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Boersma-van Dam E, Spronk I, Hofland HWC, Van Loey NEE. Gender differences in relation to stigmatization and depressive symptoms after burns. Burns 2024; 50:1662-1670. [PMID: 38637258 DOI: 10.1016/j.burns.2024.03.022] [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: 06/30/2023] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVES The aim of this study was to investigate the moderating role of gender in the relationship between burn severity, perceived stigmatization and depressive symptoms at multiple time points postburn. MATERIALS AND METHODS This multi-center study included data from two cohorts. Cohort 1 consisted of 215 burn survivors, participating in a longitudinal study with measures at 3 and 12 months postburn. Cohort 2 consisted of 180 burn survivors cross-sectionally assessed at 5 - 7 years postburn. Both cohorts completed self-reported measures of perceived stigmatization and depressive symptoms. The number of acute surgeries (i.e., no surgery, 1 surgery or 2 or more surgeries) was used as indicator of burn severity. Relations between number of surgeries, depressive symptoms, and perceived stigmatization, including possible indirect effects, were evaluated with gender-specific path models. RESULTS In both men and women, number of surgical operations was related to higher levels of depressive symptoms and perceived stigmatization at 3 months after burn. In women, number of operations was still directly related to both constructs at 12 months after burn, which was cross-sectionally confirmed in the 5-7 years after burn cohort. In men, from 3 to 12 months after burn, depressive symptoms and perceived stigmatization were bidirectionally related, and, through these effects, number of surgeries was indirectly related to both outcomes. In the cross-sectional 5-7 years after burn cohort, number of operations was related to stigma but not to depressive symptoms of men. CONCLUSION Number of operations had a different effect on psychosocial adaptation of male and female burn survivors. In women, a persistent direct link from number of operations to both depressive symptoms and perceived stigmatization was found over time. In men, the effect of number of operations was most evident in the short-term, after which perceived stigmatization and depressive symptoms became interrelated. This indicates that burn severity remains a factor of significance in psychological adjustment in women, whereas in men, this significance seems to decrease over time.
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Affiliation(s)
- Elise Boersma-van Dam
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands; Association of Dutch Burn Centres, Beverwijk, the Netherlands.
| | - Inge Spronk
- Association of Dutch Burn Centres, Beverwijk, the Netherlands; Dutch Burns Foundation, Beverwijk, the Netherlands; Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, the Netherlands
| | | | - Nancy E E Van Loey
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands
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Palackic A, Franco-Mesa C, Beck I, Nolte S, Tapking C, Panayi AC, Stolle A, Haug V, Hirche C, Kneser U, Hundeshagen G. The Impact of Facial Burns on Short- and Long-Term Quality of Life and Psychological Distress-A Prospective Matched Cohort Study. J Clin Med 2023; 12:5057. [PMID: 37568459 PMCID: PMC10419582 DOI: 10.3390/jcm12155057] [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: 06/10/2023] [Revised: 07/17/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
Burn injuries are a major healthcare challenge worldwide, with up to 50% of all minor burns located on the head and neck. With this study, we sought to describe the effect of facial burns (FB) on health-related quality of life through a prospective and matched cohort study design. Patients completed the 36 Item Short Form (SF-36) and the Hospital Anxiety and Depression Scale (HADS). Results were analyzed based on the distribution of datasets. In total, 55 patients with FB and 55 age-and sex-matched candidates were recruited. The most common mechanism of thermal injury was burns from flames. The FB group scored lower in physical and psychological dimensions than the control group, both acutely and one year after injury. An analysis of each domain showed that subjects in the FB group trended toward improvements in their score after one-year post-burn in physical functioning (acute: 71.0 ± 29.2; one-year: 83.7 ± 23.9; p = 0.02) and bodily pain (acute: 58.5 ± 30.3; one-year: 77.9 ± 30.5; p = 0.01) domains. Additionally, the FB group had significanlyt higher scores for anxiety (FB: 4.8 ± 3.2; control: 2.5 ± 2.8; p = <0.002) and depression (FB: 3.9 ± 3.5; control: 2.1 ± 2.7; p = 0.01) compared to the control. In conclusion, facial burns are associated with physical and psychosocial deficits, as well as elevated levels of psychological distress.
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Affiliation(s)
- Alen Palackic
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, 67071 Ludwigshafen am Rhein, Germany; (A.P.); (I.B.); (S.N.); (C.T.); (A.C.P.); (A.S.); (V.H.); (C.H.); (U.K.)
- Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA;
| | - Camila Franco-Mesa
- Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA;
| | - Inessa Beck
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, 67071 Ludwigshafen am Rhein, Germany; (A.P.); (I.B.); (S.N.); (C.T.); (A.C.P.); (A.S.); (V.H.); (C.H.); (U.K.)
| | - Steffen Nolte
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, 67071 Ludwigshafen am Rhein, Germany; (A.P.); (I.B.); (S.N.); (C.T.); (A.C.P.); (A.S.); (V.H.); (C.H.); (U.K.)
- Department of Otorhinolaryngology, Head and Neck Surgery, Armed Forces Hospital Ulm, 89081 Ulm, Germany
| | - Christian Tapking
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, 67071 Ludwigshafen am Rhein, Germany; (A.P.); (I.B.); (S.N.); (C.T.); (A.C.P.); (A.S.); (V.H.); (C.H.); (U.K.)
| | - Adriana C. Panayi
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, 67071 Ludwigshafen am Rhein, Germany; (A.P.); (I.B.); (S.N.); (C.T.); (A.C.P.); (A.S.); (V.H.); (C.H.); (U.K.)
| | - Annette Stolle
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, 67071 Ludwigshafen am Rhein, Germany; (A.P.); (I.B.); (S.N.); (C.T.); (A.C.P.); (A.S.); (V.H.); (C.H.); (U.K.)
| | - Valentin Haug
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, 67071 Ludwigshafen am Rhein, Germany; (A.P.); (I.B.); (S.N.); (C.T.); (A.C.P.); (A.S.); (V.H.); (C.H.); (U.K.)
| | - Christoph Hirche
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, 67071 Ludwigshafen am Rhein, Germany; (A.P.); (I.B.); (S.N.); (C.T.); (A.C.P.); (A.S.); (V.H.); (C.H.); (U.K.)
- Department of Plastic, Hand and Reconstructive Microsurgery, Hand Trauma and Replantation Center (FESSH), BG Klinik Frankfurt am Main gGmbH, Academic Teaching Hospital of Goethe-University of Frankfurt, 60629 Frankfurt am Main, Germany
| | - Ulrich Kneser
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, 67071 Ludwigshafen am Rhein, Germany; (A.P.); (I.B.); (S.N.); (C.T.); (A.C.P.); (A.S.); (V.H.); (C.H.); (U.K.)
| | - Gabriel Hundeshagen
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, 67071 Ludwigshafen am Rhein, Germany; (A.P.); (I.B.); (S.N.); (C.T.); (A.C.P.); (A.S.); (V.H.); (C.H.); (U.K.)
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