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Jawad AM, Kadhum M, Evans J, Cubitt JJ, Martin N. Recovery of functional independence following major burn: A systematic review. Burns 2024; 50:1406-1423. [PMID: 38492981 DOI: 10.1016/j.burns.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/07/2024] [Accepted: 02/21/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Major burn injury, despite advancements in care and prevention, can have a profound impact on long-term morbidity, affecting quality of life and socioeconomic standing. We aim to explore factors predicting recovery of independence, the expected rate and time in majorly burned patients, and the measures of progress used. METHOD A systematic search of four databases (MEDLINE, EMBASE, COCHRANE, CINAHL) was conducted for studies reporting outcomes pertaining to physical ability indicative of independent function in adult (>15 y) cohorts who had suffered a major burn (>20% TBSA) up to 30 years after treatment in a developed specialised burn service. Data extracted included factors affecting rate of and time to achievement of function in five independence domains, as well as the outcome measures used. RESULTS 21 eligible studies were included comprising 1298 major burns survivors with a combined mean age of 39.6 y and a mean TBSA of 25.8%. The most significant recurring factors impacting recovery of independent function were older age, female gender, burn severity, prolonged ICU and hospital admission, preceding mental health conditions, and post-acute psychological issues. Exercise-based rehabilitation conferred benefits on major burn patients even over 2 years following injury. Discharge to independent living from hospital occurred in 27% to 97% of patients, while reported return to work rates varied from 52% to 80%. Burns Specific Health Scale-Brief, Functional Independence Measure, and Physical Composite Score (SF-36) were the most widely used outcome scoring systems. CONCLUSION Major burn survivors have protracted recovery with potential for persistent chronic impairments, remaining consistently below baseline levels of function. Non-modifiable factors such as age and gender, and disease characteristics such as burn size with associated physical, physiological and psychosocial sequelae are contributory. Further research is required to explore achievement of specific milestones of major burn and polytrauma critical care patients, while early targeted rehabilitation addressing physical, psychological, and vocational needs has promising potential benefit.
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Affiliation(s)
- Ali M Jawad
- Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, UK; Welsh Centre for Burns and Plastic Surgery, Swansea, Wales, UK.
| | - Murtaza Kadhum
- Welsh Centre for Burns and Plastic Surgery, Swansea, Wales, UK
| | - Janine Evans
- Welsh Centre for Burns and Plastic Surgery, Swansea, Wales, UK
| | | | - Niall Martin
- Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, UK
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Hagendijk ME, Zipfel N, Melles M, van der Wees PJ, Hulshof CTJ, Zwaan E, van der Burg-Vermeulen SJ, Hoving JL. Patients' Needs Regarding Work-Focused Healthcare: A Qualitative Evidence Synthesis. JOURNAL OF OCCUPATIONAL REHABILITATION 2024:10.1007/s10926-024-10225-8. [PMID: 39052178 DOI: 10.1007/s10926-024-10225-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/12/2024] [Indexed: 07/27/2024]
Abstract
PURPOSE To identify, appraise, and synthesize qualitative research evidence exploring patients' needs regarding work-focused healthcare. METHODS A systematic review was conducted in accordance with the PRISMA statement guidelines to identify studies reporting patients' needs regarding work-focused healthcare. Four databases (MEDLINE, Embase, PsychInfo and Web of Science) were systematically searched from January 2000 until May 2023 and screened in duplicate by pairs of two reviewers. Inclusion criteria were qualitative data collection method, and patients' perspectives regarding healthcare focusing on work when experiencing work-related problems due to chronic medical conditions. Data extraction and synthesis was executed by means of an inductive thematic analysis approach. The quality of the included studies was assessed using the CASP Qualitative Study checklist. Confidence in the review findings was assessed through the Confidence in the Evidence from Reviews of Qualitative research (CERQual) approach. RESULTS Out of 23,677 records, 97 qualitative studies were included. Needs regarding four main themes were identified: (1) Substantive guidance, which comprises the specific content of work-focused healthcare; (2) Clear and continuous process, which comprises clarification and optimization of the work-focused healthcare process; (3) Supportive attitude and behavior, which comprises a positive and supportive attitude and behavior from professionals towards the patients; and (4) Tailored approach, which comprises the delivery of tailored care to the individuals' needs. 17 subthemes were identified. CONCLUSION The broader insight in patients' needs in work-focused healthcare can help (occupational) healthcare professionals adopt a more patient-centred approach in practice.
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Affiliation(s)
- Marije E Hagendijk
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Nina Zipfel
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Marijke Melles
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Philip J van der Wees
- Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud Institute for Health Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Carel T J Hulshof
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Elmi Zwaan
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Sylvia J van der Burg-Vermeulen
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Jan L Hoving
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Dutch Research Center for Insurance Medicine, Amsterdam, The Netherlands
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Katsu A, Mackenzie L, Elliott JM, Mackey M, Tyack Z. Return-to-employment for working-aged adults after burn injury: A mixed methods scoping review. Work 2024:WOR230148. [PMID: 38578910 DOI: 10.3233/wor-230148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND This scoping review aimed to identify the barriers, facilitators and benefits of returning to work following burn injury, outcome measures used, management strategies, and models of care. OBJECTIVE To provide a comprehensive overview about working-aged adults returning to their preinjury employment after burn injury. METHODS We followed a pre-determined scoping review protocol to search MEDLINE, CINAHL, Embase, PsycINFO, PubMed, Scopus, CCRCT and CDSR databases between 2000 to December 2023. Papers reporting primary data from previously employed adults with cutaneous burn injuries were included. RESULTS In all, 90 articles met the review criteria. Return-to-work was both an outcome goal and process of recovery from burn injury. Physical and psychological impairments were identified barriers. Job accommodations and modifications were important for supporting the transition from hospital to workplace. Employment status and quality of life sub-scales were used to measure return-to-work. CONCLUSIONS Consistent definitions of work and measurements of return-to-employment after burn injury are priorities for future research. Longitudinal studies are more likely to capture the complexity of the return-to-employment process, its impact on work participation and changes in employment over time. The social context of work may assist or hinder return-to-work more than physical environmental constraints. Equitable vocational support systems would help address disparities in vocational rehabilitation services available after burn injury.
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Affiliation(s)
- Akane Katsu
- Discipline of Occupational Therapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - James M Elliott
- The Kolling Institute, Northern Sydney Local Health District, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Martin Mackey
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Zephanie Tyack
- Australian Centre for Health Services Innovation (AusHSI), Centre for Healthcare Transformation and School of Public Health and Social Work, Queensland University of Technology, Australia
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Katsu A, Mackenzie L, Tyack Z, Mackey M. Understanding return-to-employment experiences after burns: Qualitative scoping review findings. Aust Occup Ther J 2024; 71:113-131. [PMID: 37990624 DOI: 10.1111/1440-1630.12915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/21/2023] [Accepted: 10/25/2023] [Indexed: 11/23/2023]
Abstract
INTRODUCTION Participation in work and employment is a milestone of adulthood. People returning to work after burn injury may have physical, psychological, social, and environmental barriers to overcome in order to resume their pre-injury employment. The aim of this paper is to evaluate qualitative findings regarding return-to-employment after burn injury. METHODS A qualitative synthesis was conducted based on the qualitative findings of an earlier mixed methods review. A pre-determined scoping review protocol was used in the earlier review to search MEDLINE, CINAHL, Embase, PsycINFO, PubMed, Scopus, CCRCT, and CDSR databases between 2000 and Aug 2021. Any papers presenting qualitative data from previously employed adults with cutaneous burn injuries were included. FINDINGS A total of 20 papers with qualitative data on return-to-employment after burn injury were found. Only six included studies focused on return-to-employment outcomes and the remaining studies reporting on quality of life and life experiences after burn injury. Common themes included impairments that develop and change over time; occupational identity and meaning; temporal aspects of burn recovery; burn rehabilitation services and interventions; attitudes, knowledge and support of service providers; workplace environments supporting work re-engagement after burn injury; usefulness of work accommodations; family and social supports, individuals attributes that influence re-engaging in employment; and accepting and rebuilding. CONCLUSION Resumption of work after burn injury is regarded as a key marker of recovery for working-aged adults by burn survivors and burn care professionals. Support at transition points during the burn recovery process and peer-led programmes were important. However, limited information currently exists regarding clinical practices, service gaps, and understanding of return-to-employment outcomes after burn injury.
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Affiliation(s)
- Akane Katsu
- Discipline of Occupational Therapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Zephanie Tyack
- Australian Centre for Health Services Research, Faculty of Health, Queensland University of Technology, QLD, Australia
| | - Martin Mackey
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Turner E, Robinson DM, Roaten K. Psychological Issues. Phys Med Rehabil Clin N Am 2023; 34:849-866. [PMID: 37806702 DOI: 10.1016/j.pmr.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Psychological distress is common following a burn injury, and many burn survivors have pre-morbid psychiatric illnesses including mood and trauma-related disorders, and substance and alcohol use. This article is intended to be used by all interdisciplinary health care team members to improve the identification and treatment of common psychological concerns experienced by survivors and is organized to follow the general recovery timeline.
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Affiliation(s)
- Emma Turner
- The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Suite CS6.104B, Dallas, TX 75390, USA.
| | - Diana M Robinson
- The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Suite CS6.104B, Dallas, TX 75390, USA.
| | - Kimberly Roaten
- The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Suite CS6.104B, Dallas, TX 75390, USA.
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Occupational burn injuries in Finland 2011-2015. Inj Epidemiol 2022; 9:28. [PMID: 36028913 PMCID: PMC9419400 DOI: 10.1186/s40621-022-00387-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 07/04/2022] [Indexed: 11/16/2022] Open
Abstract
Background This study comprises all hospitalized work-related burn injuries in one country during 2011–2015. The purpose was to describe demographics, causes and risk factors of occupational burn injuries with special focus on the outcome of return to work. Material and methods This is a retrospective study on two data sources of which Finnish Workers’ Compensation Center’s (FWCC) register includes all work-related burn cases at a given time. Additional data have been obtained from those patients, who were referred to the National Burn Centre (NBC) during the same time according to the Emergency Management of Severe Burns (EMSB) criteria. We compare demographics, injury mechanisms and general burn data of these two patient groups. Results Based on FWCC register, in 2011–2015 occurred 11,623 work-related burn cases of whom 54% were men. During the study period, NBC admitted 26 patients fulfilling EMSB criteria. The most severe patients treated in NBC had injuries affecting multiple body parts. In FWCC data, hand was most injured body part. Kitchen/bakery work was the most common profession in FWCC register but in NBC material industrial and transport professions dominated. In FWCC register, patients had lower mean age (37 years vs. 43 years). Most severe injuries occurred among older patients: In NBC data, those with total body surface area 40% or over had mean age 53 years. Majority of patients returned to work. Conclusion Safety at work in Finland has improved during last decades, and the vast majority of work-related burn injuries are minor. Minor burn injuries are common in young adults working in kitchen and bakery work, whereas elderly men working in transports and industry sustain the most severe burn accidents. Retirement after work-related injury becomes very expensive for all parties, and this data can be used in preventing those cases as well as the minor accidents.
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Hutter MF, Smolle C, Kamolz LP. Life after Burn, Part I: Health-Related Quality of Life, Employment and Life Satisfaction. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58050599. [PMID: 35630015 PMCID: PMC9143403 DOI: 10.3390/medicina58050599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/16/2022] [Accepted: 04/24/2022] [Indexed: 11/16/2022]
Abstract
Background and Objectives: As advances in medicine are proceeding, so are treatment goals shifting from sheer mortality rates to improving HRQoL and social reintegration after burn injury. Following this trend, we aimed to assess HRQoL, employment and life satisfaction after burn injury to gain insight on confounding factors. Materials and Methods: This single-center follow-up study was conducted using the SF-36 V1.0 in German and further questions evaluating employment and life satisfaction. It reached 128 adult in-patients (recall 33.0%) with former burn injuries, treated between 2012 and 2019 at the Division of Plastic, Aesthetic and Reconstructive Surgery at the University Hospital of Graz. The questionnaire outcomes were set into relation with clinical data obtained from the medical records. Statistical analysis was performed with SPSS 27.0 for Windows. Results: Of the 128 participants, 72.7% were male and 27.3% female. The mean age at the time of injury was 40.0 ± 15.7 years and mean %TBSA among the study population was 9.2 ± 11.0%. The male patients had sustained more extensive injuries (p = 0.005). However, the female patients scored significantly (p < 0.05) and consistently lower in all the domains of the SF-36, except for “bodily pain” (p = 0.061). Moreover, the female patients scored lower in all the domains of life satisfaction, although significant differences were only found in the domains of fulfillment (p = 0.050) and mental wellbeing (p = 0.015). Furthermore, employment status differed significantly between the male and female patients before as well as after the burn injury. Proportionally less women were employed at both time points. Overall, unemployment had declined. Conclusions: Life satisfaction after burn injury in this study cohort seems to be good. Return to work has shown a promising trend. Strikingly, HRQoL and life satisfaction were lower in women after burn injury. Further research on the reasons for this gender discrepancy might improve HRQoL and life satisfaction after burns.
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Jansen N. Return to work education group. BURNS OPEN 2021. [DOI: 10.1016/j.burnso.2021.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Motizuki CS, Maluf EMCP, Simonelli AP, Petterle RR. A prospective cohort study on the challenge to return to work after hospitalisation in Brazil. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:982-991. [PMID: 32816377 DOI: 10.1111/hsc.13132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 07/17/2020] [Accepted: 07/21/2020] [Indexed: 06/11/2023]
Abstract
After hospital discharge, workers are expected to return to work (RTW). However, the ability to return and any possible limitations after returning are unclear. Will they be able to RTW? Do they face limitations? This is a prospective cohort study with descriptive analysis aimed to investigate the RTW during 1 year following hospital discharge and to identify any limitations faced by the workers. Data collection occurred between February 2017 and July 2018 in an Internal Medicine Unit at a General Hospital. Convenience sampling was used, and participation was voluntary. Participants comprised 170 adults. Participants' RTW and limitations were followed for 1 year after discharge. During hospitalisation, 95.9% of participants planned to RTW. However, only 30% and 34.1% had returned after 1 month and 1 year respectively. Initially, 57.6% did not believe that they would present any limitation after discharge. However, 85.3% experienced restrictions after 1 month, and after 1 year this percentage rose to 88.2%. A correlation was found between young adults and RTW. The presence of limitations increased non-RTW risk. Therefore, it is recommended that the worker role should not be merely replaced by that of a patient, but it deserves attention of the latter in order to RTW activities. The work-return process must focus on understanding, treating and monitoring workers' limitations over time.
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Affiliation(s)
- Camila S Motizuki
- Department of Internal Medicine, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Eliane M C P Maluf
- Department of Internal Medicine, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Angela P Simonelli
- Occupational Therapy Departament, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Ricardo R Petterle
- Departament of Integrative Medicine, Federal University of Paraná, Curitiba, Paraná, Brazil
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Sanderson RW, Fang Q, Curatolo A, Taba A, DeJong HM, Wood FM, Kennedy BF. Smartphone-based optical palpation: towards elastography of skin for telehealth applications. BIOMEDICAL OPTICS EXPRESS 2021; 12:3117-3132. [PMID: 34221649 PMCID: PMC8221962 DOI: 10.1364/boe.424567] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 06/13/2023]
Abstract
Smartphones are now integral to many telehealth services that provide remote patients with an improved diagnostic standard of care. The ongoing management of burn wounds and scars is one area in which telehealth has been adopted, using video and photography to assess the repair process over time. However, a current limitation is the inability to evaluate scar stiffness objectively and repeatedly: an essential measurement for classifying the degree of inflammation and fibrosis. Optical elastography detects mechanical contrast on a micrometer- to millimeter-scale, however, typically requires expensive optics and bulky imaging systems, making it prohibitive for wide-spread adoption in telehealth. More recently, a new variant of optical elastography, camera-based optical palpation, has demonstrated the capability to perform elastography at low cost using a standard digital camera. In this paper, we propose smartphone-based optical palpation, adapting camera-based optical palpation by utilizing a commercially available smartphone camera to provide sub-millimeter resolution imaging of mechanical contrast in scar tissue in a form factor that is amenable to telehealth. We first validate this technique on a silicone phantom containing a 5 × 5 × 1 mm3 embedded inclusion, demonstrating comparative image quality between mounted and handheld implementations. We then demonstrate preliminary in vivo smartphone-based optical palpation by imaging a region of healthy skin and two scars on a burns patient, showing clear mechanical contrast between regions of scar tissue and healthy tissue. This study represents the first implementation of elastography on a smartphone device, extending the potential application of elastography to telehealth.
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Affiliation(s)
- Rowan W. Sanderson
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre Nedlands and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia 6009, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Crawley 6009, Australia
| | - Qi Fang
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre Nedlands and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia 6009, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Crawley 6009, Australia
| | - Andrea Curatolo
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Crawley 6009, Australia
- Currently with International Centre for Translational Eye Research, Skierniewicka 10A, 01-230 Warsaw, Poland and Institute of Physical Chemistry, Polish Academy of Sciences, ul. Kasprzaka 44/52, 01-224 Warsaw, Poland
| | - Aiden Taba
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre Nedlands and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia 6009, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Crawley 6009, Australia
| | - Helen M. DeJong
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre Nedlands and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia 6009, Australia
- Perth Scar and Pain Clinic, Mt Pleasant, Western Australia 6160, Australia
- Fiona Wood Foundation, Fiona Stanley Hospital, Murdoch, Western Australia 6150, Australia
| | - Fiona M. Wood
- Fiona Wood Foundation, Fiona Stanley Hospital, Murdoch, Western Australia 6150, Australia
- Burn Injury Research Unit, The University of Western Australia, Crawley, Western Australia 6009, Australia
- Burn Service of Western Australia, Fiona Stanley Hospital, Murdoch, Western Australia 6150, Australia
| | - Brendan F. Kennedy
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre Nedlands and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia 6009, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, Crawley 6009, Australia
- Australian Research Council Centre for Personalised Therapeutics Technologies, Australia
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Kim KJ, Boo S, Oh H. Burn Survivors' Experiences of the Ongoing Challenges after Discharge in South Korea: A Qualitative Study. Adv Skin Wound Care 2021; 34:1-6. [PMID: 33797424 DOI: 10.1097/01.asw.0000734380.80661.cc] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To help burn survivors during the recovery time after discharge, healthcare professionals need to understand their experiences and care requirements. However, little is known about the experience of burn survivors after discharge in South Korea. This study aims to explore their experiences in a community setting. METHODS Using a qualitative descriptive format, data were collected by semistructured interview from 10 patients who had sustained major burns. Each interview was based on a protocol of 60 to 90 minutes' duration and used a qualitative content analysis. RESULTS Three themes were identified in the analysis: (1) ongoing distressing symptoms and the unpredictability of hypertrophic scars, (2) difficulties in reintegration into society, and (3) burden of health expenditure. CONCLUSIONS Several participants expressed consistent difficulties with distressing symptoms such as wound pain, pruritus, sleep disturbances, and unpredictable scar and symptom changes. Survivors further described the financial burden associated with high expenditures from nonreimbursable rehabilitation expenses, and the high cost incurred with consistent skin care. By providing support based on their needs, appropriate interventions would be more readily available for burn survivors.
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Affiliation(s)
- Kyung Ja Kim
- Kyung Ja Kim, PhD, RN, is Unit Manager, Hangang Sacred Heart Hospital, Hallym University, Seoul, Korea. Sunjoo Boo, PhD, RN, is Associate Professor, Ajou University, Suwon, Korea. Hyunjin Oh, PhD, RN, is Associate Professor, Gachon University, Incheon, Korea. Acknowledgments: The authors thank the patients who participated in the study. This work was supported by the National Research Foundation of Korea grant funded by the Korean government (Ministry of Science and ICT, 2017R1C1B1005527). The authors have disclosed no other financial relationships related to this article. Submitted March 20, 2020; accepted in revised form May 13, 2020; published online ahead of print, March 31, 2021
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El Khatib A, Jeschke MG. Contemporary Aspects of Burn Care. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:386. [PMID: 33923571 PMCID: PMC8073568 DOI: 10.3390/medicina57040386] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/13/2021] [Accepted: 04/15/2021] [Indexed: 02/06/2023]
Abstract
The past one hundred years have seen tremendous improvements in burn care, allowing for decreased morbidity and mortality of this pathology. The more prominent advancements occurred in the period spanning 1930-1980; notably burn resuscitation, early tangential excision, and use of topical antibiotic dressings; and are well documented in burn literature. This article explores the advancements of the past 40 years and the areas of burn management that are presently topics of active discussion and research.
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Affiliation(s)
- Arij El Khatib
- Unité des Grands Brûlés, University of Montreal Medical Centre Sanguinet, 1051, Rue Sanguinet, Montréal, QC H2X 0C1, Canada
| | - Marc G. Jeschke
- Department of Surgery, Division of Plastic Surgery, Department of Immunology, Ross Tilley Burn Centre-Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, 2075 Bayview Avenue, Rm D704, Toronto, ON M4N 3M5, Canada;
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Tolentino-Bazán K, Chavez-Heres T, Morales-García M, Macías-Hernández SI, Ramírez-Ramírez AC, Velázquez-Bustamante AE, Rhoades-Torres GM, Velez-Palafox M. Predictive Factors for Returning to Work in Burn Adult Patients That Were Working Before Their Injury. J Burn Care Res 2021; 42:294-299. [PMID: 33128060 DOI: 10.1093/jbcr/iraa140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The goal of this study was to identify predictive factors that influence return to work in burn patients treated at the National Center for Burn Care and Research at the National Institute of Rehabilitation (CENIAQ) in México City. This is a retrospective case-control study that included all burn patients of working age (16-91 years old), treated between January 2011 and December 2013. Patients were divided into two groups: unemployed (no work group) and those who returned to work (RTW). The statistical analysis was performed by a logistic regression univariate and multivariate analysis. A total of 210 subjects were included in the study. The mean age was 38 ± 15 years and 66.7% of them were male. One hundred sixty-five patients (79.6%) were able to return to work after treatment. Through univariate analysis it was found that the predictive factors for not returning to work after injury were: education lower than elementary school (OR: 3.59; CI 95%: 1.79-7.32); history of epilepsy prior to burn injury (OR: 10.18; CI 95%: 1.9-54.43); total burned surface area (TBSA) ≥20% (OR: 2.87; CI 95%: 1.46-5.64); third-degree burns (OR: 2.64; CI 95%: 1.32-5.29); hospital stay ≥20 days (OR: 2.8; CI 95%: 1.47-5.68); length of stay in the burn intensive care unit (OR: 2.5; CI 95%: 1.25-4.97); secondary infection (OR: 2.24; CI 95%: 1.15-4.38); amputations (one or more regardless of amputation level; OR: 8; CI 95%: 2.52-25.30); burn of the upper extremity (shoulder; OR: 2.21; CI 95%: 0.97-5.03); thigh (OR: 2.41; CI 95%: 1.32-5.14); and knee (OR: 2.81; CI 95%: 1.21-6.55). Some of these factors have never been reported by other authors.
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Affiliation(s)
- Karina Tolentino-Bazán
- Centro Nacional de Investigación y Atención a Quemados (CENIAQ).,Burn Physical and Rehabilitation Medicine Department
| | | | - Mariana Morales-García
- Centro Nacional de Investigación y Atención a Quemados (CENIAQ).,Burn Physical and Rehabilitation Medicine Department
| | - Salvador Israel Macías-Hernández
- Spine Rehabilitation and Osteoporosis Department, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra (INR LGII), Mexico City, Mexico
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14
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Visser E, Den Oudsten BL, Traa MJ, Gosens T, De Vries J. Patients' experiences and wellbeing after injury: A focus group study. PLoS One 2021; 16:e0245198. [PMID: 33411828 PMCID: PMC7790403 DOI: 10.1371/journal.pone.0245198] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 12/27/2020] [Indexed: 01/07/2023] Open
Abstract
Background Injury can have physical, psychological and social consequences. It is unclear which factors have an impact on patients’ wellbeing after injury. This study aimed to explore, using focus groups, patients’ experiences and wellbeing after injury and which factors, impede or facilitate patients’ wellbeing. Methods Trauma patients, treated in the shock room of the Elisabeth-TweeSteden Hospital, the Netherlands, participated in focus groups. Purposive sampling was used. Exclusion criteria were younger than 18 years old, severe traumatic brain injury, dementia, and insufficient knowledge of the Dutch language. The interviews were recorded, transcribed verbatim, and analyzed using coding technique open, axial, and selective coding, based on phenomenological approach. Results Six focus groups (3 to 7 participants) were held before data saturation was reached. In total, 134 patients were invited, 28 (21%) agreed to participate (Median age: 59.5; min. 18 –max. 84). Main reasons to decline were fear that the discussion would be too confronting or patients experienced no problems regarding the trauma or treatment. Participants experienced difficulties on physical (no recovery to pre-trauma level), psychological (fear of dying or for permanent limitations, symptoms of posttraumatic stress disorder, cognitive dysfunction), social (impact on relatives and social support) wellbeing. These are impeding factors for recovery. However, good communication, especially clarity about the injury and expectations concerning recovery and future perspectives could help patients in surrendering to care. Patients felt less helpless when they knew what to expect. Conclusions This is the first study that explored patients’ experiences and wellbeing after injury. Patients reported that their injury had an impact on their physical, psychological, and social wellbeing up to 12 months after injury. Professionals with the knowledge of consequences after injury could improve their anticipation on patients’ need.
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Affiliation(s)
- Eva Visser
- Trauma TopCare, ETZ Hospital (Elisabeth-TweeSteden Ziekenhuis), Tilburg, The Netherlands
- * E-mail:
| | - Brenda Leontine Den Oudsten
- Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Marjan Johanna Traa
- Department of Medical Psychology; ETZ Hospital (Elisabeth-TweeSteden Ziekenhuis), Tilburg, The Netherlands
| | - Taco Gosens
- Department of Orthopaedics, ETZ Hospital (Elisabeth-TweeSteden Ziekenhuis), Tilburg, The Netherlands
| | - Jolanda De Vries
- Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
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15
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Katsu A, Tyack Z, Mackey M, Elliott JM, Mackenzie L. Return to employment for working-aged adults after burn injury: a scoping review protocol. BMJ Open 2021; 11:e044145. [PMID: 33408216 PMCID: PMC7789466 DOI: 10.1136/bmjopen-2020-044145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Cutaneous burns can have a catastrophic effect on people's lives and may restrict opportunities for employment due to physical impairment and psychosocial deficits. Failure or delay in return to work can result in loss of income and support for the family unit. It can also negatively affect life role and identity and present difficulties with future opportunities. Current literature indicates multiple discrete influences on return to work as a result of burn injury but an understanding of how working-aged adults resume employment after burn injury is lacking. This scoping review will provide a comprehensive overview of the current literature by mapping and consolidating knowledge in this area of burn recovery and thus provide an informative basis for developing return-to-work programmes for survivors of burn injury. METHODS AND ANALYSIS This scoping review protocol will follow the Arksey and O'Malley's (2005) methodological framework. A comprehensive search strategy has been developed with subject expert librarians. These databases were used: OvidSP: Medline, Embase, PsycINFO, PubMed and Cochrane Central Register of Controlled Trials and EBSCOhost: CINAHL and Scopus. Reference lists of selected full text will be hand searched for additional literature. To enhance consistency and rigour, all reviewers will undertake a calibration exercise before paired reviewers independently screen all records using Rayyan. Full-text articles meeting the study inclusion criteria will be retrieved and examined. Extracted data will be analysed using the International Classification of Functioning, Disability and Health. ETHICS AND DISSEMINATION Ethics approval is generally not required for scoping reviews. Findings of this scoping review will be reported in a peer-reviewed journal and presented at conferences.
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Affiliation(s)
- Akane Katsu
- Discipline of Occupational Therapy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Department of Occupational Therapy, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Zephanie Tyack
- Centre for Children's Burns and Trauma Research, University of Queensland, South Brisbane, Queensland, Australia
| | - Martin Mackey
- Discipline of Physiotherapy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - James M Elliott
- Discipline of Physiotherapy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Kolling Institute, Northern Sydney Local Health District, St Leonards, New South Wales, Australia
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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16
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Lamble M, Seto V, Ye Z, Couture C, de Oliveira A, Calva V, Couture MA, Poulin C, LaSalle L, Nedelec B. Perceived Value of a Knowledge Translation Intervention Designed to Facilitate Burn Survivors' Work Reintegration. J Burn Care Res 2020; 40:846-856. [PMID: 31231755 DOI: 10.1093/jbcr/irz100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Returning to work can be challenging for burn survivors. Approximately 28% never return to any form of employment, resulting in lower health-related quality of life. Open communication has been identified as a facilitator for return to work (RTW). To ease the RTW process and promote communication with coworkers and employers a knowledge translation (KT) intervention was developed for burn survivors. Following its implementation, the impact on the RTW process was evaluated. This study was a cross-sectional, mixed methods study where burn survivors included in the KT intervention were compared with a control group. Control group participants were selectively invited so that the two groups' mean age, sex, and percent total body surface area burned were similar. Semistructured interviews gathered information about their RTW process and outcomes. Qualitative data were analyzed through thematic analysis and quantitative data were summarized and compared using Mann-Whitney tests. Overall, both groups were satisfied with their RTW process. Participants from the control group identified more barriers related to support received, particularly at work, and reported more psychological symptoms such as posttraumatic stress disorder, self-consciousness, and discomfort with questions. Many participants from the KT group indicated the KT intervention gave them tools and information to provide others with a better understanding of their lived experience. It is possible that the KT intervention facilitated more open communication by empowering burn survivors to explain their situation on their own, thus reducing the prevalence of social and psychological barriers by allowing them to self-advocate for more support.
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Affiliation(s)
- Melissa Lamble
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada
| | - Vanessa Seto
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada
| | - Zi Ye
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada
| | - Charlotte Couture
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada
| | - Ana de Oliveira
- Centre de recherché, Center hospitalier de l'Université de Montréal (CRCHUM), Canada
| | - Valerie Calva
- Hôpital de réadaptation Villa Medica, Montréal, Québec, Canada
| | | | - Chantal Poulin
- Hôpital de réadaptation Villa Medica, Montréal, Québec, Canada
| | - Léo LaSalle
- Hôpital de réadaptation Villa Medica, Montréal, Québec, Canada
| | - Bernadette Nedelec
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada.,Centre de recherché, Center hospitalier de l'Université de Montréal (CRCHUM), Canada.,Hôpital de réadaptation Villa Medica, Montréal, Québec, Canada
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17
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Sadeghi N, Azizi A, Asgari S, Mohammadi Y. The effect of inhalation aromatherapy with damask rose essence on pain intensity and anxiety in burned patients: A single-blind randomized clinical trial. Burns 2020; 46:1933-1941. [DOI: 10.1016/j.burns.2020.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/28/2020] [Accepted: 05/08/2020] [Indexed: 11/17/2022]
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Mathers J, Moiemen N, Bamford A, Gardiner F, Tarver J. Ensuring that the outcome domains proposed for use in burns research are relevant to adult burn patients: a systematic review of qualitative research evidence. BURNS & TRAUMA 2020; 8:tkaa030. [PMID: 33163540 PMCID: PMC7603423 DOI: 10.1093/burnst/tkaa030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 12/31/2019] [Indexed: 11/13/2022]
Abstract
Background There have been several attempts to define core outcome domains for use in research focused on adult burns. Some have been based in expert opinion, whilst others have used primary qualitative research to understand patients' perspectives on outcomes. To date there has not been a systematic review of qualitative research in burns to identify a comprehensive list of patient-centred outcome domains. We therefore conducted a systematic review of qualitative research studies in adult burns. Methods We searched multiple databases for English-language, peer-reviewed, qualitative research papers. We used search strategies devised using the SPIDER tool for qualitative synthesis. Our review utilized an iterative three-step approach: (1) outcome-focused coding; (2) development of descriptive accounts of outcome-relevant issues; and (3) revisiting studies and the broader theoretical literature in order to frame the review findings. Results Forty-one articles were included. We categorized papers according to their primary focus. The category with the most papers was adaptation to life following burn injury (n = 13). We defined 19 outcome domains across the 41 articles: (1) sense of self; (2) emotional and psychological morbidity; (3) sensory; (4) scarring and scar characteristics; (5) impact on relationships; (6) mobility and range of joint motion; (7) work; (8) activities of daily living and self-care; (9) treatment burden; (10) engagement in activities; (11) wound healing and infection; (12) other physical manifestations; (13) financial impact; (14) impact on spouses and family members; (15) analgesia and side effects; (16) cognitive skills; (17) length of hospital stay; (18) access to healthcare; and (19) speech and communication. We suggest that sense of self is a core concern for patients that, to date, has not been clearly conceptualized in the burns outcome domain literature. Conclusions This outcome domain framework identifies domains that are not covered in previous attempts to outline core outcome domains for adult burn research. It does so with reference to existing theoretical perspectives from the sociology and psychology of medicine. We propose that this framework can be used as a basis to ensure that outcome assessment is patient-centred. Sense of self requires further consideration as a core outcome domain.
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Affiliation(s)
- Jonathan Mathers
- 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, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK
| | - Amy Bamford
- The Scar Free Foundation Centre for Burns Research, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK
| | - Fay Gardiner
- The Scar Free Foundation Centre for Burns Research, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK
| | - Joanne Tarver
- School of Life & Health Sciences, Aston University, Aston Triangle, Birmingham, B4 7ET, UK
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19
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Chen CP, Chen YW, Chang KH, Huang SW, Wu CH, Escorpizo R, Stucki G, Liou TH. Clustering of functioning and disability profile based on the WHO disability assessment schedule 2.0 - a nationwide databank study. Disabil Rehabil 2020; 44:353-362. [PMID: 32525411 DOI: 10.1080/09638288.2020.1767703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: To compare and cluster the health status and disability restrictions associated with eight major physiological functions of body systems, using functioning domains of WHO Disability Assessment Schedule 2.0.Design: Retrospective analyses of a nation-wide disability database.Setting: Population-based study.Participants: Records from patients >18 years of age with disability were obtained from the Taiwan Data Bank of Persons with Disability (July 2012-November 2017). Disability functioning profile of the following diagnosis were analyzed: stroke, schizophrenia, hearing loss, liver cirrhosis, chronic kidney disease, congestive heart failure, burn, head and neck cancer.Interventions: Not applicable.Main Outcome Measures: Demographic data, severity of impairment, and Disability Assessment Scale scores were obtained and analyzed. Radar charts were constructed using the WHO Disability Assessment Schedule 2.0. functioning domain score. Degree of similarity between any two given diagnosis was assessed by cluster analysis, comparing the Euclidean distances between radar chart data points among the six domains.Results: Based on cluster analysis of similarities between functioning domain profiles, the eight diagnoses were grouped into different disability clusters. Four clusters of disability were named according to the type restriction patterns: global-impact cluster (stroke); interaction-restriction cluster (schizophrenia, hearing loss); physical-limitation cluster, (liver cirrhosis, CKD, and congestive heart failure); and specific-impact cluster (burn, head and neck cancer). The rates of institutionalization and unemployment differed between the four clusters.Conclusion: We converted WHO Disability Assessment Schedule 2.0. functioning domain scores into six-dimensioned radar chart, and demonstrate disability restrictions can be further categorized into clusters according to similarity of functioning impairment. Understanding of disease-related disabilities provides an important basis for designing rehabilitation programs and policies on social welfare and health that reflect the daily-living needs of people according to diagnosis.Implication for RehabilitationThe use of radar charts provided a direct visualization of the scope and severity of disabilities associated with specific diagnoses.Diagnosis-related disabilities can be organized into clusters based on similarities in WHODAS 2.0 disability domain profiles.Knowledge of the characteristics of disability clusters is important to understand disease-related disabilities and provide a basis for designing rehabilitation.
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Affiliation(s)
- Chao-Pen Chen
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yi-Wen Chen
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Kwang-Hwa Chang
- Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan.,Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.,Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan.,Graduate institute of sports science, National Taiwan Sports University, Taoyuan, Taiwan
| | - Chien-Hua Wu
- Department of Applied Mathematics, Chung Yuan Christian University, Taoyuan, Taiwan
| | - Reuben Escorpizo
- Department of Rehabilitation and Movement Science, College of Nursing and Health Sciences, University of Vermont, Burlington, VT, USA.,Swiss Paraplegic Research, Nottwil, Switzerland
| | - Gerold Stucki
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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20
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Gauffin E, Öster C. Patient perception of long-term burn-specific health and congruence with the Burn Specific Health Scale-Brief. Burns 2019; 45:1833-1840. [DOI: 10.1016/j.burns.2018.12.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 12/19/2018] [Accepted: 12/22/2018] [Indexed: 12/24/2022]
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21
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Saret CJ, Ni P, Marino M, Dore E, Ryan CM, Schneider JC, Kazis LE. Social Participation of Burn Survivors and the General Population in Work and Employment: A Life Impact Burn Recovery Evaluation (LIBRE) Profile Study. J Burn Care Res 2019; 40:669-677. [PMID: 31069384 DOI: 10.1093/jbcr/irz076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Work integration and retention after burn injury is a key outcome. Little is known about how burn survivors reintegrate into the workplace. This article compares scores on the Life Impact Burn Recovery Evaluation (LIBRE) Profile, a burn-specific measure of social participation, between burn survivors and general population samples, focusing on the Work and Employment domain. METHODS Convenience samples of burn survivors and the U.S. population were obtained. Differences in demographic and clinical characteristics and LIBRE Profile scores were assessed. To examine work and employment, we compared family and friends, social activities, and social interactions scores among working vs nonworking burn survivors. RESULTS Six hundred and one burn survivors (320 employed) and 2000 U.S. residents (1101 employed) were surveyed. The mean age (P = .06), distributions of sex (P = .35), and Hispanic ethnicity (P = .07) did not differ significantly. Distributions of race (P < .01) and education (P = .01) differed significantly. The burn survivor sample had higher scores, demonstrating higher participation, for work and employment (mean = 49.5, SD = 9.42) than the general sample (mean = 46.94, SD = 8.94; P < .0001), which persisted after adjusting for demographic characteristics. Scores on the three domains administered to all respondents were higher (P < .001) for working than nonworking burn survivors. CONCLUSION Distributions indicated higher social participation in the burn survivor sample than the general sample. Possible explanations include sample bias; resilience, posttraumatic growth, or response-shift of survivors; and limitations of using items in the general sample. Working burn survivors scored higher than those not working. Future work can explore factors that mediate higher scores and develop interventions.
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Affiliation(s)
- Cayla J Saret
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Pengsheng Ni
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Molly Marino
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Emily Dore
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Colleen M Ryan
- Department of Surgery, Massachusetts General Hospital, Boston.,Harvard Medical School, Boston, Massachusetts.,Shriners Hospitals for Children-Boston®, Massachusetts
| | - Jeffrey C Schneider
- Harvard Medical School, Boston, Massachusetts.,Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts
| | - Lewis E Kazis
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
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Litchfield I, Jones LL, Moiemen N, Andrews N, Greenfield S, Mathers J. The role of self-management in burns aftercare: a qualitative research study. Burns 2018; 45:825-834. [PMID: 30545694 DOI: 10.1016/j.burns.2018.10.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 10/17/2018] [Accepted: 10/23/2018] [Indexed: 11/15/2022]
Abstract
INTRODUCTION For severe burns patient care presents a considerable challenge, necessitating an integrated multi-disciplinary approach that utilises a range of treatments. The period of care post-discharge can be lengthy and complex, and include scar management, occupational and physiotherapies, psychological support, and further surgery. How successfully the patient negotiates this complex care regimen is critical to their long-term recovery and in doing so they would appear to employ approaches recognised as "self-management" in other chronic conditions. However their exact nature and how they are used has yet to be explicitly explored amongst chronic burn patients. METHODS Semi-structured interviews were conducted with 24 patients to discuss their experiences of long-term burn treatment as part of a broader mixed- methods feasibility study of the use of pressure garment therapy in preventing hypertrophic scarring after burn injury. The topic guide included questions on the patient experience of their care post discharge, including pressure garment therapy and other scar management techniques; and their expectations and experiences of treatment and recovery. The data were analysed using an established framework of self-management processes. RESULTS Burns patients employ many of the same processes of self-management as those experiencing more widely recognised chronic diseases or illnesses. This is despite the prospect of gradual improvement amongst burns patients absent in those with incurable chronic conditions. The key processes of self-management they share are the ability to focus on their illness needs, activate the appropriate resources and coming to terms with the consequences of living with either the physical or psychological consequences of their condition. CONCLUSION Modern burn care is technologically advanced and delivered by a highly trained, multi-disciplinary team, yet the level of its success relies on the ability of the patient to independently fulfil a number of health-related tasks and activities once leaving hospital. Considering the potential cost-savings to health services and the prospect of improved outcomes for patients capable of self-management our work is an important first step in more precisely understanding the use of self-management amongst burns patients, and the level of implicit or explicit support currently offered by their care providers.
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Affiliation(s)
- Ian Litchfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
| | - Laura L Jones
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
| | - Naiem Moiemen
- The Scar Free Foundation Centre for Burns Research, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
| | - Nicole Andrews
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
| | - Sheila Greenfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
| | - Jonathan Mathers
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
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Kool MB, Geenen R, Egberts MR, Wanders H, Van Loey NE. Patients' perspectives on quality of life after burn. Burns 2017; 43:747-756. [PMID: 28069345 DOI: 10.1016/j.burns.2016.11.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 11/21/2016] [Accepted: 11/29/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND The concept quality of life (QOL) refers to both health-related outcomes and one's skills to reach these outcomes, which is not yet incorporated in the burn-related QOL conceptualisation. The aim of this study was to obtain a comprehensive overview of relevant burn-specific domains of QOL from the patient's perspective and to determine its hierarchical structure. METHODS Concept mapping was used comprising a focus group (n=6), interviews (n=25), and a card-sorting task (n=24) in burn survivors. Participants sorted aspects of QOL based on content similarity after which hierarchical cluster analysis was used to determine the hierarchical structure of burn-related QOL. RESULTS Ninety-nine aspects of burn-related QOL were selected from the interviews, written on cards, and sorted. The hierarchical structure of burn-related QOL showed a core distinction between resilience and vulnerability. Resilience comprised the domains positive coping and social sharing. Vulnerability included 5 domains subdivided in 13 subdomains: the psychological domain included trauma-related symptoms, cognitive symptoms, negative emotions, body perception and depressive mood; the economical domain comprised finance and work; the social domain included stigmatisation/invalidation; the physical domain comprised somatic symptoms, scars, and functional limitations; and the intimate/sexual domain comprised the relationship with partner, and anxiety/avoidance in sexual life. CONCLUSION From the patient's perspective, QOL following burns includes a variety of vulnerability and resilience factors, which forms a fresh basis for the development of a screening instrument. Whereas some factors are well known, this study also revealed overlooked problem and resilience areas that could be considered in client-centred clinical practice in order to customize self-management support.
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Affiliation(s)
- Marianne B Kool
- Association of Dutch Burn Centres, Postbus 1015, 1940 EA Beverwijk, The Netherlands; Utrecht University, Department of Psychology, Heidelberglaan 1, 3508 TC Utrecht, The Netherlands.
| | - Rinie Geenen
- Utrecht University, Department of Psychology, Heidelberglaan 1, 3508 TC Utrecht, The Netherlands
| | - Marthe R Egberts
- Association of Dutch Burn Centres, Postbus 1015, 1940 EA Beverwijk, The Netherlands; Utrecht University, Department of Psychology, Heidelberglaan 1, 3508 TC Utrecht, The Netherlands
| | - Hendriët Wanders
- Dutch Association of Burn Survivors, Postbus 1015, 1940 EA Beverwijk, The Netherlands
| | - Nancy E Van Loey
- Association of Dutch Burn Centres, Postbus 1015, 1940 EA Beverwijk, The Netherlands; Utrecht University, Department of Psychology, Heidelberglaan 1, 3508 TC Utrecht, The Netherlands
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25
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Nguyen NT, Lorrain M, Pognon-Hanna JN, Elfassy C, Calva V, de Oliveira A, Nedelec B. Barriers and facilitators to work reintegration and burn survivors’ perspectives on educating work colleagues. Burns 2016; 42:1477-1486. [DOI: 10.1016/j.burns.2016.05.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 04/26/2016] [Accepted: 05/18/2016] [Indexed: 12/01/2022]
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26
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Effects of mobility training on severe burn patients in the BICU: A retrospective cohort study. Burns 2016; 42:1404-1412. [PMID: 27595451 DOI: 10.1016/j.burns.2016.07.029] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 07/28/2016] [Accepted: 07/30/2016] [Indexed: 12/29/2022]
Abstract
PURPOSE To assess the effects of mobility training on severe burn patients in the Burn Intensive Care Unit (BICU). METHODS This was a retrospective cohort study. Severe burn patients with equal to or more than 50% Total Body Surface Area (TBSA) burns who received early rehabilitation in the BICU were included in this study. Based on the different early rehabilitation strategies during the two periods, patients admitted to the BICU from January 2011 to April 2013 were identified as the passive training cohort (n=49) while patients admitted to the BICU from May 2013 to December 2013 were identified as the mobility training cohort (n=24). Data on length of BICU stay, length of hospital stay, length of rehabilitation in the BICU, ventilator dependent days, strict bed rest time, range of motion (ROM), the Barthel Index (BI) and the Functional Independence Measure (FIM) were collected. RESULTS Compared with the passive training cohort, patients in the mobility training cohort had significantly shorter length of BICU stay (p=0.002), length of hospital stay (p=0.010), strict bed rest time (p<0.001) and length of rehabilitation in the BICU (p=0.026) with improved ROM of shoulder, wrist, hip, knee and ankle joints. CONCLUSIONS Mobility training in the BICU was shown to be feasible and effective in achieving better outcomes than passive training for severe burn patients.
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DeJong HM, Phillips M, Edgar DW, Wood FM. Patient opinion of scarring is multidimensional: An investigation of the POSAS with confirmatory factor analysis. Burns 2016; 43:58-68. [PMID: 27576936 DOI: 10.1016/j.burns.2016.06.026] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 05/22/2016] [Accepted: 06/17/2016] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Scarring is a significant consequence for patients following a burn. Understanding how patients perceive the physiological scar and define scar severity may provide valuable information regarding how the scar influences quality of life after burn. The Patient and Observer Scar Assessment Scale was the first scar assessment tool validated to include the patients' evaluation of the scars physical qualities, following a burn. Validation studies of this tool have previously been conducted for a discrete scar-site after burn. The aim of this study was to assess the structural validity of the POSAS to capture the patients' evaluation of the total area of burn scar(s). METHOD Statistical analysis was based on 508 completed POSAS forms from 358 patients. Exploratory factor analysis (EFA) was used initially to identify the number of factors within the tool, then confirmatory factor analysis (CFA) using structural equation modelling explored areas of misfit within each factor and whether the model provided a predicable structure to capture patient perception of scar severity. RESULTS/DISCUSSION The CFA analysis confirmed that a two dimensional model was superior to a unidimensional model when assessing the patient opinion of their total burn scar. The two dimensions were the physical scar (color, stiffness, thickness and irregularity) and the sensory scar (pain and itch). Further strain analysis of the two factor model identified additional domains. Independent factors influenced the perception of color forming a separate subdomain within the physical domain. Color is a visual characteristic, whereas the other three are predominantly tactile characteristics. A significant relationship between thickness and irregularity suggested they may form another subdomain, however further research is required to confirm this. Both pain and itch were recognized as independent, multidimensional latent variables, which require assessment tools with multidimensional structures. CONCLUSIONS When assessing the entire burn scar, three independent dimensions influence patient perception: (1) the physical scar, (2) pain and (3) itch. Within the physical domain, color formed a visual subdomain separate to a tactile subdomain. Further development of these domains within a high-order multi-dimensional structure is recommended.
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Affiliation(s)
- Helen M DeJong
- Perth Scar and Pain Clinic, Mt Pleasant, 6153, WA, Australia; Medical Sciences, Edith Cowan Universtiy, Joondaplup, 6027, WA, Australia; Harry Perkins Institute for Medical Research, Nedlands, 6009, WA, Australia; Fiona Wood Foundation, Fiona Stanley Hospital, Murdoch, 6150, WA, Australia; Burn Injury Research Unit, University of Western Australia, Crawley, 6009, WA, Australia.
| | - Michael Phillips
- Harry Perkins Institute for Medical Research, Nedlands, 6009, WA, Australia; Centre for Medical Research, University of Western Australia, Crawley, 6009, WA, Australia; Royal Perth Hospital, Perth 6000, WA, Australia
| | - Dale W Edgar
- Fiona Wood Foundation, Fiona Stanley Hospital, Murdoch, 6150, WA, Australia; Burn Injury Research Unit, University of Western Australia, Crawley, 6009, WA, Australia; Burn Injury Research Node, The Universtiy of Notre Dame Australia, Fremantle, 6160, WA, Australia; State Adult Burn Unit, Fiona Stanley Hospital, Murdoch, 6150, WA, Australia.
| | - Fiona M Wood
- Fiona Wood Foundation, Fiona Stanley Hospital, Murdoch, 6150, WA, Australia; Burn Injury Research Unit, University of Western Australia, Crawley, 6009, WA, Australia; Burn Injury Research Node, The Universtiy of Notre Dame Australia, Fremantle, 6160, WA, Australia; State Adult Burn Unit, Fiona Stanley Hospital, Murdoch, 6150, WA, Australia; Child and Adolescent Health Service of Western Australia, Princess Margaret Hospital, Subiaco, 6008, WA, Australia.
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Abrams TE, Ogletree RJ, Ratnapradipa D, Neumeister MW. Adult survivors’ lived experience of burns and post-burn health: A qualitative analysis. Burns 2016; 42:152-162. [DOI: 10.1016/j.burns.2015.09.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 09/07/2015] [Accepted: 09/14/2015] [Indexed: 10/22/2022]
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Sinha I, Zhu D, Ojomo K, Gfrerer L, Sawh-Martinez R, Patel A, Chan RK, Watkins JF. Functional and subjective assessment of burn contracture release in a mission setting. Burns 2016; 42:466-70. [PMID: 26778704 DOI: 10.1016/j.burns.2015.07.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 05/26/2015] [Accepted: 07/16/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Burns and subsequent contractures are common in developing nations. Contracture release is performed to treat such patients with functional limitations. The aim of this study is to evaluate post-operative functional and psychosocial outcomes following contracture release in a mission setting. METHODS During a surgical mission in Mumbai, India, 39 patients burn contractures underwent surgical release. A total of 31 patients (64% female, mean age 27 years) chose to participate in the study. Patients were scored preoperatively and postoperatively using a SF-36 validated survey and AMA impairment guideline assessment. RESULTS Thirty-one patients completed questionnaires pre-operative and 6-weeks post operatively. Twenty-four patients completed a survey 3-months post operatively (77.4%). Among those enrolled, 67% were women with the majority sustaining <20% total body surface area burns (70.7%) but had multiple contractures (80.6%). SF-36 physical component score increased from a mean score of 49.8 preoperatively to 55.6 by 3 months following contracture release (P<0.001). The SF-36 mental component score similarly increased from 38.8 to 51.1 by 3 months (P<0.001). AMA Whole Person Impairment (WPI) scores improved from 40.3% impairment pre-operative to 26.6% at 6-weeks post-operative (P<0.001). CONCLUSIONS Patients SF-36 and WPI scores improved following burn contracture release, confirming both functional and psychologic improvement following surgery. During the acute post-operative period, this study suggests that contracture release in a mission setting is of benefit to patients.
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Affiliation(s)
- Indranil Sinha
- Division of Plastic Surgery, Brigham and Women's Hospital, Boston, MA 02115, United States; Division of Trauma and Burn Surgery, Brigham and Women's Hospital, Boston, MA 02115, United States.
| | - Dagny Zhu
- Department of Ophthalmology, University of Southern California, Los Angeles, CA 90089, United States
| | - Kristin Ojomo
- Division of Plastic Surgery, Brigham and Women's Hospital, Boston, MA 02115, United States; Division of Trauma and Burn Surgery, Brigham and Women's Hospital, Boston, MA 02115, United States
| | - Lisa Gfrerer
- Division of Plastic Surgery, Massachusetts General Hospital, Boston, MA 02114, United States
| | - Rajendra Sawh-Martinez
- Division of Plastic Surgery, Yale University School of Medicine, New Haven, CT 06520, United States
| | - Anup Patel
- Division of Plastic Surgery, Yale University School of Medicine, New Haven, CT 06520, United States
| | - Rodney K Chan
- Clinical Division and Burn Center, San Antonio Military Medical Center, San Antonio, TX 78234, United States
| | - James F Watkins
- Division of Trauma and Critical Care, VA Eastern Colorado Healthcare System, Denver, CO 80220, United States
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Ren Z, Chang WC, Zhou Q, Wang Y, Wang H, Hu D. Recovery of lost face of burn patients, perceived changes, and coping strategies in the rehabilitation stage. Burns 2015; 41:1855-1861. [DOI: 10.1016/j.burns.2015.08.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 08/22/2015] [Accepted: 08/26/2015] [Indexed: 10/22/2022]
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Kornhaber RA, de Jong AEE, McLean L. Rigorous, robust and systematic: Qualitative research and its contribution to burn care. An integrative review. Burns 2015; 41:1619-1626. [PMID: 25979797 DOI: 10.1016/j.burns.2015.04.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 04/17/2015] [Indexed: 11/19/2022]
Abstract
Qualitative methods are progressively being implemented by researchers for exploration within healthcare. However, there has been a longstanding and wide-ranging debate concerning the relative merits of qualitative research within the health care literature. This integrative review aimed to exam the contribution of qualitative research in burns care and subsequent rehabilitation. Studies were identified using an electronic search strategy using the databases PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Excerpta Medica database (EMBASE) and Scopus of peer reviewed primary research in English between 2009 to April 2014 using Whittemore and Knafl's integrative review method as a guide for analysis. From the 298 papers identified, 26 research papers met the inclusion criteria. Across all studies there was an average of 22 participants involved in each study with a range of 6-53 participants conducted across 12 nations that focussed on burns prevention, paediatric burns, appropriate acquisition and delivery of burns care, pain and psychosocial implications of burns trauma. Careful and rigorous application of qualitative methodologies promotes and enriches the development of burns knowledge. In particular, the key elements in qualitative methodological process and its publication are critical in disseminating credible and methodologically sound qualitative research.
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Affiliation(s)
- Rachel Anne Kornhaber
- University of Tasmania, Faculty of Health, School of Health Sciences, Australia; The University of Adelaide, School of Nursing, South Australia, Australia; Severe Burns Injury Unit, Royal North Shore Hospital, Sydney, NSW, Australia.
| | - A E E de Jong
- Burn Centre, Red Cross Hospital, Beverwijk, The Netherlands; Association of Dutch Burn Centres, Beverwijk, The Netherlands
| | - L McLean
- Westmead Psychotherapy Program, Discipline of Psychiatry, and BMRI, Sydney Medical School, University of Sydney, Australia; Consultation-Liaison Psychiatry, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia; Sydney West and Greater Southern Psychiatry Training Network, Australia
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Cabulon EAIC, Cardoso JR, Maciel SM, Martins JT, Robazzi MLDCC, Cardelli AAM. Quality of life of individuals treated in an outpatient burn treatment centre: Application of the BSHS-R. Burns 2015; 41:528-35. [DOI: 10.1016/j.burns.2014.08.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 08/25/2014] [Accepted: 08/27/2014] [Indexed: 10/24/2022]
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Kornhaber R, Wilson A, Abu-Qamar M, McLean L, Vandervord J. Inpatient peer support for adult burn survivors—A valuable resource: A phenomenological analysis of the Australian experience. Burns 2015; 41:110-7. [DOI: 10.1016/j.burns.2014.05.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 05/03/2014] [Accepted: 05/06/2014] [Indexed: 11/29/2022]
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To heal and restore broken bodies: a retrospective, descriptive study of the role and impact of pastoral care in the treatment of patients with burn injury. Ann Plast Surg 2014; 72:289-94. [PMID: 24509139 DOI: 10.1097/sap.0000000000000087] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Despite advances in resuscitation, resurfacing, and reconstruction, recovery in burn patients often depends upon emotional, psychosocial, and spiritual healing. We characterized the spiritual needs of burn patients to help identify resources necessary to optimize recovery. METHODS We performed a retrospective review of all patients admitted to a regional, accredited burn center, in 2011. We accessed multiple clinical, financial, and administrative databases, collected demographic data, including religious affiliation, and recorded the number and type of pastoral care visits. Outcome measures included length of stay (LOS), physician and facility charges, and mortality. We compared patients who had a pastoral care visit with those who did not, as well as patients with a religious affiliation with those who had no or an unknown affiliation. RESULTS During the study period, our burn center admitted 1338 patients, 314 of whom were visited by chaplains, for a total of 1077 encounters (3.43 visits per patient seen). Most frequent interventions were prayer, social support, and spiritual counseling. Compared to patients who had no visit, patients who saw a chaplain had a larger total body surface area burn, longer LOS, higher charges, and higher mortality (10.2% vs. 0.78%, P < 0.001). Patients who had a religious affiliation had slightly lower mortality than patients with unknown or no religious affiliation (0.87% vs. 3.19%), but this did not reach statistical significance. CONCLUSIONS In burn patients, utilization of pastoral care appears to be linked to size of burn, financial charges, and length of stay, with religious affiliation serving as a possible marker for improved survival. Plastic surgeons and burn providers should consider and address the spiritual needs of burn patients, as a component of recovery.
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Stergiou-Kita M, Grigorovich A, Gomez M. Development of an inter-professional clinical practice guideline for vocational evaluation following severe burn. Burns 2014; 40:1149-63. [DOI: 10.1016/j.burns.2014.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Revised: 12/31/2013] [Accepted: 01/04/2014] [Indexed: 01/09/2023]
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Financial and employment impacts of serious injury: a qualitative study. Injury 2014; 45:1445-51. [PMID: 24560090 DOI: 10.1016/j.injury.2014.01.019] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 01/08/2014] [Accepted: 01/17/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To explore the financial and employment impacts following serious injury. DESIGN Semi-structured telephone administered qualitative interviews with purposive sampling and thematic qualitative analysis. PARTICIPANTS 118 patients (18-81 years) registered by the Victorian State Trauma Registry or Victorian Orthopaedic Trauma Outcomes Registry 12-24 months post-injury. RESULTS Key findings of the study were that although out-of-pocket treatment costs were generally low, financial hardship was prevalent after hospitalisation for serious injury, and was predominantly experienced by working age patients due to prolonged absences from paid employment. Where participants were financially pressured prior to injury, injury further exacerbated these financial concerns. Reliance on savings and loans and the need to budget carefully to limit financial burden were discussed. Financial implications of loss of income were generally less for those covered by compensation schemes, with non-compensable participants requiring welfare payments due to an inability to earn an income. Most participants reported that the injury had a negative impact on work. Loss of earnings payments from injury compensation schemes and income protection policies, supportive employers, and return to work programs were perceived as key factors in reducing the financial burden of injured participants. Employer-related barriers to return to work included the employer not listening to the needs of the injured participant, not understanding their physical limitations, and placing unrealistic expectations on the injured person. While the financial benefits of compensation schemes were acknowledged, issues accessing entitlements and delays in receiving benefits were commonly reported by participants, suggesting that improvements in scheme processes could have substantial benefits for injured patients. CONCLUSIONS Seriously injured patients commonly experienced substantial financial and work-related impacts of injury. Participants of working age who were unemployed prior to injury, did not have extensive leave accrual at their pre-injury employment, and those not covered by injury compensation schemes or income protection insurance clearly represent participants "at risk" for substantial financial hardship post-injury. Early identification of these patients, and improved provision of information about financial support services, budgeting and work retraining could assist in alleviating financial stress after injury.
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Dunpath T, Chetty V, Van Der Reyden D. The experience of acute burns of the hand – patients perspectives. Disabil Rehabil 2014; 37:892-8. [PMID: 25109499 DOI: 10.3109/09638288.2014.948129] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Moi AL, Gjengedal E. The lived experience of relationships after major burn injury. J Clin Nurs 2014; 23:2323-31. [PMID: 24393409 DOI: 10.1111/jocn.12514] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2013] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To explore and describe the meaning of relationships after major burn injury. BACKGROUND A major burn injury may represent a threat to preburn appearance and level of functioning. Social resources and interaction are considered important for minimising the negative impacts on life after burn through all phases of care and rehabilitation. Yet, the subjective experiences of relating to others after burns have not been extensively explored. DESIGN The study was performed by using a phenomenological approach. METHODS A purposive sample (n = 14) of patients who had experienced major burns were interviewed in average 14 (5-35) months postinjury. The interviews were analysed by the phenomenological method of Giorgi. RESULTS The essence of the experience of relationships was constituted by other people re-anchoring the burn-injured persons to preburn life, being confirming of the new self, as well as being sensitive, competent and safeguarding with respect to actual and potential problems and harms. New bodily limitations demanded assistive others. Moreover, a worry about the overall burden on close family was typical. The supportive actions from others were mostly described as positive, but could also be experienced as challenging, and sometimes even unwanted and interfering with the struggle for regained freedom. CONCLUSIONS Across variation, an increased awareness of the meaning of mutual interdependence was typical. Supportive relationships with family, friends and health professionals were important for the return to society, preburn activities and a meaningful life. RELEVANCE TO CLINICAL PRACTICE A perspective that values the significance of social support from family, friends, health professionals and others who are important for the burn-injured person, and that does not underestimate challenges that may be involved, is recommended during all phases of burn care. Health professionals should also acknowledge the importance of relationships when developing structured educational programmes and organising peer support.
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Affiliation(s)
- Asgjerd L Moi
- Department of Nursing, Faculty of Health and Social Sciences, Bergen University College, Bergen, Norway
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Stergiou-Kita M, Grigorovich A. Guidelines for vocational evaluation following burns: integrated review of relevant process and factors. JOURNAL OF OCCUPATIONAL REHABILITATION 2013; 23:476-503. [PMID: 23423804 DOI: 10.1007/s10926-013-9428-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE A systematic literature review was undertaken to gather evidence to develop a guideline for vocational evaluation following burn injuries (BI). This review aimed to identify the key processes evaluators should follow and the key factors they should consider when completing such evaluations. METHODS Steps outlined in Cochrane Handbook of Systematic Review were followed including: development of review question; search strategies and selection criteria; quality appraisal; data extraction; analysis & synthesis; drawing conclusions. Four databases (Pubmed, Medline, CINHAL, PsycINFO) and 14 websites were searched for relevant articles and studies (quantitative, qualitative), reviews and guidelines. Two reviewers independently completed reviews, performed quality assessments and extracted data into evidence tables. Using the ICF model and directed content analysis, key processes and factors were analyzed and synthesized across the evidence. RESULTS A total of 138 articles were identified using the key words (e.g. burns, work). Studies, reviews and guidelines were retrieved if they focused on adults and discussed the processes relevant to vocational evaluation and/or factors associated with successful return to work (RTW) following a BI. Items were excluded if they did not address adults who had suffered a burn, the process of work or RTW, or challenges related to work after a BI. Using the above criteria 76 items were retrieved for full review. Fifty-six items remained after the quality appraisal. Results were integrated to develop the Evidence-based Framework for Vocational Evaluation Following Burn Injury. CONCLUSIONS This framework outlines 7 key processes relevant to vocational evaluation following burn injuries.
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Affiliation(s)
- Mary Stergiou-Kita
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada,
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Kornhaber R, Wilson A, Abu-Qamar MZ, McLean L. Adult burn survivors' personal experiences of rehabilitation: an integrative review. Burns 2013; 40:17-29. [PMID: 24050979 DOI: 10.1016/j.burns.2013.08.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Revised: 07/12/2013] [Accepted: 08/02/2013] [Indexed: 11/29/2022]
Abstract
Burn rehabilitation is a lengthy process associated with physical and psychosocial problems. As a critical area in burn care, the aim was to systematically synthesise the literature focussing on personal perceptions and experiences of adult burn survivors' rehabilitation and to identify factors that influence their rehabilitation. Studies were identified through an electronic search using the databases: PubMed, CINAHL, EMBASE, Scopus, PsycINFO and Trove of peer reviewed research published between 2002 and 2012 limited to English-language research with search terms developed to reflect burn rehabilitation. From the 378 papers identified, 14 research papers met the inclusion criteria. Across all studies, there were 184 participants conducted in eight different countries. The reported mean age was 41 years with a mean total body surface area (TBSA) burn of 34% and the length of stay ranging from one day to 68 months. Significant factors identified as influential in burn rehabilitation were the impact of support, coping and acceptance, the importance of work, physical changes and limitations. This review suggests there is a necessity for appropriate knowledge and education based programmes for burn survivors with consideration given to the timing and delivery of education to facilitate the rehabilitation journey.
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Affiliation(s)
- R Kornhaber
- Severe Burns Injury Unit, Royal North Shore Hospital, Sydney, NSW, Australia; The University of Adelaide, School of Nursing, South Australia, Australia.
| | - A Wilson
- School of Medicine, Flinders University, Bedford Park, South Australia, Australia; Prince of Wales Clinical School, The University of New South Wales, Sydney, NSW, Australia
| | - M Z Abu-Qamar
- Department of Adult Health Nursing, Faculty of Nursing, Mútah University, Mútah, Jordan
| | - L McLean
- Westmead Psychotherapy Program, Discipline of Psychiatry, Sydney Medical School, University of Sydney, Australia; Consultation-Liaison Psychiatry, Royal North Shore Hospital, Sydney, NSW, Australia; Sydney West and Greater Southern Psychiatry Training Network, WSLHD, Sydney, NSW, Australia
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Tyack Z, Wasiak J, Spinks A, Kimble R, Simons M. A guide to choosing a burn scar rating scale for clinical or research use. Burns 2013; 39:1341-50. [PMID: 23768711 DOI: 10.1016/j.burns.2013.04.021] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 10/22/2012] [Accepted: 04/23/2013] [Indexed: 12/26/2022]
Abstract
INTRODUCTION A lack of high quality burn scar rating scales underpins the urgent need to introduce a guide for clinicians and researchers to choose the most appropriate scale for their requirements. METHODS An updated electronic search of Medline, CINAHL, and EMBASE databases from 2010 to 2011 of a previous published systematic review were used to identify English articles related to burn scar rating scales. The clinimetric properties, content, purpose, characteristics of the subjects tested and feasibility of each scale were critically reviewed. RESULTS An additional seven papers were identified by the updated search, bringing the total number of papers reviewed to 36. The majority (88%) covered items pertaining to the physical properties of the skin rated by an observer. All of the scales had been tested for the purpose of discriminating between patient groups; however, only preliminary evidence exists for the ability of the scales to measure change in scar properties over time. The majority of testing of scales occurred using Caucasian subjects, males, upper limb sites and adults. CONCLUSIONS This paper provides a guide to selecting the most appropriate burn scar rating scale for research and clinical practice by reviewing the content, purpose, test sample characteristics and feasibility of each scale.
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Affiliation(s)
- Zephanie Tyack
- Central Queensland Hospital and Health Service, Rockhampton, Queensland, Australia; School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia.
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Are there predicting factors for burn patients that transfer to a rehabilitation center upon completion of acute care? Burns 2012; 38:992-7. [DOI: 10.1016/j.burns.2012.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Revised: 01/19/2012] [Accepted: 02/04/2012] [Indexed: 11/20/2022]
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Abstract
Postburn contracture is a source of significant morbidity in India, even though its occurrence can be reduced significantly by comprehensive postburn injury care, including surgical intervention. This study investigates whether limited access to initial medical care after burn injury has been associated with increased contracture formation among lower socioeconomic class patients in Mumbai, India. During a surgical mission in Mumbai, India, patients presenting with functionally debilitating burn contractures and minimal income were surveyed for initial care received immediately after burn injury. The survey consisted of questions regarding the history of burn injury and details of any initial treatment. Demographic data were collected by chart review. Thirty-eight patients from the state of Maharashtra participated in the study (mean age 28.1 years). The most common etiology of burn injury was from kerosene stove blasts (74%), and the most common morbidities were contractures of the neck and upper extremity. On average, time elapsed since the original injury was 2.8 years. Nearly all patients sought initial medical care at hospitals (97%) with the majority receiving only dressing changes for their full-thickness or deep-dermal burns (61%). The most common reason for not seeking out delayed burn reconstruction was perceived cost (65%). Ultimately, 60 operations were performed, of which 9 (15%) developed postsurgical complications. These data suggest that a subset of lower socioeconomic class burn patients in Maharashtra received suboptimal initial intervention. Comprehensive initial therapy after burn injury may provide better outcomes and limit the number of patients requiring delayed reconstruction.
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Low AJF, Dyster-Aas J, Willebrand M, Ekselius L, Gerdin B. Psychiatric morbidity predicts perceived burn-specific health 1 year after a burn. Gen Hosp Psychiatry 2012; 34:146-52. [PMID: 22266132 DOI: 10.1016/j.genhosppsych.2011.12.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Revised: 12/08/2011] [Accepted: 12/12/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Individual factors such as gender, age, coping and personality traits and injury-related factors such as injury severity have been implicated as risk factors for poor perceived health after burns. As psychiatric morbidity is common in individuals who sustain burns, the aim of this study was to examine the effect of preinjury psychiatric problems on perceived health after injury. METHOD A total of 85 consecutive patients treated at a national burn center were prospectively assessed: the patients were interviewed during acute care with the Structured Clinical Interview for DSM-IV Axis I Disorders. One year after injury, perceived health was assessed with the Burn-Specific Health Scale-Brief (BSHS-B). Multiple regression analyses were used to evaluate the predictive effect of preinjury psychiatric history on perceived postinjury health. RESULTS Psychiatric morbidity, especially mood disorders, affected outcome for six of the nine BSHS-B subscales, with the covariates mainly being the length of hospital stay and total burn size. CONCLUSION The results show that a history of preinjury psychiatric disorders, especially during the year before the burn, affects perceived outcome regarding both physical and psychological aspects of health 1 year after injury and that it is a risk factor for worse perceived outcome.
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Affiliation(s)
- Aili J F Low
- Department of Surgical Sciences, Plastic and Maxillofacial Surgery, Burn Center, Uppsala University Hospital, 75185 Uppsala, Sweden.
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Öster C, Ekselius L. Return to work after burn—A prospective study. Burns 2011; 37:1117-24. [DOI: 10.1016/j.burns.2011.05.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Revised: 05/27/2011] [Accepted: 05/31/2011] [Indexed: 10/18/2022]
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Finger ME, Escorpizo R, Glässel A, Gmünder HP, Lückenkemper M, Chan C, Fritz J, Studer U, Ekholm J, Kostanjsek N, Stucki G, Cieza A. ICF Core Set for vocational rehabilitation: results of an international consensus conference. Disabil Rehabil 2011; 34:429-38. [DOI: 10.3109/09638288.2011.608145] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Current world literature. Curr Opin Support Palliat Care 2011; 5:174-83. [PMID: 21521986 DOI: 10.1097/spc.0b013e3283473351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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