1
|
Druery M, Das A, Warren J, Newcombe PA, Lipman J, Cameron CM. Early predictors of health-related quality of life outcomes at 12 months post-burn: ABLE study. Injury 2024; 55:111545. [PMID: 38584078 DOI: 10.1016/j.injury.2024.111545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/21/2024] [Accepted: 04/01/2024] [Indexed: 04/09/2024]
Abstract
There remains a paucity of evidence on the early predictors of long-term Health-Related Quality of Life (HRQoL) outcomes post-burn in hospitalised adults. The overall aim of this study was to identify the factors (personal, environmental, burn injury and burn treatment factors) that may predict long-term HRQoL outcomes among adult survivors of hospitalised burn injuries at 12 months post-burn. A total of 274 participants, aged 18 years or over, admitted to a single state-wide burn centre with a burn injury were recruited. Injury and burn treatment information were collected from medical records or the hospital database and surveys collected demographic and social data. HRQoL outcome data were collected at 3-, 6- and 12-months using the 12-Item Short Form Survey (SF-12 v1) and Burns Specific Health Scale-Brief (BSHS-B). Personal, environmental, burn injury and burn treatment factors were also recorded at baseline. Analyses were performed using linear and logistic regression. Among 274 participants, 71.5 % (N=196) remained enrolled in the study at 12 months post-burn. The majority of participants reported HRQoL outcomes comparable with population norms and statistically significant improvements in generic (SF-12 v1) and condition-specific (BSHS-B) outcomes over time. However, for participants with poor HRQoL outcomes at 12-months post-burn, Univariable predictors included longer hospital length of stay, unemployment at the time of injury, a diagnosed pre-injury mental health condition, inadequate pre-burn social support, intentional injury, recreational drug use pre-injury and female gender. The early multivariable predictors of insufficient HRQoL outcomes were female gender, a previously diagnosed mental health condition, unemployment, inadequate social support, intentional injury, and prolonged hospital length of stay. These results suggest potential factors that could be used to screen and burns patients for psychosocial intervention and long-term follow up.
Collapse
Affiliation(s)
| | - Arpita Das
- Jamieson Trauma Institute, Australia; Queensland University of Technology, Australia.
| | - Jacelle Warren
- Jamieson Trauma Institute, Australia; Queensland University of Technology, Australia
| | | | - Jeffrey Lipman
- The University of Queensland, Australia; Jamieson Trauma Institute, Australia
| | - Cate M Cameron
- Jamieson Trauma Institute, Australia; Queensland University of Technology, Australia
| |
Collapse
|
2
|
Katsu A, Mackenzie L, Elliott JM, Mackey M, Tyack Z. Return-to-employment for working-aged adults after burn injury: A mixed methods scoping review. Work 2024:WOR230148. [PMID: 38578910 DOI: 10.3233/wor-230148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND This scoping review aimed to identify the barriers, facilitators and benefits of returning to work following burn injury, outcome measures used, management strategies, and models of care. OBJECTIVE To provide a comprehensive overview about working-aged adults returning to their preinjury employment after burn injury. METHODS We followed a pre-determined scoping review protocol to search MEDLINE, CINAHL, Embase, PsycINFO, PubMed, Scopus, CCRCT and CDSR databases between 2000 to December 2023. Papers reporting primary data from previously employed adults with cutaneous burn injuries were included. RESULTS In all, 90 articles met the review criteria. Return-to-work was both an outcome goal and process of recovery from burn injury. Physical and psychological impairments were identified barriers. Job accommodations and modifications were important for supporting the transition from hospital to workplace. Employment status and quality of life sub-scales were used to measure return-to-work. CONCLUSIONS Consistent definitions of work and measurements of return-to-employment after burn injury are priorities for future research. Longitudinal studies are more likely to capture the complexity of the return-to-employment process, its impact on work participation and changes in employment over time. The social context of work may assist or hinder return-to-work more than physical environmental constraints. Equitable vocational support systems would help address disparities in vocational rehabilitation services available after burn injury.
Collapse
Affiliation(s)
- Akane Katsu
- Discipline of Occupational Therapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - James M Elliott
- The Kolling Institute, Northern Sydney Local Health District, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Martin Mackey
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Zephanie Tyack
- Australian Centre for Health Services Innovation (AusHSI), Centre for Healthcare Transformation and School of Public Health and Social Work, Queensland University of Technology, Australia
| |
Collapse
|
3
|
Chen PJ, Huang CW, Lin HL, Chang CM. Depression, postburn disability & quality of life: The moderating roles of burn specific coping strategies. Burns 2023; 49:1886-1892. [PMID: 37821286 DOI: 10.1016/j.burns.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 03/13/2023] [Accepted: 05/06/2023] [Indexed: 10/13/2023]
Abstract
Depression has been associated with poorer postburn functional outcomes. However, whether or not certain burn specific coping strategies moderate the relationships remains unknown. Burn survivors from 2015 Formosa Fun Coast Water Park explosion were recruited in a 3-year follow-up study. Using Wave 1 data collected 1 year after discharge, we conducted multivariate regression analysis to assess the associations between depression and postburn disability and quality of life. We also performed moderation analysis to determine moderating effects of burn specific coping strategies on the associations. Our results found depression was significantly associated with worsening postburn disability and poorer quality of life. When demographic and burn related variables were accounted for, we found avoidance coping moderated the depression-disability relationship. Depression was significantly and positively correlated with disability at low and medium levels of avoidance but not high. Optimism/problem solving moderated the depression-quality of life relationship. Depression was significantly and negatively correlated with quality of life at low and medium levels of optimism/problem solving but not high. Our study provided evidence supporting early identification and intervention of depression in burn survivors to optimize functional outcomes. Such knowledge may provide insights into potential targets in rehabilitation in depressed burn survivors.
Collapse
Affiliation(s)
- Pei-Jung Chen
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, United Kingdom
| | - Chih-Wan Huang
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Huang-Li Lin
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Chia-Ming Chang
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
| |
Collapse
|
4
|
Dukes K, Baldwin S, Assimacopoulos E, Grieve B, Hagedorn J, Wibbenmeyer L. Influential Factors in the Recovery Process of Burn Survivors in a Predominately Rural State: A Qualitative Study. J Burn Care Res 2021; 43:374-380. [PMID: 34891162 DOI: 10.1093/jbcr/irab232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Navigating the recovery journey following a burn injury can be challenging. Survivor stories can help define recovery constructs that can be incorporated into support programs. We undertook this study to determine themes of recovery in a predominately rural state. Eleven purposefully selected burn survivors were interviewed using a semi-structured format. Consensus coding of verbatim transcriptions was used to determine themes of successful recovery. Four support-specific themes were identified. These included: using active coping strategies, expressing altruism through helping others, finding meaning and acceptance, and the active seeking and use of support. These themes could be incorporated into support programming and would help guide future survivors through the recovery period.
Collapse
Affiliation(s)
- Kimberly Dukes
- University of Iowa Carver College of Medicine, 200 Hawkins Dr, Iowa City, IA 52242, USA.,Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Medical Center, Iowa City, Iowa 52246, USA
| | - Stephanie Baldwin
- Department of Obstetrics and Gynecology, University of Florida/Ascension Sacred Heart 5153 North 9 th Ave. #403 Pensacola, FL 32504, USA
| | - Evangelia Assimacopoulos
- University of Iowa Carver College of Medicine, 200 Hawkins Dr, Iowa City, IA 52242, USA.,Department of Emergency Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA 52242, USA
| | - Brian Grieve
- University of Iowa Carver College of Medicine, 200 Hawkins Dr, Iowa City, IA 52242, USA
| | - Joshua Hagedorn
- University of Iowa Carver College of Medicine, 200 Hawkins Dr, Iowa City, IA 52242, USA
| | - Lucy Wibbenmeyer
- University of Iowa Carver College of Medicine, 200 Hawkins Dr, Iowa City, IA 52242, USA.,Department of Surgery, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA 52242, USA
| |
Collapse
|
5
|
Al-Ghabeesh SH. Coping strategies, social support, and mindfulness improve the psychological well-being of Jordanian burn survivors: A descriptive correlational study. Burns 2021; 48:236-243. [PMID: 34696949 DOI: 10.1016/j.burns.2021.04.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 03/28/2021] [Accepted: 04/12/2021] [Indexed: 11/02/2022]
Abstract
BACKGROUND Burn injury survivors usually experience multiple psychosocial problems, which occur commonly in low and middle-income countries. However, the previous literature provides limited information about the unique roles of coping strategies, social support, and mindfulness in improving the psychological well-being of burn survivors. Therefore, this study identified the role of coping strategies, social support, and mindfulness in improving the psychological well-being of burn survivors. METHODS A descriptive correlational study on 224 burn survivors at a large government hospital in Amman, Jordan, was conducted. Participants completed questionnaires about socio-demographic and clinical data, anxiety and depression, social support, mindfulness, and coping. Standard multiple regression was performed to identify the unique role of the main study variables in improving the psychological well-being of burn survivors. RESULTS Participants were found to have a severe level of psychological distress. Escape avoidance coping had the highest mean score among all other coping strategies, while acceptance of responsibility had the lowest mean score. Regression analysis showed that confrontive coping (β = -0.224, p=p<0.01), social support (β = -.212, p=p<0.01), and mindfulness (β = -.403, p=p<0.01) were significantly associated with less psychological distress. CONCLUSIONS Therefore, confrontive coping, social support, and mindfulness-based supportive interventions could be helpful in providing enhanced support to burn survivors.
Collapse
|
6
|
Developing a Delphi-Based Comprehensive Core Set from the International Classification of Functioning, Disability, and Health Framework for the Rehabilitation of Patients with Burn Injuries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083970. [PMID: 33918802 PMCID: PMC8068789 DOI: 10.3390/ijerph18083970] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/05/2021] [Accepted: 04/07/2021] [Indexed: 02/04/2023]
Abstract
Burn injuries cause disability and functional limitations in daily living. In a 2015 fire explosion in Taiwan, 499 young people sustained burn injuries. The construction of an effective and comprehensive rehabilitation program that enables patients to regain their previous function is imperative. The International Classification of Functioning, Disability, and Health (ICF) includes multiple dimensions that can contribute to meeting this goal. An ICF core set was developed in this study for Taiwanese patients with burns. A consensus process using three rounds of the Delphi technique was employed. A multidisciplinary team of 30 experts from various institutions was formed. The questionnaire used in this study comprised 162 ICF second-level categories relevant to burn injuries. A 5-point Likert scale was used, and participants assigned a weight to the effect of each category on daily activities after burns. The consensus among ratings was assessed using Spearman's ρ and semi-interquartile range indices. The core set for post-acute SCI was developed from categories that attained a mean score of ≥4.0 in the third round of the Delphi exercise. The core ICF set contained 68 categories. Of these, 19 comprised the component of body functions, 5 comprised body structures, 37 comprised activities and participation, and 7 comprised environmental factors. This preliminary core set offers a comprehensive system for disability assessment and verification following burn injury. The core set provides information for effective rehabilitation strategy setting for patients with burns. Further feasibility and validation studies are required in the future.
Collapse
|
7
|
Satisfaction with appearance and sexual satisfaction in women with severe burn injuries. Int J Impot Res 2021; 34:215-221. [PMID: 33495584 DOI: 10.1038/s41443-021-00407-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 12/27/2020] [Accepted: 01/07/2021] [Indexed: 11/09/2022]
Abstract
Burn, particularly in women, can cause a variety of difficulties. Women's feelings of themselves and of life satisfaction are affected by their body dimensions and satisfaction with appearance, which can be significant predictors of their sexual satisfaction. Therefore, this study aimed to investigate the relationship between satisfaction with appearance and sexual satisfaction among female patients with severe burn. The present study, adopted a descriptive-analytic approach and used a convenience sampling technique, to select 180 female patients Data collection instruments included a demographic questionnaire, the index of sexual satisfaction (ISS), and the satisfaction with appearance scale (SWAP). The results of this study showed that about 82% of women with severe burn injuries, had a lower level of sexual satisfaction. It was observed that satisfaction with appearance had a significant negative relationship with sexual satisfaction in women with burns (P < 0.001). According to the results of the present study, in order to improve appearance satisfaction and consequently sexual satisfaction, intervention attempts are essential. The findings of this study may have practical applications in the formulation of plans for patients with burn injuries.
Collapse
|
8
|
Xiang J, Yang Q, Xie WG, Zhou J, Gong X, Zhang WD, Wu H. Evaluating the impact of rehabilitation nursing intervention on quality of life in patients with burn injuries: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e23879. [PMID: 33429749 PMCID: PMC7793314 DOI: 10.1097/md.0000000000023879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 11/24/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Despite the availability of pharmacological intervention, patients with burn injuries experience pain during the treatment of wounds. Supplementary rehabilitation nursing intervention are required to enhance the wellbeing of patients sustaining injuries from burns. The present study aims to conduct a systematic exploration of the impact of rehabilitation nursing intervention on the wellbeing in patients sustaining burn injuries. METHODS The electronic databases listed below will be searched systematically: PubMed, EMBASE, CINAHL, Cochrane Library, Web of Science, Scopus, China National Knowledge Infrastructure, and WanFang database. All the databases will be searched from their inauguration to November 2020. There will be no language constraints. Independent undertaking by 2 authors will select studies, extract data from selected studies, and assess the quality of the included studies. All disagreements will be resolved through discussion, or by consulting a third independent author. This study will make use of RevMan 5.3 software to perform statistical analysis. RESULTS The present protocol summarizes high-quality evidence to assess the impact of rehabilitation nursing intervention on the wellbeing of patients sustaining burn injuries. CONCLUSION The results of the present protocol has the potential to present evidence to assess whether rehabilitation nursing intervention can enhance the wellbeing of patients sustaining burn injuries. REGISTRATION NUMBER November 17, 2020.osf.io/t6b8c/. (https://osf.io/t6b8c/).
Collapse
|
9
|
Before, during and after: Trauma-informed care in burns settings. Burns 2020; 46:1170-1178. [DOI: 10.1016/j.burns.2019.12.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/03/2019] [Accepted: 12/06/2019] [Indexed: 02/04/2023]
|
10
|
Cleary M, Kornhaber R, Thapa DK, West S, Visentin D. A quantitative systematic review assessing the impact of burn injuries on body image. Body Image 2020; 33:47-65. [PMID: 32109831 DOI: 10.1016/j.bodyim.2020.02.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 02/17/2020] [Accepted: 02/17/2020] [Indexed: 10/24/2022]
Abstract
This study systematically reviewed the quantitative evidence for the impact of burn injuries on body image. Primary research assessing body image using standardized scales published in peer-reviewed journals were systematically searched using the electronic databases PubMed, Scopus, CINHAL, and PsycINFO in January 2020. Studies reporting relationships between characteristics related to burn injury and body image outcomes were included. Quality was assessed using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Included studies varied in comparison methods and body image measures, with most reporting cross-sectional relationships. Among the 33 included studies, 12 reported a negative association between burn severity and body image, 14 reported no significant association, six showed mixed (negative and null) results across the burn injury measures, and one reported more positive body image among burn survivors compared to those without burns. This review identified evidence supporting the association between burn severity and lower satisfaction with body image. Individuals with body image concerns, particularly those with higher burn severity and women, may benefit most from interventions that address self-acceptance and coping mechanisms. Further cross-sectional studies with representative control groups and longitudinal studies with longer follow-up periods are required.
Collapse
Affiliation(s)
- Michelle Cleary
- College of Health and Medicine, University of Tasmania, Sydney, NSW, Australia.
| | - Rachel Kornhaber
- College of Health and Medicine, University of Tasmania, Sydney, NSW, Australia; National Burns Center, Sheba Medical Center, Tel Hashomer, Israel
| | | | - Sancia West
- College of Health and Medicine, University of Tasmania, Sydney, NSW, Australia
| | - Denis Visentin
- College of Health and Medicine, University of Tasmania, Sydney, NSW, Australia
| |
Collapse
|
11
|
Holt R, Kornhaber R, Kwiet J, Rogers V, Shaw J, Law J, Proctor MT, Vandervord J, Streimer J, Visentin D, Cleary M, McLean L. Insecure adult attachment style is associated with elevated psychological symptoms in early adjustment to severe burn: A cross-sectional study. Burns 2019; 45:1359-1366. [PMID: 31160134 DOI: 10.1016/j.burns.2019.03.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 02/06/2019] [Accepted: 03/03/2019] [Indexed: 12/28/2022]
Abstract
Research into recovery and adjustment after burn injury has indicated a link between psychopathological symptoms including traumatic stress, distress, depression and anxiety, and worse psychosocial and physical outcomes. The severity of psychological symptoms does not always correlate with that of the burn injury, and symptoms can be ongoing in certain patients for extensive periods, leading to a need for early screening in burns patients for psychological vulnerabilities. One potential factor influencing recovery from the psychological impact of burn injury is adult attachment style, specifically secure and insecure attachment, as this describes how an individual organizes their stress regulation. This cross-sectional study measured: (a) attachment style (via the Relationship Questionnaire [RQ]): (b) negative psychological symptoms (via the Depression Anxiety and Stress Scale [DASS]); and, (c) post-traumatic symptoms (via the Davidson Trauma Scale [DTS]) in a cohort of burns patients (n = 104, 51 analysed) in a severe burns unit in Australia during the acute phase of their recovery. Secure attachment style was inversely related to psychopathological symptoms. Secure participants scored significantly lower scores on the DASS (M = 17.63, SD = 17.07) compared to self-rated insecure participants [(M = 42.38, SD = 34.69), p < .01] and on the DTS (M = 14.22, SD = 15.42) compared to insecure participants [(M = 40.54, SD = 35.72), p < .01]. Similar results were found in analyses controlling for covariates of gender, age and burn severity as potential confounders. This research suggests attachment style may play an important role in psychosocial recovery from severe burn injury.
Collapse
Affiliation(s)
- Rachael Holt
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Rachel Kornhaber
- College of Health and Medicine, University of Tasmania, Sydney Campus, Australia; National Burns Center, Sheba Medical Center, Israel
| | - Julia Kwiet
- Severe Burns Injury Unit (SBIU), Royal North Shore Hospital, St Leonards, Sydney, Australia; Social Work, Royal North Shore Hospital, St Leonards, Sydney, Australia
| | - Vanessa Rogers
- Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Australia; Consultation-Liaison Psychiatry, Royal North Shore Hospital, St Leonards, Sydney, Australia
| | - Joanne Shaw
- School of Psychology, Faculty of Science, The University of Sydney, Australia
| | - Jeremy Law
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Australia
| | | | - John Vandervord
- Severe Burns Injury Unit (SBIU), Royal North Shore Hospital, St Leonards, Sydney, Australia
| | - Jeffrey Streimer
- Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Australia; Consultation-Liaison Psychiatry, Royal North Shore Hospital, St Leonards, Sydney, Australia
| | - Denis Visentin
- College of Health and Medicine, University of Tasmania, Sydney Campus, Australia
| | - Michelle Cleary
- College of Health and Medicine, University of Tasmania, Sydney Campus, Australia
| | - Loyola McLean
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Australia; Consultation-Liaison Psychiatry, Royal North Shore Hospital, St Leonards, Sydney, Australia; Westmead Psychotherapy Program for Complex Traumatic Disorders, Western Sydney Local Health District, Parramatta, Australia.
| |
Collapse
|
12
|
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.
Collapse
|
13
|
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: 73] [Impact Index Per Article: 12.2] [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.
Collapse
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
| |
Collapse
|
14
|
McLean L, Chen R, Kwiet J, Streimer J, Vandervord J, Kornhaber R. A clinical update on posttraumatic stress disorder in burn injury survivors. Australas Psychiatry 2017; 25:348-350. [PMID: 28372459 DOI: 10.1177/1039856217700285] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Burn injuries are complex traumatic events carrying high risks of acute physical and psychosocial morbidity. With greater survival, clinical and research attention has turned to psychosocial recovery outcomes and risk factors. It is timely to summarise current issues in posttraumatic disorders after burn injury for mental health and integrative care clinicians. Posttraumatic stress disorder (PTSD) is a common outcome of severe burn injury. There are difficulties in delivering current best practice treatments to many survivors especially those in rural and remote areas and those with comorbidities. Vicarious traumatization of clinicians, families and carers requires attention and internationally there are moves to psychosocial screening and outcome tracking. CONCLUSIONS The role of the multidisciplinary treatment, integrated and trauma-informed care is essential. While level 1 evidence for PTSD treatments theoretically applies, adaptations that consider comorbidities and treatment contexts are often essential with further research required.
Collapse
Affiliation(s)
- Loyola McLean
- Senior Staff Psychiatrist, Westmead Psychotherapy Program, WSLHD, Parramatta, NSW, and; A/Prof Course Coordinator, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Runsen Chen
- Psychologist and Student Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Julia Kwiet
- Senior Social Worker, Severe Burn Injury Unit, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Jeffrey Streimer
- Senior Staff Specialist Psychiatrist and Director of Consultation-Liaison Psychiatry, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - John Vandervord
- Senior Surgeon, Severe Burn Injury Unit, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Rachel Kornhaber
- Lecturer in Nursing, Rozelle Campus, University of Tasmania, Hobart, TAS, Australia
| |
Collapse
|
15
|
Early assessment and identification of posttraumatic stress disorder, satisfaction with appearance and coping in patients with burns. Burns 2016; 42:1678-1685. [DOI: 10.1016/j.burns.2016.09.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 09/09/2016] [Accepted: 09/13/2016] [Indexed: 11/23/2022]
|
16
|
Abstract
Sexual function is a profound facet of the human personality. Burns due their sudden and devastating nature can have longstanding effects on intimate function by virtue of physical sequelae as well as alterations in body image and perceived desirability. A considerable number of patients encounter problems with intimate function in burns rehabilitation; nevertheless, the topic appears to be poorly addressed in specialist centers worldwide. Review of the literature suggests that a number of parameters can affect the quality of sexual life following burn injuries including age at the time of injury, location, and severity of the burn as well as coping mechanisms employed by the individual survivor. Addressing issues of intimacy relies on awareness, education, and a holistic approach on behalf of the multidisciplinary team members and, to this effect, recommendations are made on managing sexual function concerns in burns rehabilitation.
Collapse
|
17
|
Men, fire, and burns: Stories of fighting, healing, and emotions. Burns 2015; 41:1664-1673. [DOI: 10.1016/j.burns.2015.05.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 05/26/2015] [Accepted: 05/28/2015] [Indexed: 11/22/2022]
|
18
|
Ren Z, Chang WC, Zhou Q, Wang Y, Wang H, Hu D. Recovery of lost face of burn patients, perceived changes, and coping strategies in the rehabilitation stage. Burns 2015; 41:1855-1861. [DOI: 10.1016/j.burns.2015.08.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 08/22/2015] [Accepted: 08/26/2015] [Indexed: 10/22/2022]
|
19
|
Öster C, Sveen J. Is sexuality a problem? A follow-up of patients with severe burns 6 months to 7 years after injury. Burns 2015; 41:1572-8. [DOI: 10.1016/j.burns.2015.04.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Revised: 04/24/2015] [Accepted: 04/28/2015] [Indexed: 11/29/2022]
|
20
|
Attoe C, Pounds-Cornish E. Psychosocial adjustment following burns: An integrative literature review. Burns 2015; 41:1375-84. [PMID: 26359733 DOI: 10.1016/j.burns.2015.02.020] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 12/03/2014] [Accepted: 02/21/2015] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Burn care innovations have vastly reduced mortality rates and improved prognoses, fostering the need for multi-disciplinary input in holistic recovery. Consequently psychological and social considerations post-burn are included in National Burn Care Standards and have featured increasingly in burns literature. AIM To identify the key findings of the rapidly expanding literature base for psychosocial adjustment post-burn, highlighting the most important knowledge and future directions for both practice and research. METHOD MEDLINE, CINAHL, EMBASE, PsycINFO, BNI, HMIC databases were searched from January 2003 to September 2013 using search terms regarding psychosocial adjustment post-burn. After exclusions 24 papers underwent critical appraisal. RESULTS Studies were categorised by the element of adjustment that they examined; psychopathology, quality of life, return to work, interpersonal, post-traumatic growth. Strengths, weaknesses, and significant findings within each category were presented. DISCUSSION Although psychopathology and quality of life were well-researched compared to other categories, all would benefit from methodological improvements such as sample size or dropout rates. Coping strategies, premorbid psychopathology, and personality consistently featured as predictors of adjustment, although research should now move from identifying predictors, to clarifying the concept and parameters of psychosocial adjustment while developing and evaluating interventions to improve outcomes.
Collapse
Affiliation(s)
- Chris Attoe
- Burns Unit, Ward 11, Stoke Mandeville Hospital, Mandeville Road, Aylesbury, Buckinghamshire HP21 8AL, UK.
| | - Elizabeth Pounds-Cornish
- Burns Unit and National Spinal Injuries Centre, Department of Clinical Psychology, Stoke Mandeville Hospital, Mandeville Road, Aylesbury, Buckinghamshire HP21 8AL, UK.
| |
Collapse
|
21
|
Sveen J, Öster C. Alcohol Consumption After Severe Burn: A Prospective Study. PSYCHOSOMATICS 2015; 56:390-6. [DOI: 10.1016/j.psym.2014.05.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 05/14/2014] [Accepted: 05/15/2014] [Indexed: 11/27/2022]
|
22
|
Making meaning in a burn peer support group: qualitative analysis of attendee interviews. J Burn Care Res 2015; 35:416-25. [PMID: 24378781 DOI: 10.1097/bcr.0000000000000011] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
There is a paucity of literature on the personal experiences of burn support group members, the members' perceived benefits of group participation, and the meaning the survivors make of the support they receive. In order to provide effective psychosocial rehabilitation services and to meet the needs of burn survivors, it is important to understand the influence a support group has on its members as well as the personal experiences of those individuals who attend these groups. The purpose of this study was to explore the experiences of burn survivors in a burn survivor support group. Six self-identified burn survivors were interviewed by using a guided in-depth interview technique to explore their experiences in the support group. Key informant interviews and group observations served to triangulate the findings from the individual interviews. The experiences of the group members coalesced around four main themes: acceptance of self, perspective change, value of community, and reciprocity. The findings demonstrated the overall perceived positive impact the support group had on psychosocial recovery. For these members, the group aided the process of adjustment through the encouragement of adaptive coping strategies and the facilitation of community and relationships. Their experiences mirrored much of the literature on psychological growth from adversity. Burn survivors reported unique opportunities that allowed them to integrate their injury into their identity within an encouraging and safe environment. Using these accounts, the authors generated clinical suggestions that may encourage similar growth in other support group settings.
Collapse
|
23
|
Coping with burns: the role of coping self-efficacy in the recovery from traumatic stress following burn injuries. J Behav Med 2015; 38:642-51. [PMID: 25851608 PMCID: PMC4496529 DOI: 10.1007/s10865-015-9638-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 03/20/2015] [Indexed: 12/24/2022]
Abstract
We conducted a three-wave prospective study among patients with burns (N = 178) to examine the prospective influence of coping self-efficacy (CSE) perceptions on trajectories of posttraumatic stress symptoms in the first 12 months after burn injuries. Using linear growth curve modeling, we corrected for demographics, the number of surgeries during initial admittance, trait coping styles, and changing levels of health-related quality of life. CSE during initial admission was by far the strongest predictor of both initial PTSD symptoms and degree of symptom change with higher CSE levels associated with lower initial symptoms and a steeper decline of symptoms over time. Of the other variables only avoidant coping was associated with higher initial symptom levels, and only emotional expression associated with greater rate of recovery. Current findings suggest that CSE plays a pivotal role in recovery from posttraumatic stress after a burn injury, even when the role of burn-related impairments is taken into consideration. Implications of findings are discussed.
Collapse
|
24
|
Ekeblad F, Gerdin B, Öster C. Impact of personality disorders on health-related quality of life one year after burn injury. Disabil Rehabil 2014; 37:534-40. [PMID: 24963942 DOI: 10.3109/09638288.2014.933898] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Personality disorders (PDs) are associated with significant distress, disability, and cause great difficulties in life. PDs have been suggested to influence adaptation after major burns, but the potential relationship has not been fully elucidated. This study aimed to describe the prevalence of PDs in 107 patients with major burn injury, and to identify the impact of PDs on perceived patient outcome assessed as health-related quality of life (HRQoL) one year after burn. METHODS One burn-specific instrument (Burn Specific Health Scale-Brief (BSHS-B)) and two generic instruments (EuroQol Five Dimensions and Short Form 36 Health Survey) were used, and Psychiatric Axis I and II disorders were assessed one year post burn. RESULTS This study identified an above normal prevalence of PDs among individuals afflicted by burn, and participants with PD had a significantly larger lifetime burden of Axis I disorders compared to participants without PD. Participants with PDs scored significantly lower than those without PD in the BSHS-B domain Skin involvement, and the effect of having a PD was related to the subscale Treatment regimens. There was no relationship between the presence of PD and generic HRQoL. CONCLUSIONS An implication of these observations is that special rehabilitation efforts including more tailored interventions must be offered to these patients to ensure that the obstacles they perceive to caring for themselves in this respect are eliminated. IMPLICATIONS FOR REHABILITATION This study identified an above normal prevalence of PDs among individuals afflicted by burn and these individuals reported poor burn-specific health-related quality of life. The identification of difficulties with compliance and endurance regarding daily skin care may cause negative consequences for optimal rehabilitation and underscore the importance of offering more tailored interventions in rehabilitation. Inflexible behavioral patterns related to the PD diagnosis imply the need for communication strategies by the rehabilitation team, which include flexibility, creativity, and diplomacy. There is a need for further research focusing on identifying the factors that facilitate the individual's own ability to take action and have control.
Collapse
Affiliation(s)
- Frida Ekeblad
- Department of Neuroscience Psychiatry, Uppsala University , Uppsala , Sweden and
| | | | | |
Collapse
|
25
|
Coming to terms with it all: Adult burn survivors’ ‘lived experience’ of acknowledgement and acceptance during rehabilitation. Burns 2014; 40:589-97. [DOI: 10.1016/j.burns.2013.08.038] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 08/23/2013] [Accepted: 08/28/2013] [Indexed: 11/24/2022]
|
26
|
Sexuality in burn victims: an integrative literature review. Burns 2013; 40:552-61. [PMID: 24332436 DOI: 10.1016/j.burns.2013.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 10/08/2013] [Accepted: 11/12/2013] [Indexed: 01/23/2023]
Abstract
AIMS To analyze and synthesize knowledge concerning sexuality in adult burn victims through an integrative literature review. METHOD Two researchers independently searched six electronic databases (PUBMED, LILACS, ISI Web of Science, PSYCINFO, CINAHL and EMBASE) and also performed a hand search using the following descriptors, in different combinations: burn, sexuality, gender identity, sexual behavior and sexual factors, in order to identify the articles published in English, Portuguese or Spanish, in the last 20 years. A total of 1781 articles were found and 22 were selected based on the inclusion and exclusion criteria. RESULTS The findings were organized into two categories that influence sexuality: (1) studies where the main purpose was to assess sexuality in burn victims; (2) studies that indirectly assess sexuality. CONCLUSION The synthesis of the knowledge concerning sexuality in burn victims showed that sexual dysfunction can be related to the younger ages, TBSA > 20%, burns on the genitalia and on exposed areas, prolonged length of hospital stay, avoidance coping, and mental disorders. The multidisciplinary team should be prepared to integrate sexuality as an important variable in the continuing treatment of burn patients.
Collapse
|
27
|
Zhang LJ, Cao J, Feng P, Huang J, Lu J, Lu XY, Xia ZF. Influencing factors of the quality of life in Chinese burn patients: Investigation with adapted Chinese version of the BSHS-B. Burns 2013; 40:731-6. [PMID: 24280529 DOI: 10.1016/j.burns.2013.09.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 09/01/2013] [Accepted: 09/22/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The study aims to evaluate the quality of life (QOL) in burn patients in China and find out principal influencing factors, so as to provide evidence for interventions. METHODS A total of 271 burn patients in three major burn units in China were asked to fill in the adapted Chinese version (ACV) of the Burn Specific Health Scale-Brief (ACV BSHS-B) in order to seek out the principal influencing factors in combination with a self-designed demographic and disease condition questionnaire. Multivariable linear regression was used to analyse the principal influencing factors. RESULTS The findings showed that there were seven principal influencing factors for the overall ACV BSHS-B score. They were: percent total body surface area (TBSA) burned (with the standardised regression coefficient being -0.594), burn area of lower limber (0.241), itch level (-0.227), pain level (-0.220), gender (0.217), mechanical ventilation (0.216) and hand deformity (-0.141). CONCLUSION QOL decreased in burn patients to different degrees depending on the intensity of burns. With a better understanding of influencing factors of burn patients' QOL, the medical and nursing staff can take specific countermeasures to help patients gain a higher QOL.
Collapse
Affiliation(s)
- Ling-Juan Zhang
- Nursing Department, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Jie Cao
- Anesthesiology Department, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Ping Feng
- Burn Center, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Juan Huang
- Nursing Department, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Jian Lu
- Department of Medical Statistics, Second Military Medical University, Shanghai 200433, China
| | - Xiao-Ying Lu
- Nursing Department, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Zhao-Fan Xia
- Burn Center, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.
| |
Collapse
|
28
|
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.
Collapse
Affiliation(s)
- Tosan Ehanire
- Duke University School of Medicine, Durham, NC 27710, USA
| | | | | | | | | | | | | | | |
Collapse
|
29
|
Treatment of Patients With Severe Burns—Costs and Health-Related Quality of Life Outcome. J Burn Care Res 2013; 34:e318-25. [DOI: 10.1097/bcr.0b013e3182779c90] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
30
|
The effects of facial burns on health outcomes in children aged 5 to 18 years. J Trauma Acute Care Surg 2012; 73:S189-96. [DOI: 10.1097/ta.0b013e318265c7df] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
31
|
Ling-Juan Z, Jie C, Jian L, Xiao-Ying L, Ping F, Zhao-Fan X, Jian-Ling H, Juan H, Feng Z, Tao L. Development of quality of life scale in Chinese burn patients: cross-cultural adaptation process of burn-specific health scale - brief. Burns 2012; 38:1216-23. [PMID: 22703730 DOI: 10.1016/j.burns.2012.03.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Revised: 03/18/2012] [Accepted: 03/26/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE This study was designed to develop and test a Chinese burn patient-specific quality of life (QOL) scale based on the burn-specific health scale - brief (BSHS - B) to provide an effective assessment tool to measure quality of life in Chinese burn patients. METHOD Delphi method was used after the translation, back translation and pre-commissioning tests of BSHS - B, to amend the description of the items for cultural adaptation. The adapted Chinese version (ACV) of the BSHS - B was tested for internal consistency and validity of construct on a group of 271 burn patients from three major burn units in China. RESULTS Thirty-eight items within six domains of ACV BSHS-B were developed with scoring '0-4' in each item. The mean total score for our study group was 98.36 (standard deviation (S.D.)=37.86), ranging from 13 to 150. The total Cronbach's alpha value was 0.97 and total split-half reliability was 0.98, demonstrating that the internal consistency of the ACV was very high. Pearson correlations among the six domains of ACV BSHS - B were statistically significant. Exploratory factor analysis results showed that the six-factor function explained 78.30% of total variance; each entry in the corresponding domain had a factor-loading value higher than 0.4, indicating that the scale has a good validity. CONCLUSION The ACV of the BSHS - B showed good reliability and validity, and can be used as a tool for assessing the QOL in Chinese burn patients.
Collapse
Affiliation(s)
- Zhang Ling-Juan
- Nursing Department, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China
| | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Low AJF, Dyster-Aas J, Willebrand M, Ekselius L, Gerdin B. Psychiatric morbidity predicts perceived burn-specific health 1 year after a burn. Gen Hosp Psychiatry 2012; 34:146-52. [PMID: 22266132 DOI: 10.1016/j.genhosppsych.2011.12.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Revised: 12/08/2011] [Accepted: 12/12/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Individual factors such as gender, age, coping and personality traits and injury-related factors such as injury severity have been implicated as risk factors for poor perceived health after burns. As psychiatric morbidity is common in individuals who sustain burns, the aim of this study was to examine the effect of preinjury psychiatric problems on perceived health after injury. METHOD A total of 85 consecutive patients treated at a national burn center were prospectively assessed: the patients were interviewed during acute care with the Structured Clinical Interview for DSM-IV Axis I Disorders. One year after injury, perceived health was assessed with the Burn-Specific Health Scale-Brief (BSHS-B). Multiple regression analyses were used to evaluate the predictive effect of preinjury psychiatric history on perceived postinjury health. RESULTS Psychiatric morbidity, especially mood disorders, affected outcome for six of the nine BSHS-B subscales, with the covariates mainly being the length of hospital stay and total burn size. CONCLUSION The results show that a history of preinjury psychiatric disorders, especially during the year before the burn, affects perceived outcome regarding both physical and psychological aspects of health 1 year after injury and that it is a risk factor for worse perceived outcome.
Collapse
Affiliation(s)
- Aili J F Low
- Department of Surgical Sciences, Plastic and Maxillofacial Surgery, Burn Center, Uppsala University Hospital, 75185 Uppsala, Sweden.
| | | | | | | | | |
Collapse
|
33
|
|
34
|
Öster C, Ekselius L. Return to work after burn—A prospective study. Burns 2011; 37:1117-24. [DOI: 10.1016/j.burns.2011.05.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Revised: 05/27/2011] [Accepted: 05/31/2011] [Indexed: 10/18/2022]
|
35
|
Burn Specific Health up to 24 months after the Burn-A prospective validation of the simplified model of the Burn Specific Health Scale-Brief. ACTA ACUST UNITED AC 2011; 71:78-84. [PMID: 20805761 DOI: 10.1097/ta.0b013e3181e97780] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Outcome after burn injury is a multidimensional concept, but few multidimensional, injury-specific outcome measures have been psychometrically evaluated. A recent cross-sectional study using the Burn Specific Health Scale-Brief (BSHS-B) found three psychometrically sound health domains: function, skin involvement, and affect and relations. The aim of this study was to reexamine the psychometric properties of the BSHS-B using a prospective study design. METHODS Ninety-four consecutive adult patients with burns were included and asked to fill in questionnaires, the BSHS-B, the Hospital Anxiety and Depression Scale, and the short-form 36 (SF-36), at 6 months, 12 months, and 24 months postburn. RESULTS The factor structure was replicated and the three domains, function, skin involvement, and affect and relations, had excellent internal consistency. Over time the scores of function and skin involvement increased, indicating health improvement, whereas the domain affect and relations did not change over time. At 6 months and 12 months postburn, all domains were associated with burn severity. The function domain was highly associated with the SF-36 subscales physical functioning and role-physical, the affect and relations domain was highly associated with the Hospital Anxiety and Depression Scale and the SF-36 subscales denoting psychological health, and the domain skin involvement was highly associated with subscales indicating role-concerns, social functioning, vitality, and mental health. CONCLUSION The psychometric properties of the BSHS-B domains were excellent and they had intelligible concurrent associations with other measures. Thus, the simplified model of the BSHS-B is a reliable, valid, and useful tool in describing postburn health over time.
Collapse
|
36
|
Using the Burn Specific Health Scale-Brief as a measure of quality of life after a burn—What score should clinicians expect? Burns 2011; 37:54-60. [DOI: 10.1016/j.burns.2010.07.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2010] [Revised: 07/14/2010] [Accepted: 07/19/2010] [Indexed: 11/18/2022]
|
37
|
Functional and Psychosocial Outcomes of Older Adults After Burn Injury: Results From a Multicenter Database of Severe Burn Injury. J Burn Care Res 2011; 32:66-78. [DOI: 10.1097/bcr.0b013e318203336a] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
38
|
Yoder LH, Nayback AM, Gaylord K. The evolution and utility of the burn specific health scale: A systematic review. Burns 2010; 36:1143-56. [DOI: 10.1016/j.burns.2010.01.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2009] [Revised: 11/04/2009] [Accepted: 01/14/2010] [Indexed: 12/22/2022]
|
39
|
Ying WL, Pertrini MA, Xin LL. Gender differences in the quality of life and coping patterns after discharge in patients recovering from burns in China. J Res Nurs 2010. [DOI: 10.1177/1744987110379301] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to investigate gender differences in quality of life and coping patterns after discharge for patients with burns in China. Cross-sectional survey research design and purposive sampling were used in this study, for which 92 subjects, including 56 males and 36 females, were recruited from a medical centre in central China. Quality of life was measured by the burn-specific health scale-brief (BSHS-B) and coping patterns were measured with the coping with burns questionnaire (CBQ), while demographic data was collected using a demographic questionnaire. An independent t-test and bivariate correlate were employed to analyse the data. The study results showed significant differences in quality of life between genders and coping patterns. There was a statistically significant gender difference in the sub-domain of the BSHS-B score for affect and relations, p < 0.05, and for coping patterns: emotion support, p < 0.05. The findings indicated that optimism/problem solving, revolution/adjustment and avoidance were the most commonly used coping patterns for males and females. The rank orders were same. The study indicated that women are more sensitive to relationships with family after discharge and tend to exhibit depressive symptoms. For women, emotional support is more important than it is for men. A number of significant positive and negative correlations were found among the variables.
Collapse
Affiliation(s)
- Wang Lin Ying
- Teacher, ShaoXin University, China
- Doctor, The First Teaching Hospital of Jiang Xi Medical College, China
| | - Marcia A. Pertrini
- Professor, Wuhan University, China
- Doctor, The First Teaching Hospital of Jiang Xi Medical College, China
| | - Liao Li Xin
- Doctor, The First Teaching Hospital of Jiang Xi Medical College, China
| |
Collapse
|
40
|
Hedlund M, Ronne-Engström E, Carlsson M, Ekselius L. Coping strategies, health-related quality of life and psychiatric history in patients with aneurysmal subarachnoid haemorrhage. Acta Neurochir (Wien) 2010; 152:1375-82; discussion 1382. [PMID: 20440628 PMCID: PMC2901493 DOI: 10.1007/s00701-010-0673-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2009] [Accepted: 04/20/2010] [Indexed: 11/26/2022]
Abstract
Purpose Subarachnoid haemorrhage (SAH) reduces health-related quality of life (HRQoL) and increases the risk of psychiatric sequels such as depression and posttraumatic stress disorder. Especially those with a psychiatric history and those using maladaptive coping strategies are at risk for such sequels. The extent to which HRQoL after SAH was related to a history of psychiatric morbidity and to the use of various coping strategies was assessed. Methods Patients admitted to the Uppsala University Hospital with aneurysmal SAH (n = 59) were investigated prospectively. Seven months after SAH, data were collected using the Structured Clinical Interview for DSM-IV axis I disorders, the Short Form-36 (SF-36) Health Survey and the Jalowiec Coping Scale. Results Patients with SAH had lower HRQoL than the general Swedish population in all eight domains of the SF-36. The lower HRQoL was almost entirely in the subgroup with a psychiatric history. HRQoL was also strongly correlated to the use of coping. Physical domains of SF-36 were less affected than mental domains. Those with a psychiatric history used more coping than the remainder with respect to all emotional coping scales. Coping and the presence of a psychiatric history were more strongly related to mental than to physical components of HRQoL. Conclusions A psychiatric history and the use of maladaptive emotional coping were related to worse HRQoL, more to mental than to physical aspects.
Collapse
|
41
|
|
42
|
The impact of personality and coping on the development of depressive symptoms in adult burns survivors. Burns 2010; 36:29-37. [DOI: 10.1016/j.burns.2009.06.202] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2008] [Revised: 06/02/2009] [Accepted: 06/24/2009] [Indexed: 11/19/2022]
|
43
|
|
44
|
|
45
|
Öster C, Willebrand M, Dyster-Aas J, Kildal M, Ekselius L. Validation of the EQ-5D questionnaire in burn injured adults. Burns 2009; 35:723-32. [DOI: 10.1016/j.burns.2008.11.007] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2008] [Accepted: 11/17/2008] [Indexed: 11/24/2022]
|
46
|
Validation of a Turkish Version of the Burn-Specific Health Scale. J Burn Care Res 2009; 30:288-91; discussion 292-3. [DOI: 10.1097/bcr.0b013e318198a295] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
47
|
Moi AL, Gjengedal E. Life after burn injury: striving for regained freedom. QUALITATIVE HEALTH RESEARCH 2008; 18:1621-1630. [PMID: 18955463 DOI: 10.1177/1049732308326652] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Focusing beyond survival, the priority of modern burn care is optimal quality of life. Our aim with this study, which was informed by phenomenology, was to describe and identify invariant meanings in the experience of life after major burn injury. Fourteen adults having sustained a major burn were interviewed, on average, 14 months postinjury, and asked about their experience of important aspects of life. The accident meant facing an extreme situation that demanded vigilance, appropriate action, and the need for assistance. The aftermath of the burn injury and treatment included having to put significant effort into creating coherence in their disrupted personal life stories. Continuing life meant accepting the unchangeable, including going through recurrent processes of enduring, grief, fatalism, comparisons with others, and new feelings of gratefulness. Furthermore, a continuous struggle to change what was changeable, to achieve personal goals, independence, relationships with others, and a meaningful life, were all efforts to regain freedom, aiming for a life as it was before--and sometimes even better.
Collapse
Affiliation(s)
- Asgjerd Litleré Moi
- Department of Public Health and Primary Health Care, University of Bergen and Haukeland University Hospital, Bergen, Norway
| | | |
Collapse
|
48
|
A Simplified Domain Structure of the Burn-Specific Health Scale-Brief (BSHS-B): A Tool to Improve Its Value in Routine Clinical Work. ACTA ACUST UNITED AC 2008; 64:1581-6. [DOI: 10.1097/ta.0b013e31803420d8] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
49
|
Moi AL, Wentzel-Larsen T, Salemark L, Hanestad BR. Long-term risk factors for impaired burn-specific health and unemployment in patients with thermal injury. Burns 2006; 33:37-45. [PMID: 17079085 DOI: 10.1016/j.burns.2006.06.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2005] [Accepted: 06/01/2006] [Indexed: 11/29/2022]
Abstract
The success of acute burn therapy has led to an increased demand for high-quality rehabilitation. When optimizing burn care programs, knowledge of long-term risk factors associated with impaired health and unemployment of the patient may be significant. The health and work status of 95 patients (82.1% males; mean age 43.7 (S.D.: 14.5) years; mean total body surface burn 18.5 (S.D.: 14.2) % were assessed 47.0 (S.D.: 23.8) months after injury, using the Norwegian version of the abbreviated burn-specific health scale (BSHS-N) and a questionnaire asking for socio-demographic and medical characteristics. A regression model demonstrated that the BSHS-N total score was significantly reduced by chronic pain (P<0.001), psychological illness (P<0.001), and living alone (P=0.030), as well as full-thickness facial (P=0.011) and foot (P=0.013) burns. Unemployment was significantly associated with housing and economic problems (P=0.001), chronic pain (P=0.001), the extent of full-thickness injury (P=0.005), the presence of deformities (P=0.037), the number of operations (P=0.001) and the length of hospital stay (P=0.016). Thus, socio-demographic factors, non-burn-related morbidity and the injury itself significantly impaired long-term physical and psychosocial health and work status.
Collapse
Affiliation(s)
- Asgjerd Litleré Moi
- Section of Nursing Science, Department of Public Health and Primary Health Care, University of Bergen, Kalfarveien 31, N-5018 Bergen, Norway.
| | | | | | | |
Collapse
|
50
|
Willebrand M, Andersson G, Kildal M, Gerdin B, Ekselius L. Injury-related fear-avoidance, neuroticism and burn-specific health. Burns 2006; 32:408-15. [PMID: 16621317 DOI: 10.1016/j.burns.2005.11.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2004] [Indexed: 11/20/2022]
Abstract
Dysfunctional beliefs such as fear-avoidance (i.e. fear of re-injury) and personality traits such as neuroticism are risk factors for poor health. However, there is little information regarding associations with poor perceived health after severe burn and what level of fear-avoidance is associated with poor health. In this study, we investigated fear-avoidance and neuroticism regarding their associations with post-burn health. Participants were 86 recovered burn patients and data were collected by a postal survey. Post-burn health was assessed with the nine subscales of the Burn Specific Health Scale-Brief (BSHS-B). In logistic regressions, fear-avoidance was related to poorer health in six subscales assessing both physical and psychosocial problems. Neuroticism was associated with poorer health in three subscales assessing mainly psychosocial problems. Chi-square analyses showed that participants with a moderate or high level of fear-avoidance >or=1.0 (out of 4) were more likely to describe their health as poor and had a longer sick leave than those with a fear-avoidance level of <1.0. In summary, fear-avoidance was associated with poorer health even at moderate levels and was associated with several aspects of post-burn health.
Collapse
Affiliation(s)
- M Willebrand
- Department of Neuroscience, Psychiatry, Uppsala University Hospital, SE-751 85 Uppsala, Sweden.
| | | | | | | | | |
Collapse
|