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Zhang Y, Su J, Liu Y, Sun R, Sun R. Epidemiological and clinical characteristics of burns in adults: a 6-year retrospective study in a major burn center in Suzhou, China. Front Public Health 2024; 12:1413986. [PMID: 38989128 PMCID: PMC11233725 DOI: 10.3389/fpubh.2024.1413986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 06/10/2024] [Indexed: 07/12/2024] Open
Abstract
Background Burns are a prevalent form of unintentional injury and a significant public health concern in developing countries. We aimed to investigate the epidemiological and clinical characteristics of adult burn patients at a major center in Eastern China. Methods This 6-year retrospective study analyzed patients with varying degrees of burns between January 2017 and December 2022 at the Suzhou Burns and Trauma Center. The study extracted demographic, clinical, and epidemiological data from electronic medical records for analysis. Results The study included 3,258 adult patients, of which 64.3% were male. The largest age group affected 30-59-year-old adults (63.04%). Scalds were the leading cause of burns (1,346, 41.31%), followed by flames (1,271, 39.01%). The majority of burn hospitalizations were those with moderate burns (1791, 54.97%). The morbidity rate was low at 0.68%, while mortality was strongly associated with age, etiology, and total body surface area. Patients with certain types of burns, such as explosions, hot crush injuries, and electric burns had more operations, longer lengths of hospital stay, and higher costs compared to those with scalds and flame injuries. Conclusion Different prevention strategies should be formulated according to different etiologies, ages, and genders.
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Affiliation(s)
- Yong Zhang
- Department of Burns and Plastic Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
| | - Jiandong Su
- Department of Burns and Plastic Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
| | - Yunfeng Liu
- Department of Burns and Plastic Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
| | - Ran Sun
- Department of Burns and Plastic Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
| | - Ruizhu Sun
- Department of Ophthalmology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
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2
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Yang L, Yuan B, Ju Y, Liu W, Wang Y. Effect of quality nursing care on wound pain and anxiety in burn patients: A meta-analysis. Int Wound J 2024; 21:e14798. [PMID: 38572761 PMCID: PMC10993347 DOI: 10.1111/iwj.14798] [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: 01/26/2024] [Accepted: 02/04/2024] [Indexed: 04/05/2024] Open
Abstract
To systematically evaluate the effects of quality nursing care on wound pain and anxiety in burn patients. Computerised searches of PubMed, Google Scholar, Cochrane Library, Embase, Wanfang, China Biomedical Literature Database and China National Knowledge Infrastructure databases randomised controlled trials (RCTs) on the application of quality nursing care to burn patients were carried out from database inception to October 2023. Literature was screened and evaluated by two researchers based on inclusion and exclusion criteria, and data were extracted from the final included literature. Stata 17.0 software was employed for data analysis. Overall, 15 RCTs and 1115 burn patients were included, including 563 and 552 in the quality care and routine care groups. It was found that, compared with routine care, burn patients who implemented quality care had significantly less wound pain (SMD: -1.79, 95% CI: -2.22 to -1.36, p < 0.001), anxiety (SMD: -2.71. 95% CI: -3.49 to -1.92, p < 0.001) and depression (SMD: -1.74, 95% CI: -2.35 to -1.14, p < 0.001) levels were significantly reduced post-trauma.
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Affiliation(s)
- Ling Yang
- Department of BurnThe Southwest Hospital of Army Medical UniversityChongqingChina
| | - Bo‐Qin Yuan
- Department of BurnThe Southwest Hospital of Army Medical UniversityChongqingChina
| | - Yang‐Yang Ju
- Department of BurnThe Southwest Hospital of Army Medical UniversityChongqingChina
| | - Wei Liu
- Department of BurnThe Southwest Hospital of Army Medical UniversityChongqingChina
| | - Yang‐Ping Wang
- Department of BurnThe Southwest Hospital of Army Medical UniversityChongqingChina
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3
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Abouzeid CA, Santos E, Chacon KL, Ni P, Kelter BM, Gibran NS, Kowalske KJ, Kazis LE, Ryan CM, Schneider JC. Examining the impact of the COVID-19 pandemic on participants in a study of burn outcomes. Burns 2023; 49:1232-1235. [PMID: 37193614 PMCID: PMC10081876 DOI: 10.1016/j.burns.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 04/04/2023] [Indexed: 05/18/2023]
Affiliation(s)
- C A Abouzeid
- Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, 300 1st Avenue, Charlestown, MA 02129, USA
| | - E Santos
- Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, 300 1st Avenue, Charlestown, MA 02129, USA
| | - K L Chacon
- Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, 300 1st Avenue, Charlestown, MA 02129, USA
| | - P Ni
- Department of Health Law, Policy, and Management, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
| | - B M Kelter
- Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, 300 1st Avenue, Charlestown, MA 02129, USA
| | - N S Gibran
- Department of Surgery, The University of Washington, 1959 NE Pacific St, Seattle, WA 98195, USA
| | - K J Kowalske
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - L E Kazis
- Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, 300 1st Avenue, Charlestown, MA 02129, USA; Department of Health Law, Policy, and Management, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA; Rehabilitation Outcomes Center at Spaulding, Spaulding Rehabilitation, 300 1st Avenue, Charlestown, MA, 02129, USA
| | - C M Ryan
- Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA; Department of Surgery, Shriners Children's, 51 Blossom Street, Boston, MA 02114, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - J C Schneider
- Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, 300 1st Avenue, Charlestown, MA 02129, USA; Rehabilitation Outcomes Center at Spaulding, Spaulding Rehabilitation, 300 1st Avenue, Charlestown, MA, 02129, USA; Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
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4
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Are burns a chronic condition? Examining patient reported outcomes up to 20 years after burn injury-A Burn Model System National Database investigation. J Trauma Acute Care Surg 2022; 92:1066-1074. [PMID: 35081598 PMCID: PMC9133040 DOI: 10.1097/ta.0000000000003547] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND People living with burn injury often face long-term physical and psychological sequelae associated with their injuries. Few studies have examined the impacts of burn injuries on long-term health and function, life satisfaction, and community integration beyond 5 years postinjury. The purpose of this study was to examine these outcomes up to 20 years after burn injury. METHODS Data from the Burn Model System National Longitudinal Database (1993-2020) were analyzed. Patient-reported outcome measures were collected at discharge (preinjury status recall) and 5 years, 10 years, 15 years, and 20 years after injury. Outcomes examined were the SF-12/VR-12 Physical Component Summary and Mental Component Summary, Satisfaction with Life Scale, and Community Integration Questionnaire. Trajectories were developed using linear mixed models with repeated measures of outcome scores over time, controlling for demographic and clinical variables. RESULTS The study population included 421 adult burn survivors with a mean age of 42.4 years. Lower Physical Component Summary scores (worse health) were associated with longer length of hospital stay, older age at injury and greater time since injury. Similarly, lower Mental Component Summary scores were associated with longer length of hospital stay, female sex, and greater time since injury. Satisfaction with Life Scale scores decrease negatively over time. Lower Community Integration Questionnaire scores were associated with burn size and Hispanic/Latino ethnicity. CONCLUSION Burn survivors' physical and mental health and satisfaction with life worsened over time up to 20 years after injury. Results strongly suggest that future studies should focus on long-term follow-up where clinical interventions may be necessary. LEVEL OF EVIDENCE Prognostic and Epidemiologic; Level III.
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5
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Stockly OR, Wolfe AE, Goldstein R, Roaten K, Wiechman S, Trinh NH, Goverman J, Stoddard FJ, Zafonte R, Ryan CM, Schneider JC. Predicting Depression and Post-Traumatic Stress Symptoms Following Burn Injury: A Risk Scoring System. J Burn Care Res 2021; 43:899-905. [PMID: 34751379 DOI: 10.1093/jbcr/irab215] [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: 11/13/2022]
Abstract
Depression and post-traumatic stress are common psychiatric comorbidities following burn injury. The purpose of this study was to develop an admission scoring system that assesses the risk of development of depression or post-traumatic symptoms in the burn population. This study is a retrospective review of the prospectively collected Burn Model System National Database. Adult burn survivors enrolled from 2014-2018 (n=486) were included. The primary outcome was the presence of depression or post-traumatic stress symptoms at 6, 12, or 24 months post-injury. Logistic regression analysis was used to identify demographic and clinical predictors of depression and post-traumatic stress symptoms. A risk scoring system was then created based on assigning point values to relevant predictor factors. The study population had a mean age of 46.5±15.8 years, mean burn size of 18.3±19.7%, and was 68.3% male. Prior to injury, 71.3% of the population was working, 47.9% were married, and 50.8% had completed more than a high school education. An 8-point risk scoring system was developed using the following predictors of depression or post-traumatic stress symptom development: gender, psychiatric treatment in the past year, graft size, head/neck graft, etiology of injury, and education level. This study is the first to develop a depression and post-traumatic stress symptom risk scoring system for burn injury. This scoring system will aid in identifying burn survivors at high risk of long-term psychiatric symptoms that may be used to improve screening, monitoring, timely diagnosis and interventions.
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Affiliation(s)
- Olivia R Stockly
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA
| | - Audrey E Wolfe
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA
| | - Richard Goldstein
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA
| | - Kimberly Roaten
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX
| | - Shelley Wiechman
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| | - Nhi-Ha Trinh
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Jeremy Goverman
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Frederick J Stoddard
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA.,Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, MA
| | - Ross Zafonte
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA.,Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | - Colleen M Ryan
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA.,Harvard Medical School, Boston, MA.,Shriners Hospitals for Children-Boston, Boston, MA
| | - Jeffrey C Schneider
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA.,Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, MA.,Harvard Medical School, Boston, MA
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6
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Kilpatrick E, Fletchall S, Hickerson W. Evaluation of effectiveness of a social reintegration program following a burn injury. BURNS OPEN 2021. [DOI: 10.1016/j.burnso.2021.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Zuo KJ, Umraw N, Cartotto R. Scar Quality of Skin Graft Borders: A Prospective, Randomized, Double-Blinded Evaluation. J Burn Care Res 2020; 40:529-534. [PMID: 31181140 DOI: 10.1093/jbcr/irz087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Prominent scars may remain around the border of a mature skin graft (SG) at the interface of the SG with normal skin. The border of a SG may be constructed by either exactly approximating (A) or slightly overlapping (O) the edge of the SG on the wound margin. The purpose of this study was to evaluate whether A or O affects the quality of the border scar of SGs applied to burn patients. This prospective study was a within-border design in which adult burn patients requiring SGs served as their own control. Half of each study border was fashioned using O and the immediately adjacent other half was made using A. We randomly assigned O or A to the proximal or distal halves of vertical borders and the medial and lateral halves of horizontal borders. Both halves of the study border were identically fixated with staples or sutures and were managed in the same fashion postoperatively. Blinded evaluations at 3, 6, and 12 months of O and A borders were performed using the Vancouver Scar Scale (VSS), the observer component of the Patient and Observer Scar Assessment Scale (POSAS), and a global binary assessment of which half of the study border "looked better." Blinded patients also rated each half of the study border with a 10-point Likert scale. Values are reported as the mean ± SD or median (interquartile range), as appropriate. There were 34 borders studied in 15 subjects (46.7% female, age 29 [22,57], % TBSA burn 9.7 ± 5.3, and no inhalation injuries). Study borders were constructed at 7 (5,11) days postburn, had a total length of 12 (9.3,14.5) cm, and all involved split thickness SGs of thickness 13 (12,14)/1000th of an inch. Sheet grafts were applied in 27% and meshed grafts in 73%. SGs were applied immediately after excision in 75% or after allografting in 25%. Border scars matured between 3 and 12 months with reductions in total VSS from 8 (7,8) to 4 (3,6) for O borders (P < .001) and from 8 (7,9) to 4 (1,6) for A borders (P < .001). However, there were no significant differences between O and A borders in total VSS at 3 months (P = .165), 6 months (P = .602), and 12 months (P = .358) or in total OSAS at 3 months (P = .681), 6 months (P = .890), or 12 months (P = .601). At 12 months, 60% of O borders and 40% of A borders were globally rated as "better" (P = .258). There were no significant differences in the patients' subjective ratings of the O and A borders at 3 months (P = .920), 6 months (P = .960), and 12 months (P = .66). The scar quality at the border of a skin graft does not appear to be affected by the surgical technique used to construct the border at the time of grafting.
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Affiliation(s)
- Kevin J Zuo
- Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Ontario, Canada
| | - Nisha Umraw
- Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Robert Cartotto
- Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Ontario, Canada
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8
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Shi JJ, Sun Y, Pan SS, Xu TT, Hua JJ. Manufacture and clinical application of the forearm pronation's assistant tableware in the severely burned. Burns 2020; 47:684-691. [PMID: 32917474 DOI: 10.1016/j.burns.2020.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 08/04/2020] [Accepted: 08/17/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Even after reconstructive surgery, it is still difficult for patients with severe burns to achieve independent eating activity. In this project, we customized the forearm pronation's assistant tableware to assist in improvement with eating activities. METHODS From January 2017 to December 2018, 28 patients with severe burns including the hands were recruited. For the patient's independent eating activities, we customized forearm pronation's tableware (forks and spoons). We compared modified Barthel index (MBI) and Visual analogue scale (VAS) of satisfaction under three conditions: no auxiliary tableware, ADL universal cuff, or forearm pronation tableware; to compare the duration and the weight of food spilled during lunch when the patients wore the ADL universal cuff or the forearm pronation's tableware. Differences in MBI (rank data) were tested by the Friedman test, differences in VAS (normal distribution) were tested with One-way ANOVA (Bonferroni), differences in the duration and the weight (normal distribution data) were tested by paired sample t test. RESULTS After wearing the forearm pronation's assistant tableware, MBI VAS both increased more than when the patients did not wear the auxiliary tableware (all p<0.05). When the subjects wore forearm pronation tableware, the duration of lunch significantly decreased and the quality of eating activity significantly improved compared to the ADL universal cuff in eating activity (all p<0.05). CONCLUSION After wearing the forearm pronation's assistant tableware, the patients with severe burns completely or almost completely accomplished independent eating, the duration was decreased, and during eating activity the quality and the satisfaction were improved. CLINICAL TRIAL REGISTRATION Chinese Clinical trial registry, ChiCTR1800019963.
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Affiliation(s)
- Jia-Jia Shi
- Department of Physical Medicine and Rehabilitation Medicine, Kunshan Rehabilitation Hospital, Suzhou, Jiangsu, PR China
| | - Ying Sun
- Department of Physical Medicine and Rehabilitation Medicine, Kunshan Rehabilitation Hospital, Suzhou, Jiangsu, PR China
| | - Shan-Shan Pan
- Department of Burn Medicine, Kunshan Rehabilitation Hospital, Suzhou, Jiangsu, PR China
| | - Ting-Ting Xu
- Research Laboratory, Kunshan Rehabilitation Hospital, Suzhou, Jiangsu, PR China
| | - Jia-Jia Hua
- Department of Rehabilitation Medicine, The Sixth People's Hospital of Nantong, Nantong, Jiangsu, PR China.
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9
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O'Brien KH, Lushin V. Examining the Impact of Psychological Factors on Hospital Length of Stay for Burn Survivors: A Systematic Review. J Burn Care Res 2020; 40:12-20. [PMID: 30020458 DOI: 10.1093/jbcr/iry040] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Recovery of burn patients may be impeded by mental health problems. By gaining a better understanding of the impact that psychological factors may have on hospital length of stay, providers may be better informed to address the complex needs of burn survivors through effective and efficient practices. This systematic review summarizes existing data on the adverse psychological factors for the length of burn patients' hospitalization, and assesses the methodological quality of the extant literature on mental health conditions of burn survivors. A literature search was conducted in four electronic databases: PubMed, PsychINFO, Science Direct, and the Cumulative Index to Nursing and Allied Health Literature. Results yielded reports published between 1980 and 2016. Methodological quality was assessed by using an 11-item methodological quality score system. Seventy-four studies were identified by search; 19 articles were eligible for analysis. Findings demonstrate paucity of evidence in the area. Reports indicate longer hospital stay among burn patients with mental health problems. Substance use was the most consistent mental-health predictor of longer hospital stay. Heterogeneity in data on mental health conditions rendered impossible estimation of effect sizes of individual psychological factors on length of hospitalization. Many studies over-relied on retrospective designs, and crude indicators of psychological factors. Findings indicate that mental health problems do have an impact on the trajectory of burn recovery by increasing the length of hospital stay for burn survivors. Inpatient mental health services for burn patients are critically needed. Prospective designs, and more sensitive psychological indicators are needed for future studies.
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Affiliation(s)
- Kyle H O'Brien
- Department of Social Work, Southern Connecticut State University, School of Health and Human Services, New Haven
| | - Victor Lushin
- Department of Psychiatry, University of Pennsylvania School of Medicine, Center for Mental Health Policy and Services Research, Philadelphia
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10
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Ohrtman EA, Shapiro GD, Simko LC, Dore E, Slavin MD, Saret C, Amaya F, Lomelin-Gascon J, Ni P, Acton A, Marino M, Kazis LE, Ryan CM, Schneider JC. Social Interactions and Social Activities After Burn Injury: A Life Impact Burn Recovery Evaluation (LIBRE) Study. J Burn Care Res 2020; 39:1022-1028. [PMID: 30016442 DOI: 10.1093/jbcr/iry038] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Social interactions and activities are key components of social recovery following burn injuries. The objective of this study is to determine the predictors of these areas of social recovery. This study provides a secondary analysis of a cross-sectional survey of adult burn survivors. The Life Impact Burn Recovery Evaluation-192 was administered to 601 burn survivors for the field-testing of the Life Impact Burn Recovery Evaluation Profile. Survivors aged 18 years and older with injuries ≥5% total BSA or burns to critical areas (hands, feet, face, or genitals) were eligible to participate. Multivariate linear regression analyses were used to determine predictors of the Social Activities and Social Interactions scale scores. A total of 599 people completed the Social Interactions and Social Activities scales. Of these, 77% identified as White Non-Hispanic, 55% were female, 55% were unmarried, and 80% had burns to critical areas. Participants had a mean age of 45 years, a mean time since burn injury of 15 years, and a mean burn size of 41% total BSA. Younger age (P < .01) and being married/living with a significant other (P ≤ .01) were associated with higher Social Activities and Social Interactions scale scores. Individual item responses reveal that survivors had lower scores on items related to participating in outdoor activities (30.4%) or feeling uncomfortable with their appearance (32.4% report dressing to avoid stares). Social interactions and activities are long-term challenges for burn survivors. It is important for clinicians to identify patients who may struggle with social recovery in order to focus on future community-based interventions.
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Affiliation(s)
- Emily A Ohrtman
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts
| | - Gabriel D Shapiro
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Laura C Simko
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts
| | - Emily Dore
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Mary D Slavin
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Cayla Saret
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Flor Amaya
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - J Lomelin-Gascon
- 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
| | - Amy Acton
- Phoenix Society for Burn Survivors, Grand Rapids, Michigan
| | - Molly Marino
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Lewis E Kazis
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Colleen M Ryan
- Massachusetts General Hospital, Shriners Hospitals for Children, Harvard Medical School, Boston
| | - Jeffrey C Schneider
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts
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11
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Garimella R, Koenig HG, Larson DL, Hultman CS. Of These, Faith, Hope, and Love: Assessing and Providing for the Psychosocial and Spiritual Needs of Burn Patients. Clin Plast Surg 2018; 44:893-902. [PMID: 28888314 DOI: 10.1016/j.cps.2017.05.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Burn treatment has grown increasingly advanced and technologically capable. Clinicians must take into account, however, multidimensional patient needs that factor into long-term burn recovery. Important psychosocial factors associated with burn care include psychiatric comorbidities, such as anxiety and depression, healthy family relationships, social support, and community involvement. Spiritual factors and resources, such as time spent praying and/or meditating and access to pastoral services, are also important to consider. Further study is needed to identify specific psychosocial and spiritual needs of patients and to develop interventions or therapies that specifically provide for these needs.
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Affiliation(s)
- Roja Garimella
- The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Harold G Koenig
- Center for Spirituality, Theology, and Health, Duke University Medical Center, Durham, NC, USA; Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; Ningxia Medical University, Yinchuan, People's Republic of China
| | - David L Larson
- Department of Plastic Surgery, Medical College of Wisconsin, Milwuakee, WI, USA
| | - Charles Scott Hultman
- Center for Spirituality, Theology, and Health, Duke University Medical Center, Durham, NC, USA; Division of Plastic Surgery, NC Jaycee Burn Center, University of North Carolina at Chapel Hill, Suite 7038, Burnett-Womack, Chapel Hill, NC 27599, USA.
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12
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Jang MH, Park J, Chong MK, Sok SR. Factors Influencing Resilience of Burn Patients in South Korea. J Nurs Scholarsh 2017; 49:478-486. [DOI: 10.1111/jnu.12311] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Mi Heui Jang
- Associate Professor; College of Nursing Science; Kyung Hee University; Seoul Republic of Korea
| | - Jongui Park
- Graduate; Department of Nursing; Graduate School; Kyung Hee University; Seoul Republic of Korea
| | - Mi Kyong Chong
- Doctoral student; Department of Nursing; Graduate School; Kyung Hee University; Seoul Republic of Korea
| | - Sohyune R. Sok
- Professor; College of Nursing Science; Kyung Hee University; Seoul Republic of Korea
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13
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Barnett BS, Mulenga M, Kiser MM, Charles AG. Qualitative analysis of a psychological supportive counseling group for burn survivors and families in Malawi. Burns 2017; 43:602-607. [PMID: 27743733 PMCID: PMC5380533 DOI: 10.1016/j.burns.2016.09.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 09/13/2016] [Accepted: 09/23/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVE While psychological care, including supportive group therapy, is a mainstay of burn treatment in the developed world, few reports of support groups for burn survivors and their caregivers in the developing world exist. This study records the findings of a support group in Malawi and provides a qualitative analysis of thematic content discussed by burn survivors and caregivers. MATERIALS AND METHODS We established a support group for burn survivors and caregivers from February-May 2012 in the burn unit at Kamuzu Central Hospital in Lilongwe, Malawi. Sessions were held weekly for twelve weeks and led by a Malawian counselor. The group leader compiled transcripts of each session and these transcripts were qualitatively analyzed for thematic information. RESULTS Thematic analysis demonstrated a variety of psychological issues discussed by both survivors and caregivers. Caregivers discussed themes of guilt and self-blame for their children's injuries, worries about emotional distance now created between caregiver and survivor, fears that hospital admission meant likely patient death and concerns about their child's future and burn associated stigma. Burn survivors discussed frustration with long hospitalization courses, hope created through interactions with hospital staff, the association between mental and physical health, rumination about their injuries and how this would affect their future, decreased self-value, increased focus on their own mortality and family interpersonal difficulties. CONCLUSIONS The establishment of a support group in our burn unit provided a venue for burn survivors and their families to discuss subjective experiences, as well as the dissemination of various coping techniques. Burn survivors and their caregivers in Malawi would benefit from the establishment of similar groups in the future to help address the psychological sequelae of burns.
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Affiliation(s)
- Brian S Barnett
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA; Department of Psychiatry, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Vanderbilt University School of Medicine, Nashville, TN 37232-0740, USA; Kamuzu Central Hospital, UNC Project, P-Bag 101, Lilongwe, Malawi
| | | | - Michelle M Kiser
- Department of Surgery, University of North Carolina, CB#7228, Chapel Hill, NC 27514-7228, USA
| | - Anthony G Charles
- Department of Surgery, University of North Carolina, CB#7228, Chapel Hill, NC 27514-7228, USA.
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Hudson A, Al Youha S, Samargandi OA, Paletz J. Pre-existing psychiatric disorder in the burn patient is associated with worse outcomes. Burns 2017; 43:973-982. [PMID: 28412132 DOI: 10.1016/j.burns.2017.01.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 10/24/2016] [Accepted: 01/12/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To compare patient and burn characteristics between patients who had a pre-existing psychiatric diagnosis and patients who did not in a Burn Unit at an academic hospital. BACKGROUND Psychosocial issues are common in patients recovering from a burn; however, little is known regarding hospital course and discharge outcomes in patients with a pre-existing psychiatric diagnosis presenting with a burn. Baseline medical comorbidities of burn patients have been shown to be a significant risk for in-hospital mortality. METHODS A retrospective chart review of 479 consecutive patients admitted to the Burn Unit of an academic hospital in Halifax, Nova Scotia between March 2nd 1995 and June 1st 2013 was performed. Extensive data regarding patient and burn characteristics and outcomes was collected. Patients with and without pre-existing psychiatric diagnoses at the time of hospital admission were compared. RESULTS Sixty-three (13%) patients had a psychiatric diagnosis, with the most common being depression (52%). Forty-percent (n=25/63) of these patients had multiple pre-existing psychiatric diagnoses. Patients with a psychiatric diagnosis had a greater total-body-surface-area (TBSA)% covered by a third-degree burn (p=0.001), and were more likely to have an inhalation injury (p<0.001). These patients were also significantly more likely to experience 6 of the 10 most prevalent in-hospital complications and had a higher mortality rate (p=0.02). They were less likely to be discharged home (p=0.001), and more likely to go to a home hospital (p=0.04) or rehabilitation facility (p=0.03). Psychiatric diagnosis was associated with significantly more placement issues (e.g. rehab bed unavailability, homeless) upon discharge from the Burn Unit (p=0.01). The risk of death in burn patients with pre-existing psychiatric disorders was about three times the risk of death in patients with no psychiatric disorders when adjusting for other potential confounders (95% CI, 1.13-9.10; p-value 0.03). CONCLUSION Presence of a pre-existing psychiatric disorder in the burn patient was associated with worse outcomes and was a significant predictor of death. Psychiatric diagnoses should be identified early in burn treatment and efforts should be made to ensure a comprehensive approach to inpatient support and patient discharge to reduce unfavorable burn outcomes and placement issues.
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Affiliation(s)
| | - Sarah Al Youha
- Dalhousie University, Halifax, NS, Canada; Division of Plastic and Reconstructive Surgery, Dalhousie University, NS, Canada
| | - Osama A Samargandi
- Dalhousie University, Halifax, NS, Canada; Division of Plastic and Reconstructive Surgery, Dalhousie University, NS, Canada
| | - Justin Paletz
- Dalhousie University, Halifax, NS, Canada; Division of Plastic and Reconstructive Surgery, Dalhousie University, NS, Canada
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15
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Girard D, Laverdet B, Buhé V, Trouillas M, Ghazi K, Alexaline MM, Egles C, Misery L, Coulomb B, Lataillade JJ, Berthod F, Desmoulière A. Biotechnological Management of Skin Burn Injuries: Challenges and Perspectives in Wound Healing and Sensory Recovery. TISSUE ENGINEERING PART B-REVIEWS 2017; 23:59-82. [DOI: 10.1089/ten.teb.2016.0195] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Dorothée Girard
- University of Limoges, Myelin Maintenance and Peripheral Neuropathies (EA 6309), Faculties of Medicine and Pharmacy, Limoges, France
| | - Betty Laverdet
- University of Limoges, Myelin Maintenance and Peripheral Neuropathies (EA 6309), Faculties of Medicine and Pharmacy, Limoges, France
| | - Virginie Buhé
- University of Western Brittany, Laboratory of Neurosciences of Brest (EA 4685), Brest, France
| | - Marina Trouillas
- Paris Sud University, Unité mixte Inserm/SSA 1197, IRBA/CTSA/HIA Percy, École du Val de Grâce, Clamart, France
| | - Kamélia Ghazi
- Sorbonne University, Université de Technologie de Compiègne, CNRS UMR 7338 Biomechanics and Bioengineering, Centre de Recherche Royallieu, Compiègne, France
| | - Maïa M. Alexaline
- Paris Sud University, Unité mixte Inserm/SSA 1197, IRBA/CTSA/HIA Percy, École du Val de Grâce, Clamart, France
| | - Christophe Egles
- Sorbonne University, Université de Technologie de Compiègne, CNRS UMR 7338 Biomechanics and Bioengineering, Centre de Recherche Royallieu, Compiègne, France
| | - Laurent Misery
- University of Western Brittany, Laboratory of Neurosciences of Brest (EA 4685), Brest, France
| | - Bernard Coulomb
- Paris Sud University, Unité mixte Inserm/SSA 1197, IRBA/CTSA/HIA Percy, École du Val de Grâce, Clamart, France
| | - Jean-Jacques Lataillade
- Paris Sud University, Unité mixte Inserm/SSA 1197, IRBA/CTSA/HIA Percy, École du Val de Grâce, Clamart, France
| | - François Berthod
- Centre LOEX de l'Université Laval, Centre de recherche du CHU de Québec and Département de Chirurgie, Faculté de Médecine, Université Laval, Québec, Canada
| | - Alexis Desmoulière
- University of Limoges, Myelin Maintenance and Peripheral Neuropathies (EA 6309), Faculties of Medicine and Pharmacy, Limoges, France
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Wurzer P, Forbes AA, Hundeshagen G, Andersen CR, Epperson KM, Meyer WJ, Kamolz LP, Branski LK, Suman OE, Herndon DN, Finnerty CC. Two-year follow-up of outcomes related to scarring and distress in children with severe burns. Disabil Rehabil 2016; 39:1639-1643. [PMID: 27685196 DOI: 10.1080/09638288.2016.1209579] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE We assessed the perception of scarring and distress by pediatric burn survivors with burns covering more than one-third of total body surface area (TBSA) for up to 2 years post-burn. METHODS Children with severe burns were admitted to our hospital between 2004 and 2012, and consented to this IRB-approved-study. Subjects completed at least one Scars Problems and/or Distress questionnaire between discharge and 24 months post burn. Outcomes were modeled with generalized estimating equations or using mixed linear models. Significance was accepted at p < 0.01. RESULTS Responses of 167 children with a mean age of 7 ± 5 years and burns covering an average 54 ± 14% of TBSA were analyzed. Significant improvements over the 2-year period were seen in reduction of pain, itching, sleeping disturbance, tightness, range of motion, and strength (p < 0.01). There was a significantly increased persistent desire to hide the scarred body areas over time (p < 0.01). The perception of mouth scarring, inability to portray accurate facial expressions, and skin coloration did not improve over the follow-up period. CONCLUSIONS According to self-assessment questionnaires, severely burned children exhibit significant improvements in their overall perception of scarring and distress. However, these patients remain self-conscious with respect to their body image even 2 years after burn injury. Implications for Rehabilitation According to self-assessment questionnaires, severely burned children perceive significant improvements in scarring and distress during the first 2 years post burn. Significant improvements were seen in reduction of pain, itching, sleeping disturbances, tightness, range of motion, and strength (p < 0.01). Burn care providers should improve the treatment of burns surrounding the mouth that with result in scarring, and develop strategies to prevent skin discoloration. Careful evaluation of pain and sleeping disorders during the first year post burn are warranted to improve the patient rehabilitation. Overall, significantly more female patients expressed a persistent desire to hide their scarred body areas. The rehabilitation team should provide access to wigs or other aids to pediatric burn survivors to address these needs.
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Affiliation(s)
- Paul Wurzer
- a Department of Surgery , University of Texas Medical Branch Galveston , Galveston , TX , USA.,b Shriners Hospitals for Children , Galveston , TX , USA.,c Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery , Medical University of Graz , Graz , Austria
| | - Abigail A Forbes
- d School of Medicine , University of Texas Medical Branch Galveston , Galveston , TX , USA
| | | | - Clark R Andersen
- a Department of Surgery , University of Texas Medical Branch Galveston , Galveston , TX , USA.,b Shriners Hospitals for Children , Galveston , TX , USA
| | - Kathryn M Epperson
- a Department of Surgery , University of Texas Medical Branch Galveston , Galveston , TX , USA.,b Shriners Hospitals for Children , Galveston , TX , USA
| | - Walter J Meyer
- a Department of Surgery , University of Texas Medical Branch Galveston , Galveston , TX , USA.,b Shriners Hospitals for Children , Galveston , TX , USA
| | - Lars P Kamolz
- c Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery , Medical University of Graz , Graz , Austria
| | - Ludwik K Branski
- a Department of Surgery , University of Texas Medical Branch Galveston , Galveston , TX , USA.,b Shriners Hospitals for Children , Galveston , TX , USA.,c Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery , Medical University of Graz , Graz , Austria
| | - Oscar E Suman
- a Department of Surgery , University of Texas Medical Branch Galveston , Galveston , TX , USA.,b Shriners Hospitals for Children , Galveston , TX , USA
| | - David N Herndon
- a Department of Surgery , University of Texas Medical Branch Galveston , Galveston , TX , USA.,b Shriners Hospitals for Children , Galveston , TX , USA
| | - Celeste C Finnerty
- a Department of Surgery , University of Texas Medical Branch Galveston , Galveston , TX , USA.,b Shriners Hospitals for Children , Galveston , TX , USA.,e Institute of Translational Sciences, University of Texas Medical Branch and Shriners Hospitals for Children , Galveston , TX , USA
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