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Williford DN, Jackson CB, Durkin K, Langholz A, Aballay A, Duncan CL. Utility of a Pediatric Psychosocial Screener in an Outpatient Burn Clinic. J Burn Care Res 2024; 45:630-637. [PMID: 38050330 PMCID: PMC11073576 DOI: 10.1093/jbcr/irad190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Indexed: 12/06/2023]
Abstract
Psychosocial concerns are common among youth who sustained a burn injury. Detecting psychosocial distress early is essential to ensure appropriate treatment and referrals. Thus far, research has focused largely on the long-term outcomes of pediatric burn survivors. The current quality improvement initiative details the implementation and outcomes of brief, pragmatic screening to assess psychosocial concerns among pediatric burn survivors in an outpatient setting. A primary caregiver completed an age-appropriate psychosocial screener for youth aged 4-10 years (n = 69), while patients aged 11-17 years (n = 72) completed a self-report screener. Total scores were used to categorize patients as acute risk (i.e., emotional concerns requiring immediate attention), moderate risk (i.e., elevated symptoms, but no immediate safety concerns), or low risk (i.e., endorsing few to no symptoms). Patients with acute risk were evaluated by medical staff to determine the need for immediate psychiatric intervention or social services referrals. Patients with moderate risk met with the on-site psychology team during their clinic visit or were contacted by telephone within 1 week. Patients in the low-risk category warranted no additional follow-up post-screening. Most patients scored in the low-risk category (n = 120; 85%), while 11% (n = 16) and 4% (n = 5) endorsed symptoms consistent with moderate and acute risk, respectively. Results demonstrate the utility of implementing pediatric psychosocial screening in an outpatient burn clinic, the importance of detecting psychosocial concerns in this context, and usage of referrals to address concerns. Findings also shed light on key caveats of psychosocial screening, barriers to accessing psychosocial support, and the potential benefits of embedded psychological support during medical visits.
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Affiliation(s)
- Desireé N Williford
- Department of Psychology, West Virginia University, Morgantown, WV 26506, USA
- West Penn Hospital Burn Center, Allegheny Health Network, Pittsburgh, PA 15224, USA
| | - Carrie B Jackson
- Department of Psychology, West Virginia University, Morgantown, WV 26506, USA
- West Penn Hospital Burn Center, Allegheny Health Network, Pittsburgh, PA 15224, USA
| | - Kristine Durkin
- Department of Psychology, West Virginia University, Morgantown, WV 26506, USA
- West Penn Hospital Burn Center, Allegheny Health Network, Pittsburgh, PA 15224, USA
| | - Ariana Langholz
- West Penn Hospital Burn Center, Allegheny Health Network, Pittsburgh, PA 15224, USA
| | - Ariel Aballay
- West Penn Hospital Burn Center, Allegheny Health Network, Pittsburgh, PA 15224, USA
| | - Christina L Duncan
- Department of Psychology, West Virginia University, Morgantown, WV 26506, USA
- West Penn Hospital Burn Center, Allegheny Health Network, Pittsburgh, PA 15224, USA
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2
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Bamer AM, McMullen K, Humbert A, Kazis L, Ryan CM, Schneider JC, Stewart BT, Suman OE, Amtmann D. PROMIS-25 Reliability and Validity Among Children Living with Burn Injury: A Burn Model System National Database Study. J Burn Care Res 2023; 44:1419-1427. [PMID: 37101360 PMCID: PMC10600322 DOI: 10.1093/jbcr/irad061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Indexed: 04/28/2023]
Abstract
This study examined the reliability and validity of the Patient Reported Outcomes Measurement System (PROMIS)-25, a profile instrument consisting of four-item fixed short forms for six health domains, in children living with burn injury. Data were provided by children participating in a multi-center longitudinal study of outcomes after burn injury. Floor and ceiling effects, unidimensionality, internal consistency, reliability, and differential item functioning (DIF) of the PROMIS-25 Profile v.2.0 were examined. Correlations with other established measures were calculated to assess concurrent validity. Children (n = 256) between the ages of 8-18 years with moderate to severe injury provided responses on PROMIS-25 domains. All PROMIS-25 domains showed high internal consistency. Substantial portions of the sample reported no symptoms (anxiety [58.2%], depressive symptoms [54.6%], fatigue [50.8%], pain [60.1%]). There was a large ceiling effect on peer relationships (46.8%) and physical function mobility (57.5%). One-factor confirmatory factor analyses supported unidimensionality for all domains. Reliability was sufficient for group mean comparisons (>0.8) across at least some trait levels for most domains except fatigue and anxiety. No DIF with respect to burn status was detected when comparing the burn sample to the PROMIS pediatric general U.S. population testing sample. These results provide evidence of reliability and validity of PROMIS-25 scores among children living with burn injury. Reliability of domains was low to moderate and would likely be improved, and ceiling effects reduced for some domains, by administering the PROMIS-37, which includes six items per domain.
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Affiliation(s)
- Alyssa M Bamer
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Kara McMullen
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Andrew Humbert
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Lewis Kazis
- Department of Physical Medicine and Rehabilitation, Rehabilitation Outcomes Center (ROC) Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts , USA
- Boston University, School of Public Health, Boston, Massachusetts , USA
| | - Colleen M Ryan
- Shriners Children's Boston, Boston, Massachusetts, USA
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts , USA
| | - Jeffrey C Schneider
- Department of Physical Medicine and Rehabilitation, Rehabilitation Outcomes Center (ROC) Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts , USA
| | - Barclay T Stewart
- Department of Surgery, University of Washington Harborview, Seattle, Washington, USA
| | - Oscar E Suman
- Department of Surgery, University of Texas Medical Branch, Galveston, Texas, USA
| | - Dagmar Amtmann
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
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3
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Rodríguez-Mercedes SL, Patel KF, Rencken CA, Grant GG, Surette K, Kinney EM, Brady KJ, Slavin MD, Schneider JC, Stoddard FJ, Kazis LE, Ryan CM. Item Pool Development for the School-Aged Life Impact Burn Recovery Evaluation Profile Computerized Adaptive Test: An Observer-Reported Outcome Assessment Measuring the Impact of Burn Injuries in School-Aged Children. J Burn Care Res 2022; 43:1114-1128. [PMID: 34965302 PMCID: PMC9255664 DOI: 10.1093/jbcr/irab247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The transition from early childhood to teen years (5-12) is a critical time of development, which can be made particularly challenging by a burn injury. Assessing postburn recovery during these years is important for improving pediatric survivors' development and health outcomes. Few validated burn-specific measures exist for this age group. The purpose of this study was to generate item pools that will be used to create a future computerized adaptive test (CAT) assessing postburn recovery in school-aged children. Item pool development was guided by the previously developed School-Aged Life Impact Burn Recovery Evaluation (SA-LIBRE5-12) conceptual framework. The item pool development process involved a systematic literature review, extraction of candidate items from existing legacy measures, iterative item review during expert consensus meetings, and parent cognitive interviews. The iterative item review with experts consisted of six rounds. A total of 10 parent cognitive interviews were conducted. The three broad themes of concern were items that needed 1) clarification, needed context, or were vague, 2) age dependence and relevance, and 3) word choice. The cognitive interviews indicated that survey instructions, recall period, item stem, and response choices were interpretable by respondents. Final item pool based on parental feedback consists of 57, 81, and 60 items in physical, psychological, and family and social functioning, respectively. Developed item pools (n = 198) in three domains are consistent with the existing conceptual framework. The next step involves field testing the item pool and calibration using item response theory to develop and validate the SA-LIBRE5-12 CAT Profile.
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Affiliation(s)
| | - Khushbu F. Patel
- Shriners Hospitals for Children – Boston, Boston, MA
- Department of Surgery, Massachusetts General Hospital, Boston, MA
| | - Camerin A. Rencken
- Shriners Hospitals for Children – Boston, Boston, MA
- Department of Surgery, Massachusetts General Hospital, Boston, MA
| | - Gabrielle G. Grant
- University of North Carolina at Chapel Hill, School of Nursing, Hillman Scholars in Nursing Innovation, Chapel Hill, NC
| | - Kate Surette
- Shriners Hospitals for Children – Boston, Boston, MA
| | | | - Keri J.S. Brady
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA
| | - Mary D. Slavin
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA
| | - Jeffrey C. Schneider
- Harvard Medical School, Boston, MA
- Department of Physical Medicine and Rehabilitation, Spaulding Research Institute, Spaulding Rehabilitation Hospital, Boston, MA
| | - Frederick J. Stoddard
- Shriners Hospitals for Children – Boston, Boston, MA
- Harvard Medical School, Boston, MA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Lewis E. Kazis
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA
- Harvard Medical School, Boston, MA
- Department of Physical Medicine and Rehabilitation, Spaulding Research Institute, Spaulding Rehabilitation Hospital, Boston, MA
| | - Colleen M. Ryan
- Shriners Hospitals for Children – Boston, Boston, MA
- Department of Surgery, Massachusetts General Hospital, Boston, MA
- Department of Physical Medicine and Rehabilitation, Spaulding Research Institute, Spaulding Rehabilitation Hospital, Boston, MA
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Spronk I, Trommel N, Baartmans M, Polinder S, van Baar M. Parent-Reported Health-Related Quality of Life of Pediatric Burn Patients 5 to 7 Years after Burn Injuries: A Multicenter Study. Eur J Pediatr Surg 2022; 33:219-227. [PMID: 35882357 DOI: 10.1055/s-0042-1751047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Pediatric burns significantly impact the short-term health-related quality of life (HRQL) of children. Knowledge regarding the long-term impact is scarce. We therefore evaluated the parent-reported HRQL in pediatric burn patients 5 to 7 years after burns. METHODS We invited parents of eligible children admitted to a Dutch Burn Center between August 2011 and September 2012. This sample was enriched with children with severe burns (> 10% of total body surface area [TBSA] burned) admitted between January 2010 and March 2013. The EQ-5D was completed by parents 5 to 7 years postburn. Outcomes and predictive factors were studied and compared between children with minor/moderate and severe burns. RESULTS We included 130 children (mean TBSA burned 7%): 102 children with mild/intermediate burns and 28 with severe burns. Mean EQ-5D summary was 0.96 and EQ visual analogue scale (VAS) 93.1. These outcomes were significantly better in children with minor/moderate burns (0.97; 94.4) compared with children with severe burns (0.93; 88.3) (p < 0.05). Nineteen percent of the children with minor/moderate burns and 43% of those with severe burns reported any problems. The most frequently reported problem was anxiety/depression for both groups. Pain/discomfort (p = 0.012) and cognition (p = 0.035) were statistically significantly worse in children with severe burns compared with those with minor/moderate burns. Full thickness burns and number of surgeries were found to predict long-term HRQL impairment. CONCLUSION Five to seven years postburn, the majority of children in our study (76%) did not experience long-term problems with HRQL. In a minority of the children, burns showed to have a prolonged negative impact, especially in those being severely burned and who had to undergo surgery for their burns. Most experienced problems were related to anxiety/depression. These important insights could be used to inform children and their parents about the expected long-term HRQL after pediatric burns.
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Affiliation(s)
- Inge Spronk
- Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, Zuid-Holland, the Netherlands.,Public Health, Erasmus MC, Rotterdam, the Netherlands.,Dutch Burns Foundation, Beverwijk, the Netherlands
| | - Nicole Trommel
- Burn Center, Maasstad Hospital, Rotterdam, Zuid-Holland, the Netherlands
| | - Martin Baartmans
- Burn Center, Maasstad Hospital, Rotterdam, Zuid-Holland, the Netherlands.,Department of Pediatrics, Maasstad Hospital, Rotterdam, Zuid-Holland, the Netherlands
| | | | - Margriet van Baar
- Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, Zuid-Holland, the Netherlands.,Public Health, Erasmus MC, Rotterdam, the Netherlands
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5
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Young A, Davies A, Tsang C, Kirkham J, Potokar T, Gibran N, Tyack Z, Meirte J, Harada T, Dheansa B, Dumville J, Metcalfe C, Ahuja R, Wood F, Gaskell S, Brookes S, Smailes S, Jeschke M, Cinar MA, Zia N, Moghazy A, Mathers J, Falder S, Edgar D, Blazeby JM. Establishment of a core outcome set for burn care research: development and international consensus. BMJ MEDICINE 2022; 1:e000183. [PMID: 36936572 PMCID: PMC9978679 DOI: 10.1136/bmjmed-2022-000183] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 05/24/2022] [Indexed: 11/03/2022]
Abstract
Objective To develop a core outcome set for international burn research. Design Development and international consensus, from April 2017 to November 2019. Methods Candidate outcomes were identified from systematic reviews and stakeholder interviews. Through a Delphi survey, international clinicians, researchers, and UK patients prioritised outcomes. Anonymised feedback aimed to achieve consensus. Pre-defined criteria for retaining outcomes were agreed. A consensus meeting with voting was held to finalise the core outcome set. Results Data source examination identified 1021 unique outcomes grouped into 88 candidate outcomes. Stakeholders in round 1 of the survey, included 668 health professionals from 77 countries (18% from low or low middle income countries) and 126 UK patients or carers. After round 1, one outcome was discarded, and 13 new outcomes added. After round 2, 69 items were discarded, leaving 31 outcomes for the consensus meeting. Outcome merging and voting, in two rounds, with prespecified thresholds agreed seven core outcomes: death, specified complications, ability to do daily tasks, wound healing, neuropathic pain and itch, psychological wellbeing, and return to school or work. Conclusions This core outcome set caters for global burn research, and future trials are recommended to include measures of these outcomes.
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Affiliation(s)
- Amber Young
- Centre for Surgical Research, Population Health Sciences, Bristol Biomedical Research Centre, Bristol Medical School, University of Bristol, Bristol, UK
| | - Anna Davies
- Centre for Surgical Research, Population Health Sciences, Bristol Biomedical Research Centre, Bristol Medical School, University of Bristol, Bristol, UK
| | - Carmen Tsang
- Centre for Surgical Research, Population Health Sciences, Bristol Biomedical Research Centre, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jamie Kirkham
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester, UK
| | - Tom Potokar
- Centre for Global Burn Injury Policy and Research, Swansea University, Swansea, UK
| | - Nicole Gibran
- UW Medicine Regional Burn Center, Harborview Medical Center, UW Department of Surgery, University of Washington (UW), Seattle, WA, USA
| | - Zephanie Tyack
- Child Health Research Centre, Faculty of Medicine, Centre for Children’s Burns and Trauma Research, Queensland University of Technology, Brisbane, QLD, Australia
| | - Jill Meirte
- Department of Medicine and Health Sciences, University of Antwerp, Antwerpen, Belgium
| | - Teruichi Harada
- Seitokai Medical and Social Welfare Corporation, Teramoto Memorial Hospital, Kawachinagano, Osaka, Japan
| | - Baljit Dheansa
- Department of plastic surgery and burns, Queen Victoria Hospital, East Grinstead, UK
| | - Jo Dumville
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester, UK
- Division of Nursing, Midwifery, and Social Work, University of Manchester, Manchester, UK
| | - Chris Metcalfe
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Rajeev Ahuja
- Department of Burns & Plastic Surgery, Lok Nayak Hospital and Maulana Azad Medical College, New Delhi, India
| | - Fiona Wood
- Burn service, University of Western Australia, Perth, WA, Australia
| | - Sarah Gaskell
- Paediatric Psychosocial Service, Royal Manchester Children's Hospital, Manchester, UK
| | - Sara Brookes
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Sarah Smailes
- Department of physiontherapy, Broomfield Hospital, Mid Essex Hospitals, Chelmsford, UK
| | - Marc Jeschke
- Department of Surgery and Plastic Surgery, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Murat Ali Cinar
- Department of Physical Therapy and Rehabilitation, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Nukhba Zia
- Johns Hopkins International Injury Research Unit, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Amr Moghazy
- Department of plastic surgery, Suez Canal University, Ismailia, Egypt
| | - Jonathan Mathers
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Sian Falder
- Department of plastic surgery, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Dale Edgar
- Adult Burns Unit, Fiona Stanley Hospital, Murdoch, WA, Australia
| | - Jane Mary Blazeby
- Centre for Surgical Research, Population Health Sciences, Bristol Biomedical Research Centre, Bristol Medical School, University of Bristol, Bristol, UK
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6
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Cuttle L, Fear M, Wood FM, Kimble RM, Holland AJA. Management of non-severe burn wounds in children and adolescents: optimising outcomes through all stages of the patient journey. THE LANCET. CHILD & ADOLESCENT HEALTH 2022; 6:269-278. [PMID: 35051408 DOI: 10.1016/s2352-4642(21)00350-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/28/2021] [Accepted: 11/01/2021] [Indexed: 12/11/2022]
Abstract
Paediatric burn injuries are common, especially in children younger than 5 years, and can lead to poor physical and psychosocial outcomes in the long term. In this Review, we aim to summarise the key factors and interventions before hospital admission and following discharge that can improve the long-term outcomes of paediatric burns. Care can be optimised through first aid treatment, correct initial assessment of burn severity, and appropriate patient referral to a burns centre. Scar prevention or treatment and patient follow-up after discharge are also essential. As most burn injuries in children are comparatively small and readily survivable, this Review does not cover the perioperative management associated with severe burns that require fluid resuscitation, or inhalational injury. Burns disproportionately affect children from low socioeconomic backgrounds and those living in low-income and middle-income countries, with ample evidence to suggest that there remains scope for low-cost interventions to improve care for those patients with the greatest burden of burn injury. Current knowledge gaps and future research directions are discussed.
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Affiliation(s)
- Leila Cuttle
- Centre for Children's Health Research, Faculty of Health, School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia.
| | - Mark Fear
- Burn Injury Research Unit, School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
| | - Fiona M Wood
- Burn Injury Research Unit, School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia; Burns Service of Western Australia, Perth Children's Hospital and Fiona Stanley Hospital, Perth, WA, Australia
| | - Roy M Kimble
- Centre for Children's Burns and Trauma Research, The University of Queensland, South Brisbane, QLD, Australia; Queensland Children's Hospital, South Brisbane, QLD, Australia
| | - Andrew J A Holland
- The Children's Hospital Burns Research Institute, The Children's Hospital at Westmead, The University of Sydney, NSW, Westmead, Australia
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7
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Wang BB, Patel KF, Wolfe AE, Wiechman S, McMullen K, Gibran NS, Kowalske K, Meyer WJ, Kazis LE, Ryan CM, Schneider JC. Adolescents with and without head and neck burns: comparison of long-term outcomes in the burn model system national database. Burns 2022; 48:40-50. [PMID: 33975762 PMCID: PMC8526620 DOI: 10.1016/j.burns.2021.04.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 03/16/2021] [Accepted: 04/12/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Facial burns account for persistent differences in psychosocial functioning in adult burn survivors. Although adolescent burn survivors experience myriad chronic sequelae, little is known about the effect of facial injuries. This study examines differences in long-term outcomes with and without head and neck involvement. METHODS Data collected for 392 burn survivors between 14-17.9 years of age from the Burn Model System National Database (2006-2015) were analyzed. Comparisons were made between two groups based on presence of a head and neck burn (H&N) using the following patient reported outcome measures: Satisfaction with Appearance Scale, Satisfaction with Life Scale, Community Integration Questionnaire, and Short Form-12 Health Survey at 6, 12, and 24 months after injury. Regression analyses were used to assess association between outcome measures and H&N group at 12-months. RESULTS The H&N group had more extensive burns, had longer hospital stays, were more likely to be burned by fire/flame and were more likely to be Hispanic compared to the non-H&N group. Regression analysis found that H&N burn status was associated with worse SWAP scores. No significant associations were found between H&N burn status and other outcome measures. CONCLUSIONS Adolescents with H&N burn status showed significantly worse satisfaction with appearance at 12-months after injury. Future research should examine interventions to help improve body image and coping for adolescent burn survivors with head and neck burns.
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Affiliation(s)
| | - Khushbu F. Patel
- Shriners Hospitals for Children – Boston, Boston, MA United States,Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Audrey E. Wolfe
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Charlestown, MA, United States
| | - Shelley Wiechman
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
| | - Kara McMullen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
| | - Nicole S. Gibran
- Department of Surgery, University of Washington Harborview, Seattle, WA, United States
| | - Karen Kowalske
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Walter J. Meyer
- Department of Psychiatry, University of Texas Medical Branch, Galveston, TX, United States
| | - Lewis E. Kazis
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, United States
| | - Colleen M. Ryan
- Shriners Hospitals for Children – Boston, Boston, MA United States,Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Jeffrey C. Schneider
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Charlestown, MA, United States,Corresponding author. (J.C. Schneider)
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8
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Grant GG, Brady KJS, Stoddard FJ, Meyer WJ, Romanowski KS, Chang PH, Painting LE, Fowler LA, Nelson JK, Patel KF, Sheldrick RC, Carter A, Sheridan RL, Slavin MD, Warner P, Palmieri TL, Schneider JC, Kazis LE, Ryan CM. Measuring the impact of burn injury on the parent-reported health outcomes of children 1-to-5 years: Item pool development for the Preschool 1-5 Life Impact Burn Recovery Evaluation (LIBRE) Profile. Burns 2021; 47:1511-1524. [PMID: 33832799 PMCID: PMC8711655 DOI: 10.1016/j.burns.2021.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 01/29/2021] [Accepted: 02/03/2021] [Indexed: 11/23/2022]
Abstract
Modern, reliable, and valid outcome measures are essential to understanding the health needs of young children with burn injuries. Burn-specific and age-appropriate legacy assessment tools exist for this population but are hindered by the limitations of existing paper-based instruments. The purpose of this study was to develop item pools comprised of questions appropriate for children aged 1-5 with burn injuries. Item development was based on a framework provided by previous work to develop the Preschool Life Impact Burn Recovery Evaluation (LIBRE) Conceptual Model. The Preschool LIBRE Conceptual Model work established four sub-domains of functioning for children with burns aged 1-5. Item development involved a systematic literature review, a qualitative item review process with clinical experts, and parent cognitive interviews. Four item pools were established: (1) communication and language development; (2) physical functioning; (3) psychological functioning and (4) social functioning for preschool-aged children with burn injuries. We selected and refined candidate items, recall periods, survey instructions, and response option choices through clinical and parental feedback during the qualitative review and cognitive interview processes. Item pools are currently being field-tested as part of the process to calibrate and validate the Preschool1-5 LIBRE Computer Adaptive Test (CAT) Profile.
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Affiliation(s)
- Gabrielle G Grant
- Shriners Hospitals for Children - Boston, Boston, MA, United States; Department of Surgery, Massachusetts General Hospital, Boston, MA, United States; University of North Carolina at Chapel Hill, School of Nursing, Hillman Scholars in Nursing Innovation, Chapel Hill, NC, United States
| | - Keri J S Brady
- Shriners Hospitals for Children - Boston, Boston, MA, United States; Department of Surgery, Massachusetts General Hospital, Boston, MA, United States; Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, United States
| | - Frederick J Stoddard
- Shriners Hospitals for Children - Boston, Boston, MA, United States; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Walter J Meyer
- Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch, Galveston, TX, United States; Shriners Hospitals for Children - Galveston, Galveston, TX, United States
| | - Kathleen S Romanowski
- Shriners Hospital for Children - Northern California, Sacramento, CA, United States; University of California Davis School of Medicine, Department of Surgery, Division of Burn Surgery, Sacramento, CA, United States
| | | | - Lynda E Painting
- Shriners Hospital for Children - Northern California, Sacramento, CA, United States; University of California Davis School of Medicine, Department of Surgery, Division of Burn Surgery, Sacramento, CA, United States
| | - Laura A Fowler
- Shriners Hospital for Children - Cincinnati, Cincinnati, OH, United States
| | - Judith K Nelson
- Shriners Hospital for Children - Cincinnati, Cincinnati, OH, United States
| | - Khushbu F Patel
- Shriners Hospitals for Children - Boston, Boston, MA, United States; Department of Surgery, Massachusetts General Hospital, Boston, MA, United States
| | - R Christopher Sheldrick
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, United States
| | - Alice Carter
- Department of Psychology, University of Massachusetts - Boston, Boston, MA, United States
| | - Robert L Sheridan
- Shriners Hospitals for Children - Boston, Boston, MA, United States; Department of Surgery, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Mary D Slavin
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, United States
| | - Petra Warner
- Shriners Hospital for Children - Cincinnati, Cincinnati, OH, United States; Department of Surgery, University of Cincinnati, Cincinnati, OH, United States
| | - Tina L Palmieri
- Shriners Hospital for Children - Northern California, Sacramento, CA, United States; University of California Davis School of Medicine, Department of Surgery, Division of Burn Surgery, Sacramento, CA, United States
| | - Jeffrey C Schneider
- Shriners Hospitals for Children - Boston, Boston, MA, United States; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, United States; Spaulding Research Institute, Boston, MA, United States
| | - Lewis E Kazis
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, United States
| | - Colleen M Ryan
- Shriners Hospitals for Children - Boston, Boston, MA, United States; Department of Surgery, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
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9
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Rencken CA, Rodríguez-Mercedes SL, Patel KF, Grant GG, Kinney EM, Sheridan RL, Brady KJS, Palmieri TL, Warner PM, Fabia RB, Schneider JC, Stoddard FJ, Kazis LE, Ryan CM. Development of the School-Aged Life Impact Burn Recovery Evaluation (SA-LIBRE5-12) Profile: A Conceptual Framework. J Burn Care Res 2021; 42:1067-1075. [PMID: 34228121 DOI: 10.1093/jbcr/irab104] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Pediatric burn injuries can alter the trajectory of the survivor's entire life. Patient-centered outcome measures are helpful to assess unique physical and psychosocial needs and long-term recovery. This study aimed to develop a conceptual framework to measure pediatric burn outcomes in survivors aged 5 to 12 years as a part of the School-Aged Life Impact Burn Recovery Evaluation Computer Adaptive Test (SA-LIBRE5-12 CAT) development. This study conducted a systematic literature review guided by the WHO International Classification of Functioning - Child and Youth and domains in the American Burn Association/Shriners Hospitals for Children Burn Outcomes Questionnaire5-18. Interviews with eight parents and seven clinicians were conducted to identify important domains in child recovery. One clinician focus group with four clinicians was completed to identify gaps in the preliminary framework, and semi-weekly expert consensus meetings were conducted with three experts to solidify the framework. Qualitative data were analyzed by grounded theory methodology. Three major thematic outcome domains emerged: 1) Physical Functioning: fine motor and upper extremity, gross motor and lower extremity, pain, skin symptoms, sleep and fatigue, and physical resilience; 2) Psychological Functioning: cognitive, behavioral, emotional, resilience, and body image; and 3) Family and Social Functioning: family relationships, and parental satisfaction, school, peer relations and community participation. The framework will be used to develop item banks for a CAT-based assessment of school-aged children's health and developmental outcomes, which will be designed for clinical and research use to optimize interventions, personalize care, and improve long-term health outcomes for burned children.
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Affiliation(s)
| | | | - Khushbu F Patel
- Shriners Hospitals for Children - Boston,® Boston, MA.,Department of General Surgery Research, Massachusetts General Hospital, Boston, MA
| | | | - Erin M Kinney
- Shriners Hospitals for Children - Boston,® Boston, MA
| | | | - Keri J S Brady
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA
| | - Tina L Palmieri
- Division of Burn Surgery, Department of Surgery, University of California Davis.,Shriners Hospital for Children - Northern California®, 2425 Stockton Boulevard, Suite 718, Sacramento, CA 95817, USA
| | - Petra M Warner
- Shriners Hospital for Children - Cincinnati,® Cincinnati, OH.,University of Cincinnati, 3229 Burnet Avenue, Cincinnati, OH 45229, USA
| | - Renata B Fabia
- Nationwide Children's Hospital, General Pediatric Surgery, Director of the Burn Program, Columbus, OH
| | - Jeffrey C Schneider
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA.,Spaulding Research Institute, Boston, MA.,Harvard Medical School, Boston, MA
| | - Frederick J Stoddard
- Harvard Medical School, Boston, MA.,Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Lewis E Kazis
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA
| | - Colleen M Ryan
- Shriners Hospitals for Children - Boston,® Boston, MA.,Harvard Medical School, Boston, MA.,Department of Surgery, Massachusetts General Hospital, Boston, MA
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10
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Arumugam PK, Thayal PK. Validation of Indian Adaptation of Burn Outcomes Questionnaire-Hindi Version (I-BOQ-HV) for Pediatric Subgroup 5 to 18 Years. J Burn Care Res 2021; 42:473-480. [PMID: 33095880 DOI: 10.1093/jbcr/iraa182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The American Burn Association/Shriners Hospitals for Children Burn Outcomes Questionnaire (BOQ) is burn-specific quality of life assessment questionnaire for children. In this study, we modified the questionnaire to suit the Indian population and also translated it to Hindi. Three questions were modified according to its Indian context. One new question was added to the "Transfers and mobility" domain; a new domain "Economic impact" with two questions was added to study the economic impact on families. Twenty-five patients of age 5 to 18 years were included in the study. The Indian adaptation of Burn Outcome Questionnaire-Hindi Version 5 to 18 years (I-BOQ-HV 5-18 years) was found to be feasible in the Indian population. The internal consistency of the modified scale was good with all except one domain with Cronbach's alpha greater than 0.7. Test-retest reliability was done with intraclass correlation which was good, with values of greater than 0.7 for all domains. Pearson's correlation coefficient showed good discriminant validity between the domains. Factor analysis using principle component analysis with orthogonal rotation resulted in 10 of the 12 components with good factor loadings. The I-BOQ-HV 5 to 18 years has been shown to reliably predict quality of life of children with burns in India.
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Affiliation(s)
- Praveen Kumar Arumugam
- Department of Burns, Plastic & Maxillofacial Surgery, VM Medical College & Safdarjung Hospital, Delhi, India
| | - Piyush K Thayal
- Department of Burns, Plastic & Maxillofacial Surgery, VM Medical College & Safdarjung Hospital, Delhi, India
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11
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Riobueno-Naylor A, Williamson H, Canenguez K, Kogosov A, Drexler A, Sadeq F, DePamphilis M, Holcomb JM, Stoddard FJ, Lydon M, Murphy JM, Sheridan RL. Appearance Concerns, Psychosocial Outcomes, and the Feasibility of Implementing an Online Intervention for Adolescents Receiving Outpatient Burn Care. J Burn Care Res 2021; 42:32-40. [PMID: 32594128 DOI: 10.1093/jbcr/iraa108] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The current study assessed the prevalence of appearance concerns, psychosocial difficulty, and use of an appearance-focused social and psychological support resource (Young Person's Face IT; YPF) within a population of teens (12-17 year-olds) receiving outpatient burn care with the goal to assess the feasibility of routine use of the resource in outpatient burn care. The study sample included 78 patients ages 12 to 17 receiving outpatient care for burns at one hospital. Appearance concerns were measured via the Burn Outcomes Questionnaire Appearance Subscale, the Appearance Subscale of the Body Esteem Scale for Adolescents, and a 2-part question which asked participants directly about appearance concerns related to the burn injury. A large majority (70.0%) of study participants reported appearance concerns on at least one appearance measure and girls reported more burn-related appearance concerns compared with boys. Psychosocial difficulty was measured via the Pediatric Symptom Checklist-17 (PSC-17) and measures of social functioning were collected and compared within the sample by burn size, burn location, sex, and appearance concerns. Internalizing symptoms were prevalent on the PSC-17 (18.6% risk) and decreased self-worth and increased social anxiety symptoms were significantly associated with having appearance concerns. Although interest in YPF was high (78.3%), actual use of the resource among those who signed up to pilot it (n = 46 participants) was low (19.4% use). Results indicate that there is a need for and interest in appearance-focused social anxiety resources for adolescents with burn injuries such as YPF, but more research is needed to understand its feasibility in clinical practice.
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Affiliation(s)
- Alexa Riobueno-Naylor
- Department of Clinical Research, Shriners Hospitals for Children-Boston, Boston, Massachusetts.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Heidi Williamson
- Department of Health and Social Sciences, University of the West England, Bristol, UK
| | - Katia Canenguez
- Department of Clinical Research, Shriners Hospitals for Children-Boston, Boston, Massachusetts.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Ann Kogosov
- Department of Clinical Research, Shriners Hospitals for Children-Boston, Boston, Massachusetts
| | - Alana Drexler
- Department of Clinical Research, Shriners Hospitals for Children-Boston, Boston, Massachusetts
| | - Farzin Sadeq
- Department of Clinical Research, Shriners Hospitals for Children-Boston, Boston, Massachusetts
| | - Matthew DePamphilis
- Department of Clinical Research, Shriners Hospitals for Children-Boston, Boston, Massachusetts
| | - Juliana M Holcomb
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Frederick J Stoddard
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.,Department of Psychiatry, Shriners Hospitals for Children-Boston, Boston, Massachusetts
| | - Martha Lydon
- Department of Clinical Research, Shriners Hospitals for Children-Boston, Boston, Massachusetts
| | - J Michael Murphy
- Department of Clinical Research, Shriners Hospitals for Children-Boston, Boston, Massachusetts.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Robert L Sheridan
- Department of Surgery, Shriners Hospitals for Children-Boston, Boston, Massachusetts.,Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.,Department of Surgery, Harvard Medical School, Boston, Massachusetts
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12
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Chen B, Hou J, Song H, Gao Q, Xu M, Wang F, Wang J, Wu J, Chai J. Using rational strategies for children's scars based on more than 5 years assessment after burn. Burns 2020; 47:190-197. [PMID: 32713827 DOI: 10.1016/j.burns.2020.06.036] [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: 03/12/2020] [Revised: 06/18/2020] [Accepted: 06/29/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Paediatric patients with scars after burn are regularly encountered. Discussion of rational strategies for management are of value. The objective of the study was to describe development and utilisation of strategies for paediatric burn scars up to five years after injury. METHODS We included 164 cases aged from 5 to 8 years old in our study; all had burn scar deformities. RESULTS Assessments were made up to December 31, 2019. The following strategies were used: sequential treatment, reconstruction based on facial aesthetic units, predicting the effect of surgery on development, releasing skin tension and application of photoelectric technology or other non-surgical measures. CONCLUSIONS Using rational strategies for paediatric burn scars is very important.
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Affiliation(s)
- Baoguo Chen
- The Fourth Medical Center of Chinese People's Liberation Army General Hospital, China.
| | - Jian Hou
- The Fourth Medical Center of Chinese People's Liberation Army General Hospital, China
| | - Huifeng Song
- The Fourth Medical Center of Chinese People's Liberation Army General Hospital, China.
| | - Quanwen Gao
- The Fourth Medical Center of Chinese People's Liberation Army General Hospital, China
| | - Minghuo Xu
- The Fourth Medical Center of Chinese People's Liberation Army General Hospital, China
| | - Fang Wang
- The Fourth Medical Center of Chinese People's Liberation Army General Hospital, China
| | - Jue Wang
- The Fourth Medical Center of Chinese People's Liberation Army General Hospital, China
| | - Jiang Wu
- The Fourth Medical Center of Chinese People's Liberation Army General Hospital, China
| | - Jiake Chai
- The Fourth Medical Center of Chinese People's Liberation Army General Hospital, China
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13
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Evaluation of Patient-Reported Outcomes in Burn Survivors Undergoing Reconstructive Surgery in the Rehabilitative Period. Plast Reconstr Surg 2020; 146:171-182. [PMID: 32590661 PMCID: PMC9836002 DOI: 10.1097/prs.0000000000006909] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Health-related quality of life is decreased in burn survivors, with scars implicated as a cause. The authors aim to characterize the use of reconstructive surgery following hospitalization and determine whether patient-reported outcomes change over time. The authors hypothesized improvement in health-related quality of life following reconstructive surgery. METHODS Adult burn survivors undergoing reconstructive surgery within 24 months after injury were extracted from a prospective, longitudinal database from 5 U.S. burn centers (Burn Model System). Surgery was classified by problem as follows: scar, contracture, and open wound. The authors evaluated predictors of surgery using logistic regression. Short Form-12/Veterans RAND 12 health survey outcomes at 6, 12, and 24 months were compared at follow-up intervals and matched with nonoperated participants using propensity score matching. RESULTS Three hundred seventy-two of 1359 participants (27.4 percent) underwent one or more reconstructive operation within 24 months of injury. Factors that increased the likelihood of surgery included number of operations during index hospitalization (p < 0.001), hand (p = 0.001) and perineal involvement (p = 0.042), and range-of-motion limitation at discharge (p < 0.001). Compared to the physical component scores of peers who were not operated on, physical component scores increased for participants undergoing scar operations; however, these gains were only significant for those undergoing surgery more than 6 months after injury (p < 0.05). Matched physical component scores showed nonsignificant differences following contracture operations. Mental component scores were unchanged or lower following scar and contracture surgery. CONCLUSIONS Participants requiring more operations during index admission were more likely to undergo reconstructive surgery. There were improvements in Short Form-12/Veterans RAND 12 scores for those undergoing scar operations more than 6 months after injury, although contracture operations were not associated with significant differences in Short Form-12/Veterans RAND 12 scores.
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14
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Oosterwijk AM, Disseldorp LM, van der Schans CP, Mouton LJ, Nieuwenhuis MK. Joint flexibility problems and the impact of its operationalisation. Burns 2019; 45:1819-1826. [PMID: 31679794 DOI: 10.1016/j.burns.2019.03.010] [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: 03/16/2018] [Revised: 12/08/2018] [Accepted: 03/03/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Dissatisfaction is being voiced with the generally used way joint flexibility problems are defined (operationalised), i.e. as a range of motion (ROM) one or more degrees lower than normative ROM of healthy subjects. Other, specifically more function-related operationalisations have been proposed. The current study evaluated the effect of applying different operationalisations of joint flexibility problems on its prevalence. METHOD ROM data of 95 joints affected by burns of 23 children were used, and data on 18 functional activities (Burn Outcome Questionnaire (BOQ)). Five methods were used to operationalise joint flexibility problems: (1) ROM below normative ROM, (2) ROM below normative ROM minus 1SD, (3) ROM below normative ROM minus 2SD, (4) ROM below functional ROM, and (5) a score of 2 or more on the Likert Scale (BOQ). RESULTS Prevalence of joint flexibility problems on a group level ranged from 13 to 100% depending on the operationalisation used. Per joint and movement direction, prevalence ranged from 40% to 100% (Method 1) and 0% to 80% (Methods 2-4). 18% of the children received '2' on the Likert Scale (Method 5). CONCLUSION The operationalisation of joint flexibility problems substantially influences prevalence, both on group and joint level. Changing to a function-related operationalisation seems valuable; however, international consensus is required regarding its adoption. TRIAL REGISTRATION The study is registered in the National Academic Research and Collaborations Information System of the Netherlands (OND1348800).
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Affiliation(s)
- A M Oosterwijk
- Hanze University of Applied Sciences Groningen, Research group Healthy Ageing, Allied Health Care and Nursing, Het Wiebenga, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands; Association of Dutch Burn Centres, Burn Centre Martini Hospital, Van Swietenplein 1, 9728 NT Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
| | - L M Disseldorp
- Hanze University of Applied Sciences Groningen, Research group Healthy Ageing, Allied Health Care and Nursing, Het Wiebenga, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands; Association of Dutch Burn Centres, Burn Centre Martini Hospital, Van Swietenplein 1, 9728 NT Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Health Psychology, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands.
| | - C P van der Schans
- Hanze University of Applied Sciences Groningen, Research group Healthy Ageing, Allied Health Care and Nursing, Het Wiebenga, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Health Psychology, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
| | - L J Mouton
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands.
| | - M K Nieuwenhuis
- Association of Dutch Burn Centres, Burn Centre Martini Hospital, Van Swietenplein 1, 9728 NT Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands.
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15
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The Brisbane Burn Scar Impact Profile (child and young person version) for measuring health-related quality of life in children with burn scars: A longitudinal cohort study of reliability, validity and responsiveness. Burns 2019; 45:1537-1552. [DOI: 10.1016/j.burns.2019.07.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 05/19/2019] [Accepted: 07/10/2019] [Indexed: 12/24/2022]
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16
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Riobueno-Naylor A, Romo S, Kazis L, Wang S, Lydon M, Nelson J, Fowler L, Drexler A, Kogosov A, Haile H, Ryan CM, Chang P, Warner P, Palmieri TL, Lee AF, Stoddard F, Murphy JM, Sheridan RL. Usefulness of a Novel System for Feedback of Patient-Reported Outcome Measures in Children Recovering From Burns. J Burn Care Res 2019; 40:776-784. [PMID: 31102446 DOI: 10.1093/jbcr/irz082] [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
The Burn Outcomes Questionnaire for children ages 5-18 years (BOQ5-18) is a widely used, reliable, and valid parent-reported outcome measure designed to assess children's recovery from burn injuries in 12 physical and psychosocial domains. This study evaluated the feasibility, acceptability, and usefulness of a feedback system that delivered BOQ and Pediatric Symptom Checklist (PSC-17; a widely used measure of psychosocial functioning) results to burn care clinicians prior to an outpatient appointment or a postoperative surgical encounter. The BOQ and the PSC-17 were administered to the parents of 147 children receiving outpatient or surgical care in two pediatric burn hospitals. Clinician and parent perceptions of the feedback system were evaluated using debriefing questionnaires. Over half of all patients were at-risk on at least one BOQ subscale, and risk on three or more BOQ domains was significantly associated with a higher likelihood of poor psychological scores on the PSC-17 (P < .001). Significant differences in BOQ scores were found between the two hospital sites on four BOQ subscales, three related to physical ability and one to psychosocial well-being. Parent ratings of the feedback system were positive, with 90% of parents in both settings agreeing that the BOQ tablet experience was easy and helpful. Clinician attitudes differed across the two settings with more positive clinician ratings of the system in the outpatient setting (P < .001). Clinician interviews revealed that the data was especially useful in bringing to light psychosocial aspects of functioning relevant to long-term recovery from burn injuries.
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Affiliation(s)
- Alexa Riobueno-Naylor
- Department of Clinical Research, Shriners Hospitals for Children - Boston, Massachusetts.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Stephanie Romo
- Department of Clinical Research, Shriners Hospitals for Children - Boston, Massachusetts
| | - Lewis Kazis
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Shirley Wang
- Department of Clinical Research, Shriners Hospitals for Children - Boston, Massachusetts
| | - Martha Lydon
- Department of Clinical Research, Shriners Hospitals for Children - Boston, Massachusetts
| | - Judith Nelson
- Department of Clinical Research, Shriners Hospitals for Children - Cincinnati, Ohio
| | - Laura Fowler
- Department of Clinical Research, Shriners Hospitals for Children - Cincinnati, Ohio
| | - Alana Drexler
- Department of Clinical Research, Shriners Hospitals for Children - Boston, Massachusetts
| | - Ann Kogosov
- Department of Clinical Research, Shriners Hospitals for Children - Boston, Massachusetts
| | - Haregnesh Haile
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Colleen M Ryan
- Department of Surgery, Shriners Hospitals for Children - Boston, Massachusetts.,Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Philip Chang
- Department of Surgery, Shriners Hospitals for Children - Cincinnati, Ohio
| | - Petra Warner
- Department of Surgery, Shriners Hospitals for Children - Cincinnati, Ohio
| | - Tina L Palmieri
- Department of Surgery, Shriners Hospitals for Children - Northern California, Sacramento, California.,Department of Surgery, University of California Davis, Sacramento, California
| | - Austin F Lee
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Frederick Stoddard
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,Department of Psychiatry, Shriners Hospitals for Children - Boston, Massachusetts
| | - J Michael Murphy
- Department of Clinical Research, Shriners Hospitals for Children - Boston, Massachusetts.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Robert L Sheridan
- Department of Surgery, Shriners Hospitals for Children - Boston, Massachusetts.,Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
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17
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Brady KJS, Grant GG, Stoddard FJ, Meyer WJ, Romanowski KS, Chang PH, Painting LE, Fowler LA, Nelson JK, Rivas P, Epperson K, Sheridan RL, Murphy M, O’Donnell EH, Ceranoglu TA, Sheldrick RC, Ni P, Slavin MD, Warner P, Palmieri TL, Schneider JC, Kazis LE, Ryan CM. Measuring the Impact of Burn Injury on the Parent-Reported Health Outcomes of Children 1 to 5 Years: A Conceptual Framework for Development of the Preschool Life Impact Burn Recovery Evaluation Profile CAT. J Burn Care Res 2019; 41:84-94. [DOI: 10.1093/jbcr/irz110] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
AbstractDue to the rapid developmental growth in preschool-aged children, more precise measurement of the effects of burns on child health outcomes is needed. Expanding upon the Shriners Hospitals for Children/American Burn Association Burn Outcome Questionnaire 0 to 5 (BOQ0–5), we developed a conceptual framework describing domains important in assessing recovery from burn injury among preschool-aged children (1–5 years). We developed a working conceptual framework based on the BOQ0–5, the National Research Council and Institute of Medicine’s Model of Child Health, and the World Health Organization’s International Classification of Functioning, Disability, and Health for Children and Youth. We iteratively refined our framework based on a literature review, focus groups, interviews, and expert consensus meetings. Data were qualitatively analyzed using methods informed by grounded theory. We reviewed 95 pediatric assessments, conducted two clinician focus groups and six parent interviews, and consulted with 23 clinician experts. Three child health outcome domains emerged from our analysis: symptoms, functioning, and family. The symptoms domain describes parents’ perceptions of their child’s pain, skin-related discomfort, and fatigue. The functioning domain describes children’s physical functioning (gross and fine motor function), psychological functioning (internalizing, externalizing, and dysregulation behavior; trauma; toileting; resilience), communication and language development (receiving and producing meaning), and social functioning (connecting with family/peers, friendships, and play). The family domain describes family psychological and routine functioning outcomes.
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Affiliation(s)
- Keri J S Brady
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
- Shriners Hospitals for Children—Boston, Massachusetts
- Department of Surgery, Massachusetts General Hospital
| | - Gabrielle G Grant
- Shriners Hospitals for Children—Boston, Massachusetts
- Department of Surgery, Massachusetts General Hospital
| | - Frederick J Stoddard
- Shriners Hospitals for Children—Boston, Massachusetts
- Department of Psychiatry, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, Massachusetts
| | - Walter J Meyer
- Department of Psychiatry and Behavioral Sciences, The University of Texas Medical Branch, Galveston
- Shriners Hospitals for Children—Galveston, Texas
| | - Kathleen S Romanowski
- Shriners Hospital for Children—Northern California, Sacramento
- Department of Surgery, Division of Burn Surgery, University of California Davis School of Medicine, Sacramento
| | | | | | | | | | - Perla Rivas
- Shriners Hospitals for Children—Galveston, Texas
| | | | - Robert L Sheridan
- Shriners Hospitals for Children—Boston, Massachusetts
- Department of Surgery, Massachusetts General Hospital
- Harvard Medical School, Boston, Massachusetts
| | - Michael Murphy
- Shriners Hospitals for Children—Boston, Massachusetts
- Department of Psychiatry, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, Massachusetts
| | - Ellen H O’Donnell
- Shriners Hospitals for Children—Boston, Massachusetts
- Department of Psychiatry, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, Massachusetts
| | - T Atilla Ceranoglu
- Shriners Hospitals for Children—Boston, Massachusetts
- Department of Psychiatry, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, Massachusetts
| | - R Christopher Sheldrick
- 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
| | - Mary D Slavin
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Petra Warner
- Shriners Hospital for Children—Cincinnati, Ohio
- Department of Surgery, University of Cincinnati, Ohio
| | - Tina L Palmieri
- Shriners Hospital for Children—Northern California, Sacramento
- Department of Surgery, Division of Burn Surgery, University of California Davis School of Medicine, Sacramento
| | - Jeffrey C Schneider
- Shriners Hospitals for Children—Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts
| | - Lewis E Kazis
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Colleen M Ryan
- Shriners Hospitals for Children—Boston, Massachusetts
- Department of Surgery, Massachusetts General Hospital
- Harvard Medical School, Boston, Massachusetts
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18
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Simons M, Kimble R, McPhail S, Tyack Z. The longitudinal validity, reproducibility and responsiveness of the Brisbane Burn Scar Impact Profile (caregiver report for young children version) for measuring health-related quality of life in children with burn scars. Burns 2019; 45:1792-1809. [PMID: 31147101 DOI: 10.1016/j.burns.2019.04.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/22/2019] [Accepted: 04/16/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND The measurement of health-related quality of life (HRQoL) provides information about the perceived burden of the health condition and treatments from a lived experience. The Brisbane Burn Scar Impact Profile (caregiver report for young children, BBSIP0-8), developed in 2013, is a proxy-report measure of burn scar-specific HRQoL. The aim of this study was to report its psychometric properties in line with an evaluative purpose. METHODS Caregivers of children up to 8 years of age at risk of burn scarring were recruited into a prospective, longitudinal cohort study. Caregivers completed the BBSIP0-8, Pediatric Quality of Life Inventory and Patient Observer Scar Assessment Scale at baseline (approximately ≥85% of the total body surface area re-epithelialised), 1-2 weeks after baseline and 1-month after baseline. Psychometric properties measured included internal consistency, test-retest reliability, validity and responsiveness. RESULTS Eighty-six caregivers of mostly male children (55%), of a median age (IQR) of 1 year, 10 months (2 years, 1 month) and total body surface area burn of 1.5% (3.0%) were recruited. Over one third of participants were grafted and 15% had contractures or skin tightness at baseline. Internal consistency of ten item groups ranged from 0.73 to 0.96. Hypothesised correlations of changes in the BBSIP0-8 items with changes in criterion measures supported longitudinal validity (ρ ranging from -0.73 to 0.68). The majority of item groups had acceptable reproducibility (ICC = 0.65-0.83). The responsiveness of five item groups was supported (AUC = 0.71-0.90). CONCLUSION The psychometric properties tested support the use of the BBSIP0-8 as an evaluative measure of burn scar-related health-related quality of life for children aged below eight years in the early post-acute period of rehabilitation. Further investigation at longer time period after burn injury is indicated.
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Affiliation(s)
- M Simons
- Department of Occupational Therapy, Queensland Children's Hospital, 501 Stanley St, South Brisbane, Queensland 4101, Australia; Centre for Burns and Trauma Research, Child Health Research Centre, Level 7, Centre for Children's Health Research, Raymond Terrace, South Brisbane, 4101, Australia.
| | - R Kimble
- Centre for Burns and Trauma Research, Child Health Research Centre, Level 7, Centre for Children's Health Research, Raymond Terrace, South Brisbane, 4101, Australia; Department of Paediatric Surgery, Urology, Neonatal Surgery, Burns and Trauma, Queensland Children's Hospital, Brisbane, Queensland 4101, Australia; School of Medicine, The University of Queensland, St Lucia, Queensland 4067, Australia.
| | - S McPhail
- Institute of Health and Biomedical Innovation and School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia; Centre for Functioning and Health Research, Metro South Health, Buranda, Queensland 4102, Australia.
| | - Z Tyack
- Centre for Burns and Trauma Research, Child Health Research Centre, Level 7, Centre for Children's Health Research, Raymond Terrace, South Brisbane, 4101, Australia; Centre for Functioning and Health Research, Metro South Health, Buranda, Queensland 4102, Australia.
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Weed VF, Canenguez K, Romo S, Wang SL, Kazis L, Lee AF, Herndon D, Palmieri TL, Warner P, Haile H, Sheridan RL, Murphy JM. The Use of a Brief Measure to Assess Longitudinal Changes in Appearance Concerns for Youth Recovering From Burn Injuries. J Burn Care Res 2019; 40:97-103. [PMID: 30371792 DOI: 10.1093/jbcr/iry054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Burns are among the most common injuries to children, and, although survival rates have improved, many burn survivors are left with scars and/or other visible differences, which may be associated with anxiety, depression, and/or low self-esteem. A better understanding of the prevalence and persistence of these problems in child and adolescent burn survivors might lead to an expanded paradigm of care and possibly to better outcomes. The present study provides longitudinal prevalence data for the Appearance Concerns (AC) subscale of the parent-reported Burn Outcomes Questionnaire (BOQ) for 5- to 18-year-old children and identifies patient characteristics associated with higher risk for appearance concerns. Subjects were 799 pediatric burn survivors who were assessed prospectively using the parent-reported BOQ5-18, which was administered soon after their discharge from acute care and again every 3 to 6 months for up to 4 years. Approximately 20% of all youth were reported to have appearance concerns over the first 2 years, after which the rate declined gradually, falling to around 10% after 3 years. This study showed that such concerns were prevalent and persistent years after burn injuries and suggested that larger burns, facial burns, and country of origin outside of the United States were all associated with higher scores on the AC subscale. These findings highlight the importance of assessing appearance concerns in the long-term care of young burn survivors and suggest that the BOQ5-18 AC subscale could be used to identify individuals with heightened appearance concerns and to measure their response to interventions.
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Affiliation(s)
- Valerie F Weed
- Clinical Research, Shriners Hospitals for Children-Boston, Massachusetts
| | - Katia Canenguez
- Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Stephanie Romo
- Clinical Research, Shriners Hospitals for Children-Boston, Massachusetts
| | - Shirley L Wang
- Clinical Research, Shriners Hospitals for Children-Boston, Massachusetts
| | - Lewis Kazis
- Public Health, Boston University, Massachusetts
| | - Austin F Lee
- Mathematical Sciences, Bentley University, Waltham, Massachusetts
| | - David Herndon
- Surgery, Shriners Hospitals for Children-Galveston, Texas
| | - Tina L Palmieri
- Surgery, Shriners Hospitals for Children-Northern California, Sacramento
| | - Petra Warner
- Surgery, Shriners Hospitals for Children-Cincinnati, Ohio
| | - Haregnesh Haile
- Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | | | - J Michael Murphy
- Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
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A Review of Validated Quality-of-Life Patient-Reported Outcome Measures in Pediatric Plastic Surgery. Plast Reconstr Surg 2018; 142:694e-707e. [DOI: 10.1097/prs.0000000000004841] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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21
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Dore EC, Marino M, Ni P, Lomelin-Gascon J, Sonis L, Amaya F, Ryan CM, Schneider JC, Jette AM, Kazis LE. Reliability & validity of the LIBRE Profile. Burns 2018; 44:1750-1758. [PMID: 30075970 DOI: 10.1016/j.burns.2018.04.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 03/20/2018] [Accepted: 04/04/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND The Life Impact Burn Recovery Evaluation (LIBRE) Profile© was developed using Item Response Theory methods to assess social participation after a burn injury. The LIBRE Profile measures six areas of social participation: Relationships with Family & Friends, Social Interactions, Social Activities, Work & Employment, Romantic Relationships, and Sexual Relationships. It can be administered through a computerized adaptive test or through fixed short forms. The goal of this study was to further examine the psychometric properties of the LIBRE Profile, including reliability and validity. METHODS We examined the validity of the LIBRE Profile by administering the six LIBRE Profile scales as well as legacy measures that assessed similar constructs. We calculated the Pearson correlations between the LIBRE Profile scales and the scores on the same-domain and cross-domain legacy measures to evaluate convergent and divergent validity. We then administered the LIBRE Profile scales a second time, seven to ten days after the first administration, to a sample of adult burn survivors to evaluate test-retest reliability. We calculated repeatability coefficients, standard error of measurement, and minimal detectable change to establish the threshold beyond which the amount of change observed across an episode of care cannot be explained as measurement error. RESULTS For reliability, the repeatability coefficients ranged from 7.31 to 9.27 and SEMs ranged from 2.62 to 3.39 for all six scales. MDC90 values ranged from 6.08 to 7.86 points, and MDC95 values ranged from 7.26 to 9.40 points. All correlations between the LIBRE Profile scales and legacy measures are significant (p<0.05) and in the expected directions for both convergent and divergent validity. CONCLUSIONS This study provided evidence for the reliability and validity of the LIBRE Profile, one of the first tools that measures exclusively the social participation after a burn injury.
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Affiliation(s)
- Emily C Dore
- Boston University School of Public Health, Department of Health Law, Policy, and Management, United States
| | - Molly Marino
- Boston University School of Public Health, Department of Health Law, Policy, and Management, United States
| | - Pengsheng Ni
- Boston University School of Public Health, Department of Health Law, Policy, and Management, United States
| | - Julieta Lomelin-Gascon
- Boston University School of Public Health, Department of Health Law, Policy, and Management, United States
| | - Lily Sonis
- Boston University School of Public Health, Department of Health Law, Policy, and Management, United States
| | - Flor Amaya
- Boston University School of Public Health, Department of Health Law, Policy, and Management, United States
| | - Colleen M Ryan
- Department of Surgery, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States; Shriners Hospitals for Children - Boston(®), Boston, MA, United States
| | - Jeffrey C Schneider
- Harvard Medical School, Boston, MA, United States; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Alan M Jette
- MGH Institute of Health Professions, United States
| | - Lewis E Kazis
- Boston University School of Public Health, Department of Health Law, Policy, and Management, United States.
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King ICC. Body image in paediatric burns: a review. BURNS & TRAUMA 2018; 6:12. [PMID: 29744373 PMCID: PMC5930865 DOI: 10.1186/s41038-018-0114-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 04/04/2018] [Indexed: 11/10/2022]
Abstract
Burn injuries in children can result in life-long disfigurement. As medical and surgical techniques of burn management improve survival prospects more than ever before, body image adjustment is increasingly a central consideration in the care of burn-injured individuals. An appreciation that both physiological and psychosocial processes underpin such injuries is key to understanding wound healing. Perceptions of idealized body images in Western society challenge children and their families as they grow up with and adapt to disfigurement from burns. Whilst many studies have examined the psychosocial recovery of adults with burn injuries, few have considered the impact on burn-injured children. This paper explores the models of body image and discusses the relevance of these to research and practice in understanding how to manage burns in children.
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Affiliation(s)
- Ian C C King
- Department of Plastic and Reconstructive Surgery, St George's Hospital, Tooting, London, SW17 0QT UK
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Marino ME, Dore EC, Ni P, Ryan CM, Schneider JC, Acton A, Jette AM, Kazis LE. Developing Item Response Theory–Based Short Forms to Measure the Social Impact of Burn Injuries. Arch Phys Med Rehabil 2018; 99:521-528. [PMID: 28888383 PMCID: PMC10176271 DOI: 10.1016/j.apmr.2017.06.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 06/28/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To develop self-reported short forms for the Life Impact Burn Recovery Evaluation (LIBRE) Profile. DESIGN Short forms based on the item parameters of discrimination and average difficulty. SETTING A support network for burn survivors, peer support networks, social media, and mailings. PARTICIPANTS Burn survivors (N=601) older than 18 years. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The LIBRE Profile. RESULTS Ten-item short forms were developed to cover the 6 LIBRE Profile scales: Relationships with Family & Friends, Social Interactions, Social Activities, Work & Employment, Romantic Relationships, and Sexual Relationships. Ceiling effects were ≤15% for all scales; floor effects were <1% for all scales. The marginal reliability of the short forms ranged from .85 to .89. CONCLUSIONS The LIBRE Profile-Short Forms demonstrated credible psychometric properties. The short form version provides a viable alternative to administering the LIBRE Profile when resources do not allow computer or Internet access. The full item bank, computerized adaptive test, and short forms are all scored along the same metric, and therefore scores are comparable regardless of the mode of administration.
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Burns in Children. J Burn Care Res 2018; 38:e618-e624. [PMID: 28328667 DOI: 10.1097/bcr.0000000000000536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Children have a great deal to gain from recent and future advances in burn care. A very broad range of realized and potential developments are involved. These will be very briefly reviewed within the context of four areas: 1) early evaluation and care issues, 2) acute surgical and critical care issues, 3) rehabilitation and reconstruction issues, and 4) organizational and outcomes issues.
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25
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Parents' perceived quality of pediatric burn care. J Crit Care 2018; 43:256-259. [DOI: 10.1016/j.jcrc.2017.08.037] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 08/26/2017] [Indexed: 11/22/2022]
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Jones LL, Calvert M, Moiemen N, Deeks JJ, Bishop J, Kinghorn P, Mathers J. Outcomes important to burns patients during scar management and how they compare to the concepts captured in burn-specific patient reported outcome measures. Burns 2017; 43:1682-1692. [PMID: 29031889 DOI: 10.1016/j.burns.2017.09.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 08/21/2017] [Accepted: 09/15/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND Pressure garment therapy (PGT) is an established treatment for the prevention and treatment of hypertrophic scarring; however, there is limited evidence for its effectiveness. Burn survivors often experience multiple issues many of which are not adequately captured in current PGT trial measures. To assess the effectiveness of PGT it is important to understand what outcomes matter to patients and to consider whether patient-reported outcome measures (PROMs) can be used to ascertain the effect of treatments on patients' health-related quality of life. This study aimed to (a) understand the priorities and perspectives of adult burns patients and the parents of burns patients who have experienced PGT via in-depth qualitative data, and (b) compare these with the concepts captured within burn-specific PROMs. METHODS We undertook 40 semi-structured interviews with adults and parents of paediatric and adolescent burns patients who had experienced PGT to explore their priorities and perspectives on scar management. Interviews were audio-recorded, transcribed and thematically analysed. The outcomes interpreted within the interview data were then mapped against the concepts captured within burn-specific PROMs currently in the literature. RESULTS Eight core outcome domains were identified as important to adult patients and parents: (1) scar characteristics and appearance, (2) movement and function, (3) scar sensation, (4) psychological distress, adjustments and a sense of normality, (5) body image and confidence, (6) engagement in activities, (7) impact on relationships, and (8) treatment burden. CONCLUSIONS The outcome domains presented reflect a complex holistic patient experience of scar management and treatments such as PGT. Some currently available PROMs do capture the concepts described here, although none assess psychological adjustments and attainment of a sense of normality following burn injury. The routine use of PROMs that represent patient experience and their relative contribution to trial outcome assessment versus clinical measures is now a matter for further research and debate.
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Affiliation(s)
- Laura L Jones
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Melanie Calvert
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Naiem Moiemen
- The Scar Free Foundation Centre for Burns Research, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TH, UK
| | - Jonathan J Deeks
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Jonathan Bishop
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Philip Kinghorn
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Jonathan Mathers
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK.
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- Membership of the Pegasus Study Group is provided in the Acknowledgements
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28
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Development of International Outcomes Instrument for Hand and Upper Extremity Burn Scar Contracture Release. J Burn Care Res 2017; 38:e395-e401. [DOI: 10.1097/bcr.0000000000000403] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ryan CM, Cartwright S, Schneider JC, Tompkins RG, Kazis LE. The burn outcome questionnaires: Patient and family reported outcome metrics for children of all ages. Burns 2016; 42:1144-1145. [PMID: 26803370 PMCID: PMC10001424 DOI: 10.1016/j.burns.2015.10.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 10/27/2015] [Indexed: 11/16/2022]
Affiliation(s)
- Colleen M Ryan
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, USA; Shriners Hospitals for Children-Boston, USA; Spaulding Rehabilitation Hospital, Harvard Medical School, USA.
| | - Sara Cartwright
- Spaulding Rehabilitation Hospital, Harvard Medical School, USA
| | - Jeffrey C Schneider
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, USA; Shriners Hospitals for Children-Boston, USA; Spaulding Rehabilitation Hospital, Harvard Medical School, USA
| | - Ronald G Tompkins
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, USA
| | - Lewis E Kazis
- Center for the Assessment of Pharmaceutical Practices (CAPP), Department of Health Policy and Management, Boston University School of Public Health, Boston, MA, USA
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Griffiths C, Armstrong-James L, White P, Rumsey N, Pleat J, Harcourt D. Response to Letter to the Editor: 'The Burn Outcome Questionnaires: Patient and Family Reported Outcome Metrics for Children of All Ages'. Burns 2016; 42:1145-1147. [PMID: 27215150 DOI: 10.1016/j.burns.2015.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 11/23/2015] [Indexed: 12/22/2022]
Affiliation(s)
- Catrin Griffiths
- Centre for Appearance Research (CAR), University of the West of England, Bristol, United Kingdom.
| | - Laura Armstrong-James
- Centre for Appearance Research (CAR), University of the West of England, Bristol, United Kingdom
| | - Paul White
- Department of Engineering Design and Mathematics, University of the West of England, Bristol, United Kingdom
| | - Nichola Rumsey
- Centre for Appearance Research (CAR), University of the West of England, Bristol, United Kingdom
| | - Jonathon Pleat
- Department of Plastic Surgery, Southmead Hospital, Bristol, United Kingdom
| | - Diana Harcourt
- Centre for Appearance Research (CAR), University of the West of England, Bristol, United Kingdom
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Hardwicke J. The influence of outcomes on the provision and practice of burn care. Burns 2016; 42:307-15. [DOI: 10.1016/j.burns.2015.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Accepted: 07/06/2015] [Indexed: 01/10/2023]
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Willebrand M, Sveen J. Perceived support in parents of children with burns. Gen Hosp Psychiatry 2016; 38:105-8. [PMID: 26596191 DOI: 10.1016/j.genhosppsych.2015.10.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 10/14/2015] [Accepted: 10/15/2015] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Children sustaining burns that require treatment in a burn center have a need for multiprofessional aftercare services over a prolonged time. So far, there is little research into satisfaction with care and support after pediatric burns. The aim was to investigate parents' perception of support after pediatric burn and associations with parent, child and injury characteristics. METHOD Parents (n=101) of children aged 0.4-17.8 years completed questionnaires on support, parent's psychological symptoms and health of the child. Time since injury was 0.1-9.0 years. RESULTS Perceived lack of psychosocial, medical, societal or family support was reported by 21% of the parents. Lack of support was not associated with injury or sociodemographic characteristics, but it was significantly associated with parents' symptoms of general anxiety, depression and injury-related fear avoidance, as well as parents' ratings of their child's general health and heat sensitivity. CONCLUSION Perceived support did not differ on account of burn severity or sociodemographic status. However, care providers should be more attentive to and supportive of parents signaling poorer general health in their child and cognitive beliefs that the child is at risk for harm when active and parents who themselves show signs of psychological symptoms.
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Affiliation(s)
- M Willebrand
- Department of Neuroscience (Psychiatry), Uppsala University, 751 85 Uppsala, Sweden.
| | - J Sveen
- Department of Neuroscience (Psychiatry), Uppsala University, 751 85 Uppsala, Sweden.
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Internet-based information and self-help program for parents of children with burns: Study protocol for a randomized controlled trial. Internet Interv 2015. [DOI: 10.1016/j.invent.2015.09.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Tyack Z, Ziviani J, Kimble R, Plaza A, Jones A, Cuttle L, Simons M. Measuring the impact of burn scarring on health-related quality of life: Development and preliminary content validation of the Brisbane Burn Scar Impact Profile (BBSIP) for children and adults. Burns 2015; 41:1405-19. [PMID: 26421693 DOI: 10.1016/j.burns.2015.05.021] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 05/29/2015] [Accepted: 05/29/2015] [Indexed: 12/26/2022]
Abstract
INTRODUCTION No burn-scar specific, health-related quality of life (HRQOL) measure exists. This study aimed to develop a patient-reported, evaluative HRQOL measure to assess the impact of burn scarring in children and adults. METHOD Semi-structured interviews, content validation surveys, and cognitive interviews were used to develop and test content validity of a new measure - the Brisbane Burn Scar Impact Profile (BBSIP). RESULTS Participants comprised Australian adults (n=23) and children (n=19) with burn scarring; caregivers of children with burn scarring (n=28); and international scar management experts (n=14). Items distinct from other burn scar measures emerged. Four versions of the BBSIP were developed; one for children aged 8-18 years, one for adults, one for caregivers (as proxies for children aged less than 8-years), and one for caregivers of children aged 8-18 years. Preliminary content validity of the BBSIP was supported. Final items covered physical and sensory symptoms; emotional reactions; impact on social functioning and daily activities; impact of treatment; and environmental factors. CONCLUSION The BBSIP was developed to assess burn-scar specific HRQOL and will be available at http://www.coolburns.com.au under a creative commons license. Further testing is underway.
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Affiliation(s)
- Zephanie Tyack
- Centre for Children's Burns and Trauma Research, Child Health Research Centre, Level 4, Foundation Building, Royal Children's Hospital, Herston Rd, Herston, Brisbane, Queensland 4006, Australia; Central Queensland Hospital and Health Service, East St, Rockhampton, Queensland 4700, Australia.
| | - Jenny Ziviani
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, Queensland 4067, Australia.
| | - Roy Kimble
- Centre for Children's Burns and Trauma Research, Child Health Research Centre, Level 4, Foundation Building, Royal Children's Hospital, Herston Rd, Herston, Brisbane, Queensland 4006, Australia; Department of Paediatric Surgery, Urology, Neonatal Surgery, Burns and Trauma, Lady Cilento Children's Hospital, Brisbane, Queensland 4101, Australia; School of Medicine, The University of Queensland, St Lucia, Brisbane, Queensland 4067, Australia.
| | - Anita Plaza
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Butterfield St, Herston, Brisbane, Queensland 4006, Australia.
| | - Amber Jones
- Occupational Therapy Department, Royal Brisbane and Women's Hospital, Butterfield St, Herston, Brisbane, Queensland 4006, Australia.
| | - Leila Cuttle
- Centre for Children's Burns and Trauma Research, Child Health Research Centre, Level 4, Foundation Building, Royal Children's Hospital, Herston Rd, Herston, Brisbane, Queensland 4006, Australia.
| | - Megan Simons
- Centre for Children's Burns and Trauma Research, Child Health Research Centre, Level 4, Foundation Building, Royal Children's Hospital, Herston Rd, Herston, Brisbane, Queensland 4006, Australia; Department of Occupational Therapy, Lady Cilento Children's Hospital, 501 Stanley St, South Brisbane, Queensland 4101, Australia.
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Ahmedov A, Shakirov B, Karabaev H. Early diagnostics and treatment with acute burn sepsis. JOURNAL OF ACUTE DISEASE 2015. [DOI: 10.1016/j.joad.2015.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Pan R, Egberts MR, Nascimento LC, Rossi LA, Vandermeulen E, Geenen R, Van Loey NE. Health-Related Quality of Life in adolescent survivors of burns: Agreement on self-reported and mothers’ and fathers’ perspectives. Burns 2015; 41:1107-13. [DOI: 10.1016/j.burns.2014.12.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 12/05/2014] [Accepted: 12/11/2014] [Indexed: 11/26/2022]
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Griffiths C, Armstrong-James L, White P, Rumsey N, Pleat J, Harcourt D. A systematic review of patient reported outcome measures (PROMs) used in child and adolescent burn research. Burns 2014; 41:212-24. [PMID: 25300756 DOI: 10.1016/j.burns.2014.07.018] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 07/21/2014] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Patient reported outcome measures (PROMs) can identify important information about patient needs and therapeutic progress. The aim of this review was to identify the PROMs that are being used in child and adolescent burn care and to determine the quality of such scales. METHODS Computerised and manual bibliographic searches of Medline, Social Sciences Index, Cinahl, Psychinfo, Psycharticles, AMED, and HAPI, were used to identify English-language articles using English-language PROMs from January 2001 to March 2013. The psychometric quality of the PROMs was assessed. RESULTS 23 studies met the entry criteria and identified 32 different PROMs (31 generic, 1 burns-specific). Overall, the psychometric quality of the PROMs was low; only two generic scales (the Perceived Stigmatisation Questionnaire and the Social Comfort Scale) and only one burns-specific scale (the Children Burn Outcomes Questionnaire for children aged 5-18) had psychometric evidence relevant to this population. CONCLUSIONS The majority of PROMs did not have psychometric evidence for their use with child or adolescent burn patients. To appropriately identify the needs and treatment progress of child and adolescent burn patients, new burns-specific PROMs need to be developed and validated to reflect issues that are of importance to this population.
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Affiliation(s)
- C Griffiths
- Centre for Appearance Research (CAR), University of the West of England, Bristol, United Kingdom.
| | - L Armstrong-James
- Centre for Appearance Research (CAR), University of the West of England, Bristol, United Kingdom.
| | - P White
- Department of Engineering Design and Mathematics, University of the West of England, Bristol, United Kingdom.
| | - N Rumsey
- Centre for Appearance Research (CAR), University of the West of England, Bristol, United Kingdom.
| | - J Pleat
- Department of Plastic Surgery, Southmead Hospital, Bristol, United Kingdom.
| | - D Harcourt
- Centre for Appearance Research (CAR), University of the West of England, Bristol, United Kingdom.
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Abstract
Burn injury affects all facets of life. Burn care has improved over time. Improved survival after burn injury has resulted in a shift in outcome measurement from inpatient morbidity and mortality to long-term functional and health-related quality-of-life measures. Integration of professionals from different disciplines has enabled burn centers to develop collaborative methods of assessing the quality of care delivered to patients with burns based on their ability to reintegrate into their normal physical, social, psychological, and functional activities. Burn outcomes will continue to develop on the foundation that has been built and will generate evidence-based best practices in the future.
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Affiliation(s)
- Tina L Palmieri
- Department of Surgery, University of California, Davis, Regional Burn Center, Davis, CA, USA; Shriners Hospital for Children Northern California, Sacramento, CA, USA.
| | - Rene Przkora
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX, USA; Shriners Hospital for Children, Galveston, TX, USA
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Health-related quality of life in Swedish pediatric burn patients and associations with burn and family characteristics. Burns 2014; 40:987-94. [DOI: 10.1016/j.burns.2013.10.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 10/03/2013] [Accepted: 10/04/2013] [Indexed: 11/20/2022]
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Sveen J, Sjöberg F, Öster C. Response to Letter to the Editor: ‘Sleep quality implicates in life quality: An analysis about children who suffered burns.’. Burns 2014; 40:775-6. [DOI: 10.1016/j.burns.2013.12.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 12/20/2013] [Indexed: 11/15/2022]
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Ehanire T, Vissoci JRN, Slaughter K, Coêlho R, Bond J, Rodrigues C, Pietrobon R, Levinson H. A systematic review of the psychometric properties of self-reported scales assessing burn contractures reveals the need for a new tool to measure contracture outcomes. Wound Repair Regen 2013; 21:520-9. [PMID: 23758108 DOI: 10.1111/wrr.12058] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2012] [Accepted: 03/25/2013] [Indexed: 12/18/2022]
Abstract
Approximately 40% of burn patients develop scar contractures. It is unknown which scar contracture therapy best optimizes activities of daily living (ADL).The appropriateness of self-reported outcome tools in measuring anti-scar contracture therapies has not been assessed. We conducted a systematic review to determine the quality of existing self-reported scales in measuring ADL among burn patients by analyzing and comparing psychometric properties-factor analysis, validity, reliability, and responsiveness. EMBASE, LILACS, American Psychological Association PsycNET databases were searched for relevant articles. Forty-one articles discussing 10 burn and non-burn-specific scales met eligibility criteria of ADL assessment, and available psychometric analyses. A common strength in most scales was good overall reliability. Common weaknesses were insufficient data on factor analyses, content validity specific to ADL assessment, and responsiveness. The psychometric analyses studies on these scales had poor sample variability. There is insufficient data on the dimensionality and responsiveness of existing scales to support their use for measuring ADL in burn patients. Existing scales do not comprehensively measure ADLs as an isolated parameter. A psychometrically valid, comprehensive self-reported burn contracture scale that measures ADLs among a diverse group of burn patients needs to be developed to optimize burn contracture treatments and develop new therapies.
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Affiliation(s)
- Tosan Ehanire
- Duke University School of Medicine, Durham, NC 27710, USA
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The American Burn Association/Shriners Hospitals for Children Burn Outcomes Program: a progress report at 15 years. J Trauma Acute Care Surg 2012; 73:S173-8. [PMID: 22929544 DOI: 10.1097/ta.0b013e318265c53e] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The American Burn Association and the Shriners Hospitals for Children Outcomes Program has been in development for more than 15 years. Many of the tools and important findings are described in this special issue of The Journal of Trauma. This unique program in outcomes research introduces a model for outcome assessments from the patient-centered perspective with a cohort of 1,140 children with burn injury after hospitalization for up to 4 years. The findings represent a fundamental contribution to the field of burn care for monitoring outcomes from the perspective of the parent or child/adolescent. The Multi-Center Benchmarking Study of four burn centers serve as a model for collecting empiric scientific data on the variation and the expected trajectories of recovery in the most important domains of patient outcomes and can inform clinical decisions and the conduct of health service research. The dramatic progress in survival of children with severe burn injury and other advances in burn management can now move into a new phase of understanding the most cost-effective components of this care.
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Adolescent survivors of burn injuries and their parents’ perceptions of recovery outcomes. J Trauma Acute Care Surg 2012; 73:S213-20. [DOI: 10.1097/ta.0b013e318265c843] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Methods for assessment of health outcomes in children with burn injury. J Trauma Acute Care Surg 2012; 73:S179-88. [DOI: 10.1097/ta.0b013e318265c552] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
BACKGROUND Burns occur frequently in young children. To date, insufficient data are available to fully describe the functional consequences of burns. In different patient populations and countries, the WeeFIM instrument ("WeeFIM") often is used to measure functional independence in children. OBJECTIVE The purpose of this study was to examine the psychometric properties of the WeeFIM instrument for use in Dutch burn centers. DESIGN This was an observational study. METHODS The WeeFIM instrument was translated into Dutch. All clinicians who rated the children with the instrument passed the WeeFIM credentialing examination. They scored consecutive children (n=134) aged 6 months to 16 years admitted to Dutch burn centers with acute burns during a 1-year period at 2 to 3 weeks, 3 months, and 6 months postburn. To examine reliability, 2 raters scored a child at the same time (n=52, 9 raters) or the same rater scored a child twice within 1 week (n=7, 3 raters). RESULTS After a few weeks, the WeeFIM assessment could be administered in less than 15 minutes. Clinicians thought it was difficult to rate a child aged between 2 and 4 years as well as the cognitive items. Nevertheless, reliability was good (all intraclass correlation coefficients [1,1] were above .80). The standard error of measurement was 3.7. LIMITATIONS Intrarater reliability was based on only 7 test-retest measurements. Within our clinical setting, it turned out to be difficult to schedule the same rater and patient twice in one week for repeated assessments. Assessments for interrater reliability, on the other hand, worked out well. CONCLUSIONS The WeeFIM instrument is a feasible and reliable instrument for use in children with burns. For evaluation of a child's individual progress, at least 11 points' improvement should be observed to state that a child has significantly improved.
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Outcome measurement tools currently used to assess pediatric burn patients: an occupational therapy and physiotherapy perspective. J Burn Care Res 2012; 32:600-7. [PMID: 22002208 DOI: 10.1097/bcr.0b013e31822dc450] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Given the high incidence of burn injuries in children, it is important that all clinicians involved in the care of these patients, including occupational therapists and physiotherapists, are able to assess patients with valid, sensitive, and reliable measurement tools to optimize outcomes and clinical management. The aims of this study were to identify therapist- relevant outcome measurement tools that have been previously used with pediatric burn patients and to ascertain the outcome measurement tools currently used by occupational therapists and physiotherapists working in pediatric burns units. A literature review was undertaken to identify therapist-relevant outcome measurement tools that have been used in the pediatric burn population. A survey involving therapists working in Australian pediatric burns units was then conducted to identify outcome measurement tools in common usage. Few outcome measurement tools were identified that had been specifically validated for use, or were in common usage in Australia, with pediatric patients with burn injury. The lack of validated and widely used measurement tools adversely impacts on the ability of therapists to accurately assess outcomes of treatment and undertake clinical research involving pediatric patients with burn injury.
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Affiliation(s)
- Ronald G Tompkins
- Massachusetts General Hospital/Harvard Medical School, Boston, 02114, USA.
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Psychometric Properties of the Swedish Version of the Burn Outcomes Questionnaire for Children Aged 5 to 18 Years. J Burn Care Res 2012; 33:e286-94. [DOI: 10.1097/bcr.0b013e3182331aaa] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Willebrand M, Sveen J, Ramklint MM, Bergquist RM, Huss MF, Sjöberg MF. Psychological problems in children with burns—Parents’ reports on the Strengths and Difficulties Questionnaire. Burns 2011; 37:1309-16. [DOI: 10.1016/j.burns.2011.08.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Accepted: 08/03/2011] [Indexed: 11/28/2022]
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