31 Patients in Need: Are We Identifying and Helping Them?

Introduction Healing from a burn injury is a complex process that takes months to years. Survivors and families with basic needs or mental health issues may experience additional challenges during recovery. We previously showed a significant and positive correlation between adverse childhood events (ACEs) and number of needs (r = 0.5), housing insecurity (r = 0.23), food insecurity (r = 0.34), stress (r = 0.39), and symptoms of depression (r = 0.44). Herein, we assessed whether these needs were identified and addressed prior to discharge. Methods Medical charts of the 175 burn patients enrolled in our ACEs study were reviewed to assess if a social worker assessment (SWA) was done. SWA is primarily performed for discharge planning. We collected patient/family identified needs, resources provided, mental health consultation (adults only), and whether patients received additional information (burn bag) on support programs, burn/wound care guide, alternative dressings, post-traumatic stress disorder, and intimacy; the latter being only distributed to adult patients. Collected data were compared to the Family Strengths and Needs Assessment Survey (Strengths and Needs Survey) completed at the time of consent and analyzed using SPSS. Results SWA was completed on 50 inpatients (63.3%) and one outpatient. Based on the Strengths and Needs Survey, patients receiving SWA were more likely to rent (45.2% vs. 30%) or live in shared/temporary housing or be homeless (9.4% vs. 5.7%; p = 0.035) and report police interaction (15.1% vs. 4.1%; p = 0.023). Housing was addressed in only three SWA (5.7%). A higher number of patients with SWA reported food insecurity (22.6% vs. 12.3%; p = 0.082). Five SWA included food stamp status, with only one patient being provided information on food stamps. No difference was observed regarding stress and symptoms of depression between those who received a SWA and those who did not (45.3% vs. 39.3%; p = 0.36 and 39.6% vs 29.5%; p = 0.5, respectively). Psychosocial assessment need was noted in 46 SWA (90.6%). Only 12 adult inpatients (15%) were seen by mental health providers; 10 had a SWA. Burn bags were provided to 30 patients (58.8%), more often to adult than to pediatric patients (73.3% vs. 40%; p = 0.04). Conclusions Our study shows that many of our patients’ needs are not adequately assessed with the current social work and mental health capabilities. While SWA is performed on many of our patients with basic needs, many are not addressed, and individualized resources are often not provided. Moreover, only a third of our patients with identified psychosocial needs received consultation. Further study is warranted to develop a targeted approach to better meet the needs of our burn patients and their families. Applicability of Research to Practice By further assessing our patients’ needs, we will be able to better connect them with relevant resources to lighten the burden they face during their recovery.