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Spronk I, Trommel N, Baartmans M, Polinder S, van Baar M. Parent-Reported Health-Related Quality of Life of Pediatric Burn Patients 5 to 7 Years after Burn Injuries: A Multicenter Study. Eur J Pediatr Surg 2022; 33:219-227. [PMID: 35882357 DOI: 10.1055/s-0042-1751047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Pediatric burns significantly impact the short-term health-related quality of life (HRQL) of children. Knowledge regarding the long-term impact is scarce. We therefore evaluated the parent-reported HRQL in pediatric burn patients 5 to 7 years after burns. METHODS We invited parents of eligible children admitted to a Dutch Burn Center between August 2011 and September 2012. This sample was enriched with children with severe burns (> 10% of total body surface area [TBSA] burned) admitted between January 2010 and March 2013. The EQ-5D was completed by parents 5 to 7 years postburn. Outcomes and predictive factors were studied and compared between children with minor/moderate and severe burns. RESULTS We included 130 children (mean TBSA burned 7%): 102 children with mild/intermediate burns and 28 with severe burns. Mean EQ-5D summary was 0.96 and EQ visual analogue scale (VAS) 93.1. These outcomes were significantly better in children with minor/moderate burns (0.97; 94.4) compared with children with severe burns (0.93; 88.3) (p < 0.05). Nineteen percent of the children with minor/moderate burns and 43% of those with severe burns reported any problems. The most frequently reported problem was anxiety/depression for both groups. Pain/discomfort (p = 0.012) and cognition (p = 0.035) were statistically significantly worse in children with severe burns compared with those with minor/moderate burns. Full thickness burns and number of surgeries were found to predict long-term HRQL impairment. CONCLUSION Five to seven years postburn, the majority of children in our study (76%) did not experience long-term problems with HRQL. In a minority of the children, burns showed to have a prolonged negative impact, especially in those being severely burned and who had to undergo surgery for their burns. Most experienced problems were related to anxiety/depression. These important insights could be used to inform children and their parents about the expected long-term HRQL after pediatric burns.
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Affiliation(s)
- Inge Spronk
- Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, Zuid-Holland, the Netherlands.,Public Health, Erasmus MC, Rotterdam, the Netherlands.,Dutch Burns Foundation, Beverwijk, the Netherlands
| | - Nicole Trommel
- Burn Center, Maasstad Hospital, Rotterdam, Zuid-Holland, the Netherlands
| | - Martin Baartmans
- Burn Center, Maasstad Hospital, Rotterdam, Zuid-Holland, the Netherlands.,Department of Pediatrics, Maasstad Hospital, Rotterdam, Zuid-Holland, the Netherlands
| | | | - Margriet van Baar
- Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, Zuid-Holland, the Netherlands.,Public Health, Erasmus MC, Rotterdam, the Netherlands
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2
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Grant GG, Brady KJS, Stoddard FJ, Meyer WJ, Romanowski KS, Chang PH, Painting LE, Fowler LA, Nelson JK, Patel KF, Sheldrick RC, Carter A, Sheridan RL, Slavin MD, Warner P, Palmieri TL, Schneider JC, Kazis LE, Ryan CM. Measuring the impact of burn injury on the parent-reported health outcomes of children 1-to-5 years: Item pool development for the Preschool 1-5 Life Impact Burn Recovery Evaluation (LIBRE) Profile. Burns 2021; 47:1511-1524. [PMID: 33832799 PMCID: PMC8711655 DOI: 10.1016/j.burns.2021.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 01/29/2021] [Accepted: 02/03/2021] [Indexed: 11/23/2022]
Abstract
Modern, reliable, and valid outcome measures are essential to understanding the health needs of young children with burn injuries. Burn-specific and age-appropriate legacy assessment tools exist for this population but are hindered by the limitations of existing paper-based instruments. The purpose of this study was to develop item pools comprised of questions appropriate for children aged 1-5 with burn injuries. Item development was based on a framework provided by previous work to develop the Preschool Life Impact Burn Recovery Evaluation (LIBRE) Conceptual Model. The Preschool LIBRE Conceptual Model work established four sub-domains of functioning for children with burns aged 1-5. Item development involved a systematic literature review, a qualitative item review process with clinical experts, and parent cognitive interviews. Four item pools were established: (1) communication and language development; (2) physical functioning; (3) psychological functioning and (4) social functioning for preschool-aged children with burn injuries. We selected and refined candidate items, recall periods, survey instructions, and response option choices through clinical and parental feedback during the qualitative review and cognitive interview processes. Item pools are currently being field-tested as part of the process to calibrate and validate the Preschool1-5 LIBRE Computer Adaptive Test (CAT) Profile.
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Affiliation(s)
- Gabrielle G Grant
- Shriners Hospitals for Children - Boston, Boston, MA, United States; Department of Surgery, Massachusetts General Hospital, Boston, MA, United States; University of North Carolina at Chapel Hill, School of Nursing, Hillman Scholars in Nursing Innovation, Chapel Hill, NC, United States
| | - Keri J S Brady
- Shriners Hospitals for Children - Boston, Boston, MA, United States; Department of Surgery, Massachusetts General Hospital, Boston, MA, United States; Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, United States
| | - Frederick J Stoddard
- Shriners Hospitals for Children - Boston, Boston, MA, United States; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Walter J Meyer
- Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch, Galveston, TX, United States; Shriners Hospitals for Children - Galveston, Galveston, TX, United States
| | - Kathleen S Romanowski
- Shriners Hospital for Children - Northern California, Sacramento, CA, United States; University of California Davis School of Medicine, Department of Surgery, Division of Burn Surgery, Sacramento, CA, United States
| | | | - Lynda E Painting
- Shriners Hospital for Children - Northern California, Sacramento, CA, United States; University of California Davis School of Medicine, Department of Surgery, Division of Burn Surgery, Sacramento, CA, United States
| | - Laura A Fowler
- Shriners Hospital for Children - Cincinnati, Cincinnati, OH, United States
| | - Judith K Nelson
- Shriners Hospital for Children - Cincinnati, Cincinnati, OH, United States
| | - Khushbu F Patel
- Shriners Hospitals for Children - Boston, Boston, MA, United States; Department of Surgery, Massachusetts General Hospital, Boston, MA, United States
| | - R Christopher Sheldrick
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, United States
| | - Alice Carter
- Department of Psychology, University of Massachusetts - Boston, Boston, MA, United States
| | - Robert L Sheridan
- Shriners Hospitals for Children - Boston, Boston, MA, United States; Department of Surgery, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Mary D Slavin
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, United States
| | - Petra Warner
- Shriners Hospital for Children - Cincinnati, Cincinnati, OH, United States; Department of Surgery, University of Cincinnati, Cincinnati, OH, United States
| | - Tina L Palmieri
- Shriners Hospital for Children - Northern California, Sacramento, CA, United States; University of California Davis School of Medicine, Department of Surgery, Division of Burn Surgery, Sacramento, CA, United States
| | - Jeffrey C Schneider
- Shriners Hospitals for Children - Boston, Boston, MA, United States; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, United States; Spaulding Research Institute, Boston, MA, United States
| | - Lewis E Kazis
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, United States
| | - Colleen M Ryan
- Shriners Hospitals for Children - Boston, Boston, MA, United States; Department of Surgery, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
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3
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Sadeq F, Riobueno-Naylor A, DePamphilis MA, Lydon M, Sheridan RL, Ceranoglu TA. Evaluating Burn Recovery Outcomes in Children with Neurodevelopmental Symptoms. J Burn Care Res 2021; 43:679-684. [PMID: 34520544 DOI: 10.1093/jbcr/irab172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Neurodevelopmental symptoms (NS) including attention and behavioral problems, developmental delays, intellectual disabilities and learning problems are prevalent in children with burn injuries. The presence of NS may predispose children to poorer burn injury recovery outcomes compared to children without these symptoms (non-NS). The Multi-Center Benchmarking Study (MCBS) monitored recovery outcomes in children with burn injuries in real time utilizing the Burn Outcomes Questionnaire (BOQ). The objective of this study was to retrospectively assess the long term burn recovery outcomes in NS patients versus non-NS patients from the MCBS population. This study assessed parent-reported BOQ outcomes in a sample of 563 patients aged 5 to 18 years who were admitted for burn injuries to a pediatric burn center. A subsample of patients had reported NS (n=181). Analyses compared BOQ outcomes within the NS subsample and the non-NS subsample (n=382) across three longitudinal points post-discharge. The prevalence rate of NS was 32.1% in the full sample. Findings revealed statistically significant improvement in the recovery curves in all five BOQ subscales for the non-NS group and all subscales except for Compliance for the NS group across all longitudinal points. When compared to non-NS patients, NS patients had significantly poorer burn recovery outcomes on the Satisfaction and Compliance subscales. Although it is important to educate all clinicians, parents, and children on burn prevention efforts, targeted education is necessary for children with NS since they may be at greater risk for burn injury as well as worse recovery outcomes.
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Affiliation(s)
- Farzin Sadeq
- Shriners Hospitals for Children - Boston, Boston MA, USA
| | | | | | - Martha Lydon
- Shriners Hospitals for Children - Boston, Boston MA, USA
| | - Robert L Sheridan
- Shriners Hospitals for Children - Boston, Boston MA, USA.,Massachusetts General Hospital, Boston MA, USA.,Harvard Medical School, Boston MA, USA
| | - Tolga A Ceranoglu
- Shriners Hospitals for Children - Boston, Boston MA, USA.,Massachusetts General Hospital, Boston MA, USA.,Harvard Medical School, Boston MA, USA
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4
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Rencken CA, Rodríguez-Mercedes SL, Patel KF, Grant GG, Kinney EM, Sheridan RL, Brady KJS, Palmieri TL, Warner PM, Fabia RB, Schneider JC, Stoddard FJ, Kazis LE, Ryan CM. Development of the School-Aged Life Impact Burn Recovery Evaluation (SA-LIBRE5-12) Profile: A Conceptual Framework. J Burn Care Res 2021; 42:1067-1075. [PMID: 34228121 DOI: 10.1093/jbcr/irab104] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Pediatric burn injuries can alter the trajectory of the survivor's entire life. Patient-centered outcome measures are helpful to assess unique physical and psychosocial needs and long-term recovery. This study aimed to develop a conceptual framework to measure pediatric burn outcomes in survivors aged 5 to 12 years as a part of the School-Aged Life Impact Burn Recovery Evaluation Computer Adaptive Test (SA-LIBRE5-12 CAT) development. This study conducted a systematic literature review guided by the WHO International Classification of Functioning - Child and Youth and domains in the American Burn Association/Shriners Hospitals for Children Burn Outcomes Questionnaire5-18. Interviews with eight parents and seven clinicians were conducted to identify important domains in child recovery. One clinician focus group with four clinicians was completed to identify gaps in the preliminary framework, and semi-weekly expert consensus meetings were conducted with three experts to solidify the framework. Qualitative data were analyzed by grounded theory methodology. Three major thematic outcome domains emerged: 1) Physical Functioning: fine motor and upper extremity, gross motor and lower extremity, pain, skin symptoms, sleep and fatigue, and physical resilience; 2) Psychological Functioning: cognitive, behavioral, emotional, resilience, and body image; and 3) Family and Social Functioning: family relationships, and parental satisfaction, school, peer relations and community participation. The framework will be used to develop item banks for a CAT-based assessment of school-aged children's health and developmental outcomes, which will be designed for clinical and research use to optimize interventions, personalize care, and improve long-term health outcomes for burned children.
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Affiliation(s)
| | | | - Khushbu F Patel
- Shriners Hospitals for Children - Boston,® Boston, MA.,Department of General Surgery Research, Massachusetts General Hospital, Boston, MA
| | | | - Erin M Kinney
- Shriners Hospitals for Children - Boston,® Boston, MA
| | | | - Keri J S Brady
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA
| | - Tina L Palmieri
- Division of Burn Surgery, Department of Surgery, University of California Davis.,Shriners Hospital for Children - Northern California®, 2425 Stockton Boulevard, Suite 718, Sacramento, CA 95817, USA
| | - Petra M Warner
- Shriners Hospital for Children - Cincinnati,® Cincinnati, OH.,University of Cincinnati, 3229 Burnet Avenue, Cincinnati, OH 45229, USA
| | - Renata B Fabia
- Nationwide Children's Hospital, General Pediatric Surgery, Director of the Burn Program, Columbus, OH
| | - Jeffrey C Schneider
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA.,Spaulding Research Institute, Boston, MA.,Harvard Medical School, Boston, MA
| | - Frederick J Stoddard
- Harvard Medical School, Boston, MA.,Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Lewis E Kazis
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA
| | - Colleen M Ryan
- Shriners Hospitals for Children - Boston,® Boston, MA.,Harvard Medical School, Boston, MA.,Department of Surgery, Massachusetts General Hospital, Boston, MA
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5
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Riobueno-Naylor A, Williamson H, Canenguez K, Kogosov A, Drexler A, Sadeq F, DePamphilis M, Holcomb JM, Stoddard FJ, Lydon M, Murphy JM, Sheridan RL. Appearance Concerns, Psychosocial Outcomes, and the Feasibility of Implementing an Online Intervention for Adolescents Receiving Outpatient Burn Care. J Burn Care Res 2021; 42:32-40. [PMID: 32594128 DOI: 10.1093/jbcr/iraa108] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The current study assessed the prevalence of appearance concerns, psychosocial difficulty, and use of an appearance-focused social and psychological support resource (Young Person's Face IT; YPF) within a population of teens (12-17 year-olds) receiving outpatient burn care with the goal to assess the feasibility of routine use of the resource in outpatient burn care. The study sample included 78 patients ages 12 to 17 receiving outpatient care for burns at one hospital. Appearance concerns were measured via the Burn Outcomes Questionnaire Appearance Subscale, the Appearance Subscale of the Body Esteem Scale for Adolescents, and a 2-part question which asked participants directly about appearance concerns related to the burn injury. A large majority (70.0%) of study participants reported appearance concerns on at least one appearance measure and girls reported more burn-related appearance concerns compared with boys. Psychosocial difficulty was measured via the Pediatric Symptom Checklist-17 (PSC-17) and measures of social functioning were collected and compared within the sample by burn size, burn location, sex, and appearance concerns. Internalizing symptoms were prevalent on the PSC-17 (18.6% risk) and decreased self-worth and increased social anxiety symptoms were significantly associated with having appearance concerns. Although interest in YPF was high (78.3%), actual use of the resource among those who signed up to pilot it (n = 46 participants) was low (19.4% use). Results indicate that there is a need for and interest in appearance-focused social anxiety resources for adolescents with burn injuries such as YPF, but more research is needed to understand its feasibility in clinical practice.
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Affiliation(s)
- Alexa Riobueno-Naylor
- Department of Clinical Research, Shriners Hospitals for Children-Boston, Boston, Massachusetts.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Heidi Williamson
- Department of Health and Social Sciences, University of the West England, Bristol, UK
| | - Katia Canenguez
- Department of Clinical Research, Shriners Hospitals for Children-Boston, Boston, Massachusetts.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Ann Kogosov
- Department of Clinical Research, Shriners Hospitals for Children-Boston, Boston, Massachusetts
| | - Alana Drexler
- Department of Clinical Research, Shriners Hospitals for Children-Boston, Boston, Massachusetts
| | - Farzin Sadeq
- Department of Clinical Research, Shriners Hospitals for Children-Boston, Boston, Massachusetts
| | - Matthew DePamphilis
- Department of Clinical Research, Shriners Hospitals for Children-Boston, Boston, Massachusetts
| | - Juliana M Holcomb
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Frederick J Stoddard
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.,Department of Psychiatry, Shriners Hospitals for Children-Boston, Boston, Massachusetts
| | - Martha Lydon
- Department of Clinical Research, Shriners Hospitals for Children-Boston, Boston, Massachusetts
| | - J Michael Murphy
- Department of Clinical Research, Shriners Hospitals for Children-Boston, Boston, Massachusetts.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Robert L Sheridan
- Department of Surgery, Shriners Hospitals for Children-Boston, Boston, Massachusetts.,Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.,Department of Surgery, Harvard Medical School, Boston, Massachusetts
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6
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Brady KJS, Ni P, Grant GG, Thorpe CR, Nadler D, Lee A, Shapiro GD, Kogosov A, Palmieri TL, Tompkins RG, Schneider JC, Kazis LE, Ryan CM. Translation and Cross-cultural Validation of the English Young Adult Burn Outcome Questionnaire (YABOQ) in Spanish. J Burn Care Res 2020; 41:640-646. [PMID: 31930334 PMCID: PMC9834989 DOI: 10.1093/jbcr/iraa011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The Young Adult Burn Outcome Questionnaire (YABOQ) is a validated, English-language patient-reported outcome assessment of young adults' recovery from burn injury across 15 scale domains. We evaluated the cross-cultural validity of a newly developed Spanish version of the YABOQ. Secondary data from English- and Spanish-speaking burn survivors (17 to 30 years of age) were obtained from the Multicenter Benchmarking Study. We conducted classic psychometric analyses and evaluated the measurement equivalence of the English and Spanish YABOQs in logistic and ordinal logistic regression differential item functioning analyses. All multi-item scales in the Spanish YABOQ demonstrated adequate reliability except the Pain and Itch scales. One item in the Perceived Appearance scale showed differential item functioning across English- and Spanish-speaking burn survivors, but the observed differential item functioning had no clinically significant impact on scale-level Perceived Appearance scores. Our findings support the cross-cultural validity of the YABOQ Physical Function, Perceived Appearance, Sexual Function, Emotion, Family Function, Family Concern, Satisfaction with Symptom Relief, Satisfaction with Role, Work Reintegration and Religion scales among English- and Spanish-speaking young adult burn survivors. This work supports the use of these English and Spanish YABOQ scales to assess the effect of therapeutic interventions on young adults' burn outcomes in pooled analyses and to assess disparities in young adults' burn outcomes across language groups.
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Affiliation(s)
- Keri J. S. Brady
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA,Shriners Hospitals for Children—Boston, Boston, MA,Department of Surgery, Massachusetts General Hospital, Boston, MA
| | - Pengsheng Ni
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA
| | - Gabrielle G. Grant
- Shriners Hospitals for Children—Boston, Boston, MA,Department of Surgery, Massachusetts General Hospital, Boston, MA
| | - Catherine R. Thorpe
- Shriners Hospitals for Children—Boston, Boston, MA,Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA
| | - Deborah Nadler
- Department of Internal Medicine, Rhode Island Hospital, Providence, RI
| | - Austin Lee
- Department of Surgery, Massachusetts General Hospital, Boston, MA,Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA
| | | | - Ann Kogosov
- Shriners Hospitals for Children—Boston, Boston, MA
| | - Tina L. Palmieri
- Shriners Hospital for Children—Northern California, Sacramento, CA,University of California Davis School of Medicine, Department of Surgery, Division of Burn Surgery and Reconstruction, Sacramento, CA
| | | | - Jeffrey C. Schneider
- Shriners Hospitals for Children—Boston, Boston, MA,Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA
| | - Lewis E. Kazis
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA
| | - Colleen M. Ryan
- Shriners Hospitals for Children—Boston, Boston, MA,Department of Surgery, Massachusetts General Hospital, Boston, MA
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7
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Abstract
Burn injuries are under-appreciated injuries that are associated with substantial morbidity and mortality. Burn injuries, particularly severe burns, are accompanied by an immune and inflammatory response, metabolic changes and distributive shock that can be challenging to manage and can lead to multiple organ failure. Of great importance is that the injury affects not only the physical health, but also the mental health and quality of life of the patient. Accordingly, patients with burn injury cannot be considered recovered when the wounds have healed; instead, burn injury leads to long-term profound alterations that must be addressed to optimize quality of life. Burn care providers are, therefore, faced with a plethora of challenges including acute and critical care management, long-term care and rehabilitation. The aim of this Primer is not only to give an overview and update about burn care, but also to raise awareness of the ongoing challenges and stigmata associated with burn injuries.
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Affiliation(s)
- Marc G Jeschke
- Ross Tilley Burn Center, Department of Surgery, Sunnybrook Health Science Center, Toronto, Ontario, Canada.
- Departments of Surgery and Immunology, University of Toronto, Toronto, Ontario, Canada.
| | - Margriet E van Baar
- Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, Netherlands
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, Netherlands
| | - Mashkoor A Choudhry
- Burn and Shock Trauma Research Institute, Alcohol Research Program, Stritch School of Medicine, Loyola University Chicago Health Sciences Division, Maywood, IL, USA
| | - Kevin K Chung
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Nicole S Gibran
- Department of Surgery, University of Washington School of Medicine, Seattle, WA, USA
| | - Sarvesh Logsetty
- Departments of Surgery and Psychiatry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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8
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Spronk I, Van Loey NEE, Sewalt C, Nieboer D, Renneberg B, Moi AL, Oster C, Orwelius L, van Baar ME, Polinder S. Recovery of health-related quality of life after burn injuries: An individual participant data meta-analysis. PLoS One 2020; 15:e0226653. [PMID: 31923272 PMCID: PMC6953837 DOI: 10.1371/journal.pone.0226653] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 11/29/2019] [Indexed: 01/23/2023] Open
Abstract
Background A prominent outcome measure within burn care is health related quality of life (HRQL). Until now, no model for long-term recovery of HRQL exists for adult burn patients which requires large samples with repeated measurements. Re-use and the combination of existing data is a way to achieve larger data samples that enable the estimation of long-term recovery models. The aim of this secondary data analysis was to assess the recovery of HRQL after a burn injury over time. Methods and findings Data from ten European studies on generic HRQL assessed in adult burn patients (either with the EQ-5D or SF-36) from five different countries were merged into one dataset. SF-36 outcomes were transformed into EQ-5D outcomes. A 24-month recovery of HRQL (EQ-5D utility) was modeled using a linear mixed-effects model and adjusted for important patient and burn characteristics. Subgroups of patients with mild and intermediate burns (≤20% total body surface area (TBSA) burned) and with major burns (>20% TBSA burned) were compared. The combined database included 1687 patients with a mean age of 43 (SD 15) years and a median %TBSA burned of 9% (IQR 4–18). There was large improvement in HRQL up to six months after burns, and HRQL remained relatively stable afterwards (studied up to 24 months post burn). However, the estimated EQ-5D utility scores remained below the norm scores of the general population. In this large sample, females, patients with a long hospital stay and patients with major burns had a delayed and worse recovery. The proportion of patients that reported problems for the EQ-5D dimensions ranged from 100% (pain/discomfort at baseline in patients with major burns) to 10% (self-care ≥3 months after injury in patients with mild and intermediate burns). After 24 months, both subgroups of burn patients did not reach the level of the general population in the dimensions pain/discomfort and anxiety/depression, and patients with major burns in the dimension usual activities. A main limitation of the study includes that the variables in the model were limited to age, gender, %TBSA, LOS and time since burn as these were the only variables available in all datasets. Conclusions The 24-month recovery model can be used in clinical practice to inform patients on expected HRQL outcomes and provide clinicians insights into the expected recovery of HRQL. In this way, a delayed recovery can be recognized in an early stage and timely interventions can be started in order to improve patient outcomes. However, external validation of the developed model is needed before implementation into clinical practice. Furthermore, our study showed the benefit of secondary data usage within the field of burns.
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Affiliation(s)
- Inge Spronk
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands
- Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, the Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Plastic, Reconstructive and Hand Surgery, Amsterdam Movement Sciences, Amsterdam, Netherlands
- * E-mail:
| | - Nancy E. E. Van Loey
- Association of Dutch Burn Centres, Department Behavioural Research, Beverwijk, the Netherlands
- Utrecht University, Department Clinical Psychology, Utrecht, the Netherlands
| | - Charlie Sewalt
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands
| | - Daan Nieboer
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands
| | - Babette Renneberg
- Freie Universität Berlin, Department of Clinical Psychology and Psychotherapy, Berlin, Germany
| | - Asgjerd Litleré Moi
- Western Norway University of Applied Sciences, Department of Health and Caring Sciences, Faculty of Health and Social Sciences, Bergen, Norway
- National Burn Centre, Haukeland University Hospital, Department of Plastic, Hand and Reconstructive Surgery, Bergen, Norway
| | - Caisa Oster
- Uppsala University, Department of Neuroscience, Psychiatry, Sweden
| | - Lotti Orwelius
- Linköping University, Department of Anaesthesiology and Intensive Care, and Department of Clinical and Experimental Medicine, Linköping, Sweden
| | - Margriet E. van Baar
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands
- Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, the Netherlands
| | - Suzanne Polinder
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands
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9
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Riobueno-Naylor A, Romo S, Kazis L, Wang S, Lydon M, Nelson J, Fowler L, Drexler A, Kogosov A, Haile H, Ryan CM, Chang P, Warner P, Palmieri TL, Lee AF, Stoddard F, Murphy JM, Sheridan RL. Usefulness of a Novel System for Feedback of Patient-Reported Outcome Measures in Children Recovering From Burns. J Burn Care Res 2019; 40:776-784. [PMID: 31102446 DOI: 10.1093/jbcr/irz082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The Burn Outcomes Questionnaire for children ages 5-18 years (BOQ5-18) is a widely used, reliable, and valid parent-reported outcome measure designed to assess children's recovery from burn injuries in 12 physical and psychosocial domains. This study evaluated the feasibility, acceptability, and usefulness of a feedback system that delivered BOQ and Pediatric Symptom Checklist (PSC-17; a widely used measure of psychosocial functioning) results to burn care clinicians prior to an outpatient appointment or a postoperative surgical encounter. The BOQ and the PSC-17 were administered to the parents of 147 children receiving outpatient or surgical care in two pediatric burn hospitals. Clinician and parent perceptions of the feedback system were evaluated using debriefing questionnaires. Over half of all patients were at-risk on at least one BOQ subscale, and risk on three or more BOQ domains was significantly associated with a higher likelihood of poor psychological scores on the PSC-17 (P < .001). Significant differences in BOQ scores were found between the two hospital sites on four BOQ subscales, three related to physical ability and one to psychosocial well-being. Parent ratings of the feedback system were positive, with 90% of parents in both settings agreeing that the BOQ tablet experience was easy and helpful. Clinician attitudes differed across the two settings with more positive clinician ratings of the system in the outpatient setting (P < .001). Clinician interviews revealed that the data was especially useful in bringing to light psychosocial aspects of functioning relevant to long-term recovery from burn injuries.
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Affiliation(s)
- Alexa Riobueno-Naylor
- Department of Clinical Research, Shriners Hospitals for Children - Boston, Massachusetts.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Stephanie Romo
- Department of Clinical Research, Shriners Hospitals for Children - Boston, Massachusetts
| | - Lewis Kazis
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Shirley Wang
- Department of Clinical Research, Shriners Hospitals for Children - Boston, Massachusetts
| | - Martha Lydon
- Department of Clinical Research, Shriners Hospitals for Children - Boston, Massachusetts
| | - Judith Nelson
- Department of Clinical Research, Shriners Hospitals for Children - Cincinnati, Ohio
| | - Laura Fowler
- Department of Clinical Research, Shriners Hospitals for Children - Cincinnati, Ohio
| | - Alana Drexler
- Department of Clinical Research, Shriners Hospitals for Children - Boston, Massachusetts
| | - Ann Kogosov
- Department of Clinical Research, Shriners Hospitals for Children - Boston, Massachusetts
| | - Haregnesh Haile
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Colleen M Ryan
- Department of Surgery, Shriners Hospitals for Children - Boston, Massachusetts.,Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Philip Chang
- Department of Surgery, Shriners Hospitals for Children - Cincinnati, Ohio
| | - Petra Warner
- Department of Surgery, Shriners Hospitals for Children - Cincinnati, Ohio
| | - Tina L Palmieri
- Department of Surgery, Shriners Hospitals for Children - Northern California, Sacramento, California.,Department of Surgery, University of California Davis, Sacramento, California
| | - Austin F Lee
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Frederick Stoddard
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,Department of Psychiatry, Shriners Hospitals for Children - Boston, Massachusetts
| | - J Michael Murphy
- Department of Clinical Research, Shriners Hospitals for Children - Boston, Massachusetts.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Robert L Sheridan
- Department of Surgery, Shriners Hospitals for Children - Boston, Massachusetts.,Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
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10
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Brady KJS, Grant GG, Stoddard FJ, Meyer WJ, Romanowski KS, Chang PH, Painting LE, Fowler LA, Nelson JK, Rivas P, Epperson K, Sheridan RL, Murphy M, O’Donnell EH, Ceranoglu TA, Sheldrick RC, Ni P, Slavin MD, Warner P, Palmieri TL, Schneider JC, Kazis LE, Ryan CM. Measuring the Impact of Burn Injury on the Parent-Reported Health Outcomes of Children 1 to 5 Years: A Conceptual Framework for Development of the Preschool Life Impact Burn Recovery Evaluation Profile CAT. J Burn Care Res 2019; 41:84-94. [DOI: 10.1093/jbcr/irz110] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
AbstractDue to the rapid developmental growth in preschool-aged children, more precise measurement of the effects of burns on child health outcomes is needed. Expanding upon the Shriners Hospitals for Children/American Burn Association Burn Outcome Questionnaire 0 to 5 (BOQ0–5), we developed a conceptual framework describing domains important in assessing recovery from burn injury among preschool-aged children (1–5 years). We developed a working conceptual framework based on the BOQ0–5, the National Research Council and Institute of Medicine’s Model of Child Health, and the World Health Organization’s International Classification of Functioning, Disability, and Health for Children and Youth. We iteratively refined our framework based on a literature review, focus groups, interviews, and expert consensus meetings. Data were qualitatively analyzed using methods informed by grounded theory. We reviewed 95 pediatric assessments, conducted two clinician focus groups and six parent interviews, and consulted with 23 clinician experts. Three child health outcome domains emerged from our analysis: symptoms, functioning, and family. The symptoms domain describes parents’ perceptions of their child’s pain, skin-related discomfort, and fatigue. The functioning domain describes children’s physical functioning (gross and fine motor function), psychological functioning (internalizing, externalizing, and dysregulation behavior; trauma; toileting; resilience), communication and language development (receiving and producing meaning), and social functioning (connecting with family/peers, friendships, and play). The family domain describes family psychological and routine functioning outcomes.
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Affiliation(s)
- Keri J S Brady
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
- Shriners Hospitals for Children—Boston, Massachusetts
- Department of Surgery, Massachusetts General Hospital
| | - Gabrielle G Grant
- Shriners Hospitals for Children—Boston, Massachusetts
- Department of Surgery, Massachusetts General Hospital
| | - Frederick J Stoddard
- Shriners Hospitals for Children—Boston, Massachusetts
- Department of Psychiatry, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, Massachusetts
| | - Walter J Meyer
- Department of Psychiatry and Behavioral Sciences, The University of Texas Medical Branch, Galveston
- Shriners Hospitals for Children—Galveston, Texas
| | - Kathleen S Romanowski
- Shriners Hospital for Children—Northern California, Sacramento
- Department of Surgery, Division of Burn Surgery, University of California Davis School of Medicine, Sacramento
| | | | | | | | | | - Perla Rivas
- Shriners Hospitals for Children—Galveston, Texas
| | | | - Robert L Sheridan
- Shriners Hospitals for Children—Boston, Massachusetts
- Department of Surgery, Massachusetts General Hospital
- Harvard Medical School, Boston, Massachusetts
| | - Michael Murphy
- Shriners Hospitals for Children—Boston, Massachusetts
- Department of Psychiatry, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, Massachusetts
| | - Ellen H O’Donnell
- Shriners Hospitals for Children—Boston, Massachusetts
- Department of Psychiatry, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, Massachusetts
| | - T Atilla Ceranoglu
- Shriners Hospitals for Children—Boston, Massachusetts
- Department of Psychiatry, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, Massachusetts
| | - R Christopher Sheldrick
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Pengsheng Ni
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Mary D Slavin
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Petra Warner
- Shriners Hospital for Children—Cincinnati, Ohio
- Department of Surgery, University of Cincinnati, Ohio
| | - Tina L Palmieri
- Shriners Hospital for Children—Northern California, Sacramento
- Department of Surgery, Division of Burn Surgery, University of California Davis School of Medicine, Sacramento
| | - Jeffrey C Schneider
- Shriners Hospitals for Children—Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts
| | - Lewis E Kazis
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Colleen M Ryan
- Shriners Hospitals for Children—Boston, Massachusetts
- Department of Surgery, Massachusetts General Hospital
- Harvard Medical School, Boston, Massachusetts
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11
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Weed VF, Canenguez K, Romo S, Wang SL, Kazis L, Lee AF, Herndon D, Palmieri TL, Warner P, Haile H, Sheridan RL, Murphy JM. The Use of a Brief Measure to Assess Longitudinal Changes in Appearance Concerns for Youth Recovering From Burn Injuries. J Burn Care Res 2019; 40:97-103. [PMID: 30371792 DOI: 10.1093/jbcr/iry054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Burns are among the most common injuries to children, and, although survival rates have improved, many burn survivors are left with scars and/or other visible differences, which may be associated with anxiety, depression, and/or low self-esteem. A better understanding of the prevalence and persistence of these problems in child and adolescent burn survivors might lead to an expanded paradigm of care and possibly to better outcomes. The present study provides longitudinal prevalence data for the Appearance Concerns (AC) subscale of the parent-reported Burn Outcomes Questionnaire (BOQ) for 5- to 18-year-old children and identifies patient characteristics associated with higher risk for appearance concerns. Subjects were 799 pediatric burn survivors who were assessed prospectively using the parent-reported BOQ5-18, which was administered soon after their discharge from acute care and again every 3 to 6 months for up to 4 years. Approximately 20% of all youth were reported to have appearance concerns over the first 2 years, after which the rate declined gradually, falling to around 10% after 3 years. This study showed that such concerns were prevalent and persistent years after burn injuries and suggested that larger burns, facial burns, and country of origin outside of the United States were all associated with higher scores on the AC subscale. These findings highlight the importance of assessing appearance concerns in the long-term care of young burn survivors and suggest that the BOQ5-18 AC subscale could be used to identify individuals with heightened appearance concerns and to measure their response to interventions.
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Affiliation(s)
- Valerie F Weed
- Clinical Research, Shriners Hospitals for Children-Boston, Massachusetts
| | - Katia Canenguez
- Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Stephanie Romo
- Clinical Research, Shriners Hospitals for Children-Boston, Massachusetts
| | - Shirley L Wang
- Clinical Research, Shriners Hospitals for Children-Boston, Massachusetts
| | - Lewis Kazis
- Public Health, Boston University, Massachusetts
| | - Austin F Lee
- Mathematical Sciences, Bentley University, Waltham, Massachusetts
| | - David Herndon
- Surgery, Shriners Hospitals for Children-Galveston, Texas
| | - Tina L Palmieri
- Surgery, Shriners Hospitals for Children-Northern California, Sacramento
| | - Petra Warner
- Surgery, Shriners Hospitals for Children-Cincinnati, Ohio
| | - Haregnesh Haile
- Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | | | - J Michael Murphy
- Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
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12
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King ICC. Body image in paediatric burns: a review. BURNS & TRAUMA 2018; 6:12. [PMID: 29744373 PMCID: PMC5930865 DOI: 10.1186/s41038-018-0114-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 04/04/2018] [Indexed: 11/10/2022]
Abstract
Burn injuries in children can result in life-long disfigurement. As medical and surgical techniques of burn management improve survival prospects more than ever before, body image adjustment is increasingly a central consideration in the care of burn-injured individuals. An appreciation that both physiological and psychosocial processes underpin such injuries is key to understanding wound healing. Perceptions of idealized body images in Western society challenge children and their families as they grow up with and adapt to disfigurement from burns. Whilst many studies have examined the psychosocial recovery of adults with burn injuries, few have considered the impact on burn-injured children. This paper explores the models of body image and discusses the relevance of these to research and practice in understanding how to manage burns in children.
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Affiliation(s)
- Ian C C King
- Department of Plastic and Reconstructive Surgery, St George's Hospital, Tooting, London, SW17 0QT UK
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13
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Osborne CL, Meyer WJ, Ottenbacher KJ, Arcari CM. Burn patients' return to daily activities and participation as defined by the International Classification of Functioning, Disability and Health: A systematic review. Burns 2016; 43:700-714. [PMID: 28041750 DOI: 10.1016/j.burns.2016.10.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 10/17/2016] [Indexed: 10/20/2022]
Abstract
The World Health Organization's International Classification of Functioning, Disability and Health (ICF) is a universal classification system of health and health-related domains. The ICF has been successfully applied to a wide range of health conditions and diseases; however, its application in the field of burn recovery has been minimal. This systematic review uses the domains of the ICF component 'activities and participation' to explore: (1) the extent to which return to daily activities and community participation after burn has been examined in the pediatric population, (2) the most common assessments used to determine activity and participation outcomes, and (3) what activity and participation areas are most affected in the pediatric burn population after discharge from acute care. Results determined that it is difficult to draw overarching conclusions in the area of return to 'activities and participation' for children with burn based on the paucity of current evidence. Of the studies conducted, few examined the same subtopics or used similar measurements. This suggests a need for more robust studies in this area in order to inform and improve burn rehabilitation practices to meet the potential needs of burn patients beyond an acute care setting.
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Affiliation(s)
- Candice L Osborne
- Department of Physical Medicine and Rehabilitation, University of Texas Southwest Medical Center, Dallas, TX 75390, USA; Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX 77555, USA.
| | - Walter J Meyer
- Shriners Hospital for Children, Shriners Burn Hospital, Galveston, TX 77555, USA; Department of Surgery, School of Medicine, University of Texas Medical Branch, Galveston, TX 77555, USA; Department of Psychiatry and Behavioral Science, School of Medicine, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Kenneth J Ottenbacher
- Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Christine M Arcari
- Department of Preventative Medicine and Community Health, University of Texas Medical Branch, Galveston, TX 77555, USA
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14
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Osborne CL, Petersson C, Graham JE, Meyer WJ, Simeonsson RJ, Suman OE, Ottenbacher KJ. The multicenter benchmarking study of burn injury: A content analysis of the outcome measures using the international classification of functioning, disability and health. Burns 2016; 42:1396-1403. [DOI: 10.1016/j.burns.2016.07.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 07/21/2016] [Accepted: 07/22/2016] [Indexed: 11/25/2022]
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15
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Ryan CM, Cartwright S, Schneider JC, Tompkins RG, Kazis LE. The burn outcome questionnaires: Patient and family reported outcome metrics for children of all ages. Burns 2016; 42:1144-1145. [PMID: 26803370 PMCID: PMC10001424 DOI: 10.1016/j.burns.2015.10.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 10/27/2015] [Indexed: 11/16/2022]
Affiliation(s)
- Colleen M Ryan
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, USA; Shriners Hospitals for Children-Boston, USA; Spaulding Rehabilitation Hospital, Harvard Medical School, USA.
| | - Sara Cartwright
- Spaulding Rehabilitation Hospital, Harvard Medical School, USA
| | - Jeffrey C Schneider
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, USA; Shriners Hospitals for Children-Boston, USA; Spaulding Rehabilitation Hospital, Harvard Medical School, USA
| | - Ronald G Tompkins
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, USA
| | - Lewis E Kazis
- Center for the Assessment of Pharmaceutical Practices (CAPP), Department of Health Policy and Management, Boston University School of Public Health, Boston, MA, USA
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16
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Abstract
Burn injury affects all facets of life. Burn care has improved over time. Improved survival after burn injury has resulted in a shift in outcome measurement from inpatient morbidity and mortality to long-term functional and health-related quality-of-life measures. Integration of professionals from different disciplines has enabled burn centers to develop collaborative methods of assessing the quality of care delivered to patients with burns based on their ability to reintegrate into their normal physical, social, psychological, and functional activities. Burn outcomes will continue to develop on the foundation that has been built and will generate evidence-based best practices in the future.
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Affiliation(s)
- Tina L Palmieri
- Department of Surgery, University of California, Davis, Regional Burn Center, Davis, CA, USA; Shriners Hospital for Children Northern California, Sacramento, CA, USA.
| | - Rene Przkora
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX, USA; Shriners Hospital for Children, Galveston, TX, USA
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17
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Abstract
Approximately 2457 research articles were published with burns in the title, abstract, and/or keyword in 2012. This number continues to rise through the years; this article reviews those selected by the Editor of one of the major journals in the field (Burns) and his colleague that are most likely to have the greatest likelihood of affecting burn care treatment and understanding. As done previously, articles were found and divided into these topic areas: epidemiology of injury and burn prevention, wound and scar characterization, acute care and critical care, inhalation injury, infection, psychological considerations, pain and itching management, rehabilitation, long-term outcomes, and burn reconstruction. Each selected article is mentioned briefly with comment from the authors; readers are referred to the full papers for further details.
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Affiliation(s)
- Steven E Wolf
- Division of Burn, Trauma, and Critical Care, Department of Surgery, University of Texas - Southwestern Medical Center, Dallas, TX 75390-9158, United States.
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18
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The American Burn Association/Shriners Hospitals for Children Burn Outcomes Program: a progress report at 15 years. J Trauma Acute Care Surg 2012; 73:S173-8. [PMID: 22929544 DOI: 10.1097/ta.0b013e318265c53e] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The American Burn Association and the Shriners Hospitals for Children Outcomes Program has been in development for more than 15 years. Many of the tools and important findings are described in this special issue of The Journal of Trauma. This unique program in outcomes research introduces a model for outcome assessments from the patient-centered perspective with a cohort of 1,140 children with burn injury after hospitalization for up to 4 years. The findings represent a fundamental contribution to the field of burn care for monitoring outcomes from the perspective of the parent or child/adolescent. The Multi-Center Benchmarking Study of four burn centers serve as a model for collecting empiric scientific data on the variation and the expected trajectories of recovery in the most important domains of patient outcomes and can inform clinical decisions and the conduct of health service research. The dramatic progress in survival of children with severe burn injury and other advances in burn management can now move into a new phase of understanding the most cost-effective components of this care.
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