 1 year of burn injury. The purpose of this study is to determine outcomes of burn patients after a positive outpatient screen for depression or PTSD at an American Burn Association-verified burn center. All patients who screened positive were offered referral for psychologic and/or psychiatric counseling. Rescreening was performed with a goal of approximately 6 months. A total of 445 patients were enrolled with 91 (20.6%) screening positive for depression and 59 (13.4%) for PTSD. TBSA burned was associated with a positive screen for depression (P = .008) and PTSD (P = .012) while electrical injury was associated with a positive screen for depression (P = .029). Rescreening was done in 15.5% with 23% rescreening positive for depression and 15% for PTSD. The study validated the need for early screening and referral for psychologic and/or psychiatric counseling in this population.
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Affiliation(s)
- Melissa Carmean
- UC Irvine Health Rehabilitation Services, Orange, California
| | | | | | | | | | - Victor C Joe
- UC Irvine Department of Surgery, Orange, California
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