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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Murphy ME, Holzer CE, Richardson LM, Epperson K, Ojeda S, Martinez EM, Suman OE, Herndon DN, Meyer WJ. Quality of Life of Young Adult Survivors of Pediatric Burns Using World Health Organization Disability Assessment Scale II and Burn Specific Health Scale-Brief: A Comparison. J Burn Care Res 2015; 36:521-33. [PMID: 25167373 PMCID: PMC4362787 DOI: 10.1097/bcr.0000000000000156] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The objective was to determine long-term psychological distress and quality of life (QOL) in young adult survivors of pediatric burns using the World Health Organization Disability Assessment Scale II (WHODAS) and the Burn Specific Health Scale-Brief (BSHS-B). Fifty burn survivors 2.5 to 12.5 years postburn (16-21.5 years old; 56% male, 82% Hispanic) completed the WHODAS and BSHS-B. The WHODAS measures health and disability and the BSHS-B measures psychosocial and physical difficulties. Scores were calculated for each instrument, and then grouped by years postburn, TBSA, sex, burn age, and survey age to compare the effects of each. Next, the instruments were compared with each other. The WHODAS disability score mean was 14.4 ± 2.1. BSHS-B domain scores ranged from 3 to 3.7. In general, as TBSA burned increased, QOL decreased. Female burn survivors, survivors burned prior to school entry, and adolescents who had yet to transition into adulthood reported better QOL than their counterparts. In all domains except Participation, the WHODAS consistently identified more individuals with lower QOL than the BSHS-B. Young adult burn survivors' QOL features more disability than their nonburned counterparts, but score in the upper 25% for QOL on the BSHS-B. This analysis revealed the need for long-term psychosocial intervention for survivors with larger TBSA, males, those burned after school entry, and those transitioning into adulthood. Both instruments are useful tools for assessing burn survivors' QOL and both should be given as they discern different individuals. However, the WHODAS is more sensitive than the BSHS-B in identifying QOL issues.
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Affiliation(s)
- Mary Elizabeth Murphy
- From the Shriners Hospitals for Children and University of Texas Medical Branch, Galveston, and University of Colorado Denver-Anschutz Medical Campus, Aurora
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Millatmal T, Daughton D, Thompson AB, Floreani AA, Romberger D, Epperson K, Larson L, Rennard SI. Smoking reduction: an alternative approach for smokers who cannot quit. Monaldi Arch Chest Dis 1994; 49:421-4. [PMID: 7841980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Cigarette smoking is the foremost cause of death in the United States and is a major health problem worldwide. Clearly, the best way to eliminate the risk of smoking-related diseases, is to quit smoking. Smoking cessation has immediate and long-term benefits and substantially reduces the risk of many smoking-related diseases. Unfortunately, quitting smoking is rarely easy. For those smokers who cannot or do not wish to quit, reduction in their total smoking may represent a potential health benefit. Reduction in total smoking can, theoretically, be achieved by: 1) reducing the number of cigarettes smoked daily; and/or 2) switching to a low tar/low nicotine cigarette. Smokers, however, tend to self-adjust nicotine to maintain relatively constant levels. Reduction in tar/nicotine content or number of cigarettes, therefore, may not produce health benefits. Smoking reduction with alternative nicotine delivery, however, may represent an alternative option for smokers who cannot, or do not, wish to quit.
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Affiliation(s)
- T Millatmal
- University of Nebraska Medical Center, Omaha 68198-5300
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