572 Examination of Gender Differences in Return to School and PROMIS-25® Outcomes for Pediatric Burn Survivors

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S127-S128
Author(s):  
Olivia Stockly ◽  
Audrey E Wolfe ◽  
Nicole S Gibran ◽  
Colleen M Ryan ◽  
Jeffrey C Schneider
Keyword(s):  
Gender Differences ◽  
Health Outcomes ◽  
Clinical Characteristics ◽  
Burn Injury ◽  
National Database ◽  
Post Injury ◽  
Burn Survivors ◽  
School Status ◽  
The Impact

Abstract Introduction Gender differences in pediatric burn outcomes are not well-known. Long-term physical and mental health outcomes, in addition to school status, serve as important markers in recovery for school-aged burn survivors. This study aimed to assess the impact of gender on school status and health outcomes in pediatric burn survivors. Methods Data from pediatric burn survivors, age 8–17 years at time of injury that are participating in the Burn Model System National Database (2015–2019) were analyzed. Descriptive statistics were generated for demographic and clinical characteristics. Scores on the seven subscales of the PROMIS-25 (physical function, anxiety, depression, fatigue, peer support, pain interference, and pain intensity) and school status at 12 months post-injury were examined. All demographic, clinical, and outcome data were compared by gender using Chi-square tests of association and two-sample t-tests for categorical and continuous variables, respectively. Results A total of 104 individuals (76 male, 28 female) were included in the demographic analysis. Additionally, 60 individuals had complete PROMIS-25® data at 12 months post-injury and were included in analysis. Demographic and clinical characteristics including age at time of burn injury, race/ethnicity, burn etiology, burn location and burn size did not differ by gender. No differences were found in PROMIS-25® subscales (p=0.22–0.87; Table 1) or school status by gender. Nearly 80% of male and female burn survivors were in school at 12-months post-injury (76.6% male vs. 88.2% female; p=0.307). Conclusions In this study, burn survivors between the ages of 8 and 17 years old did not experience any differences in long-term PROMIS-25® outcomes or school status at 12 months post-injury based on gender. Applicability of Research to Practice Preliminary data suggest similar physical, mental, and school outcomes for school aged children based on gender. A more robust examination of long-term pediatric outcomes and school status are needed in the future.

119 Satisfaction with Life and Community Integration Outcomes up to 20 Years after Burn Injury

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S79-S80
Author(s):  
Callie Abouzeid ◽  
Audrey E Wolfe ◽  
Gretchen J Carrougher ◽  
Nicole S Gibran ◽  
Radha K Holavanahalli ◽  
...  
Keyword(s):  
Satisfaction With Life ◽  
Burn Injury ◽  
Community Integration ◽  
Satisfaction With Life Scale ◽  
National Database ◽  
Patient Reported ◽  
Burn Survivors ◽  
The Impact ◽  
Over Time

Abstract Introduction Among the many challenges burn survivors face, community integration is often difficult and might affect overall satisfaction with life long-term. The purpose of this study is to examine quality of life, based on life satisfaction and community integration, at long-term follow-ups in the burn population. Methods Data from the Burn Model System National Database (1997–2020) were analyzed. Patient-reported outcome measures were collected at discharge with a recall of preinjury status, and at 5, 10, 15, and 20 years after injury. The Satisfaction with Life Scale (SWLS) was used to measure participants’ satisfaction with life and the Community Integration Questionnaire (CIQ) measured level of community integration. A random intercept model was used to fit the data and generate a score trajectory with 95% confidence intervals to demonstrate the changes in scores over time and the impact of the demographic and clinical covariates on the model. SWLS trajectory is depicted in the Figure. Results The study population included 214 adult burn survivors with a mean age of 45.2 years. The population was mainly male (65.9%) and white (77.1%) with a mean burn size of 22.5% and average length of hospital stay of 34.7 days. This study found that SWLS scores decrease over time, but CIQ scores were relatively stable. The CIQ model with additional covariates were not statistically significant and did not improve the fit of the model. Conclusions Satisfaction with life was significantly worse over time. Community integration showed little or no change over the long term.

612 Assessing the Impact of Burns on Children Aged 5–18 Years: A Narrative Review of Health Outcomes Literature

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S150-S150
Author(s):  
Amelia Austen ◽  
Carina Hou ◽  
Khushbu Patel ◽  
Keri Brady ◽  
Gabrielle G Grant ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Outcomes ◽  
Social Functioning ◽  
Physical Functioning ◽  
Psychological Functioning ◽  
Burn Injury ◽  
Health Domains ◽  
The Impact

Abstract Introduction Burn injuries can have major long-term effects on the health and quality of life for children and adolescents. This study narratively reviewed the health outcomes literature focusing on the impact of burn injury for children aged 5–18. Methods Literature targeting pediatric outcomes was reviewed to identify the effects of burns on children aged 5–18 (n=16). Inclusion criteria included studies that focused on the impact of burns on health and quality of life and were age-appropriate for this population. Articles were identified via PubMed, Web of Science, and manual reference checks. Data collected included the outcomes and health domains assessed in each article and the findings of the effects of the burn injury on those specific outcomes. The Preschool LIBRE Conceptual Model served as a ‘domains framework’ to guide the identification of outcomes and health domains. Results Long-term burn-specific outcomes and broad health domains identified were physical functioning (n=9), psychological functioning (n=12), social functioning (n=4), symptoms (n=8), and family (n=7). Some studies exclusively focused on one domain whereas others assessed two domains or more. Subdomains such as upper extremity functioning and functional independence were addressed in the physical functioning domain. Psychological functioning outcomes included subdomains such as emotional health and behavioral problems. Social functioning outcomes evaluated subdomains such as problems with peers and social participation. The symptoms domain addressed post-burn pain and itch. Family outcomes subdomains such as parental satisfaction with appearance and general family functioning were identified. Conclusions Burn-specific outcomes and health domains assessing the effects of burns on children aged 5–18 were identified among 16 studies. There is a need for a comprehensive assessment tool that more precisely measures the impact of burn injury across these domains. This work will inform the development of the School-Aged Life Impact Burn Recovery Evaluation (LIBRE) Computer Adaptive Test (CAT) Profile – a new outcome metric for children and adolescents with burns. Applicability of Research to Practice This review is relevant to researchers and clinicians assessing health outcomes and measuring burn recovery in children aged 5–18.

81 Inhalation Injury Is Associated with Long-term Physical, Satisfaction with Life, and Employment Outcomes: A Longitudinal National Database Study

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S52-S53
Author(s):  
Olivia Stockly ◽  
Audrey E Wolfe ◽  
Gretchen J Carrougher ◽  
Barclay T Stewart ◽  
Nicole S Gibran ◽  
...  
Keyword(s):  
Satisfaction With Life ◽  
Short Form ◽  
Inhalation Injury ◽  
Satisfaction With Life Scale ◽  
National Database ◽  
Life Outcomes ◽  
Post Injury ◽  
Composite Scale ◽  
Burn Survivors

Abstract Introduction The effects of inhalation injury on mortality are well established. However, little is known about the long-term impacts of inhalation injuries on survivors. This study aims to describe the inhalation injury population and examine differences in long-term physical, mental, employment, and satisfaction with life outcomes between adult burn survivors with and without inhalation injury. Methods Data from the Burn Model System National Database (1993–2019) were analyzed. Demographic and clinical characteristics of those with and without inhalation injury were assessed. The Physical Health Composite Scale (PCS) and Mental Health Composite Scale (MCS) of the Short Form-12 Health Survey, Employment Status, and Satisfaction with Life Scale (SWLS) were analyzed at 24 months post-injury. Regression analyses assessed whether inhalation injury was associated with each outcome, which were adjusted for age, gender, race, ethnicity, and burn size. Results The analysis included 4,045 individuals (452 with inhalation injury, 3,593 without inhalation injury). Those with inhalation injury had larger burn size, longer hospital lengths of stay, and more operations; they were less likely to be employed at injury and injured at work, and took longer to gain employment after injury (Table 1). Two years after injury, individuals with inhalation injury were half as likely to be working (OR = 0.49, p< 0.001), and had worse PCS (β=-2.51, p=0.021) and SWL scores (β=-2.35, p=0.006) compared to those without inhalation injury. MCS scores did not differ between groups. Conclusions Burn survivors with inhalation injuries experience lower rates of employment, worse physical functioning, and worse satisfaction with life outcomes at 24 months post-injury compared to those without inhalation injuries. Applicability of Research to Practice Burn survivors with an inhalation injury may require supplementary resources and treatment as well as monitoring of sequelae long-term.

scholarly journals Psychological evaluation of adult burn survivors: a pilot study

2019 ◽  
Vol 6 (12) ◽  
pp. 4428
Author(s):  
Silvana Kurian ◽  
Sebastian Padickaparambil ◽  
Joseph Thomas ◽  
N. C. Sreekumar ◽  
Alphy Rose James
Keyword(s):  
Social Support ◽  
Body Image ◽  
Burn Injury ◽  
Personal Data ◽  
Social Situations ◽  
Post Injury ◽  
Self Monitoring ◽  
Burn Victims ◽  
Burn Survivors ◽  
The Impact

Background: Survivors of disfiguring burn injury often become social handicaps. Therefore, it is of utmost importance to understand their perception of body image, their coping skills, their appraisals about social support and self-monitoring behaviour in social situations and explore the factors that can promote better psychological adjustment.Methods: Using a single group cohort design, a sample of 18 individuals with burn injury, were recruited through purposive sampling. Personal data sheet, self-monitoring scale (SMS) and satisfaction with appearance scale (SWAP) were administered when the patients were admitted post-injury. Social support appraisal scale (SSA), coping with burns questionnaire along with SMS and SWAP were administered at one-month post-discharge.Results: The findings indicated that gender and education played a significant role in body image, coping, social support appraisal and self-monitoring behaviours. Further, higher scores on coping strategies were associated with better body satisfaction.Conclusions: The findings indicate the need to look into the variables of coping, body image, social support, self-monitoring behaviours of burns patients and the need to develop interventions for improving their quality of life. A mixed-method study design for better understanding of the psychosocial factors impacting adjustment post-burn injury would be beneficial. Although a larger cohort needs to be studied for understanding the impact of these factors, one may already notice definite indicators that are risk factors that may lead to poorer psycho-social wellbeing of burn victims and potential areas where interventions may be effective.

5 Examining ‘Return to Productivity’ Among People Living with Burn Injury: A Burn Model System National Database Report

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S9-S10
Author(s):  
Clifford C Sheckter ◽  
Gretchen J Carrougher ◽  
Mallory B Smith ◽  
Steven E Wolf ◽  
Jeffrey C Schneider ◽  
...  
Keyword(s):  
Burn Injury ◽  
Private Insurance ◽  
Model System ◽  
National Database ◽  
Post Injury ◽  
Explanatory Variables ◽  
Job Type ◽  
Burn Survivors ◽  
Gain Loss

Abstract Introduction Burn injuries can be life-altering events that involve intensive healthcare, changes in body image, psychological stress and financial toxicity. Burn survivors frequently experience numerous and varied barriers to returning to work. For those who return to work, little is known regarding whether they achieve pre-injury productivity (i.e., equivalent work output and/or pay). Understanding return to productivity and patients at risk of not achieving pre-injury productivity is important for targeting services that support this population and their families. Methods Burn survivors with complete occupational and personal income data through 24 months post-injury were extracted from the NIDILRR Burn Model System National Database. Participant annual income was reported in six groups: < $25k, $25k-50k, $50k-99k, $100k-149k, $150k-199k, $ >199k. Participants were classified by their change in income at each follow up (i.e., gain, loss, equivalent). Explanatory variables of interest included demographics, payer, job type, and injury characteristics. Logistic regression modeled return to productivity (i.e., equivalent or gain in income compared to pre-injury status) at each follow up interval. Results Data from 402 participants were analyzed. At 6-, 12-, and 24-months post-injury, 77%, 79%, and 71% of participants reported equivalent or gain in income, respectively. Physical and labor-based jobs were reported by 60% of participants who had return to productivity versus 63% of those who lost income. Demographics, payer, and job type were not significantly associated with differences in return to productivity. Mean %TBSA burn size was 17.4% in those who returned to productivity versus 26.1% among those who did not. Burn size ≥50% TBSA was the only predictor of decreased likelihood for return to productivity (OR 0.24, 95%CI 0.06–0.90). Post hoc comparison to participants who did not have complete financial data demonstrated that participants with complete data were significantly more likely to be older, white, have smaller burns, and carry private insurance. Conclusions Most burn survivors returned to pre-injury productivity by 24-months after injury regardless of demographics, job type, and payer status. Burn survivors who experienced ≥50% TBSA burns were much more likely to not return to pre-injury productivity.

T3 Are Burns a Chronic Condition: Examining Physical and Mental Functioning up to 20 Years After Injury

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S2-S3
Author(s):  
Callie Abouzeid ◽  
Audrey E Wolfe ◽  
Gretchen J Carrougher ◽  
Nicole S Gibran ◽  
Radha K Holavanahalli ◽  
...  
Keyword(s):  
Mental Health ◽  
Hospital Stay ◽  
National Database ◽  
Time Points ◽  
Patient Reported ◽  
Burn Survivors ◽  
Population Demographic ◽  
The Impact ◽  
Over Time

Abstract Introduction Burn survivors often face many long-term physical and psychological symptoms associated with their injury. To date, however, few studies have examined the impact of burn injuries on quality of life beyond 2 years post-injury. The purpose of this study is to examine the physical and mental well-being of burn survivors up to 20 years after injury. Methods Data from the Burn Model System National Database (1997–2020) were analyzed. Patient-reported outcome measures were collected at discharge with a recall of preinjury status, and then at 5, 10, 15, and 20 years after injury. Outcomes examined were the Physical Component Summary (PCS) and Mental Component Summary (MCS) of the Short Form-12. Trajectories were developed using linear mixed methods model with repeated measures of PCS and MCS scores over time and controlling for demographic and clinical variables. The model fitted score trajectory was generated with 95% confidence intervals to demonstrate score changes over time and associations with covariates. Results The study population included 420 adult burn survivors with a mean age of 42.4 years. The population was mainly male (66%) and white (76.4%) with a mean burn size of 21.5% and length of hospital stay of 31.3 days. Higher PCS scores were associated with follow-up time points closer to injury, shorter hospital stay, and younger age. Similarly, higher MCS scores were associated with earlier follow-up time points, shorter hospital stay, female gender, and non-perineal burns. MCS trajectories are demonstrated in the Figure. Conclusions Burn survivors’ physical and mental health worsened over time. Such a trend is different from previous reported results for mental health in the general population. Demographic and clinical predictors of recovery over time are identified.

scholarly journals Psychological profiles derived by cluster analysis of Minnesota Multiphasic Personality Inventory and long term clinical outcome after coronary artery by pass grafting

2015 ◽  
Vol 78 (1) ◽  
Author(s):  
Maddalena Modica ◽  
Roberta Carabalona ◽  
Rosa Spezzaferri ◽  
Monica Tavanelli ◽  
A. Torri ◽  
...  
Keyword(s):  
Cluster Analysis ◽  
Coronary Artery ◽  
Clinical Characteristics ◽  
Minnesota Multiphasic Personality Inventory ◽  
Personality Inventory ◽  
Psychological Characteristics ◽  
Term Outcome ◽  
Long Term Outcome ◽  
The Impact

Background: To evaluate the psychological characteristics of coronary heart disease (CHD) patients after coronary artery bypass grafting (CABG) by cluster analysis of Minnesota Multiphasic Personality Inventory (MMPI-2) questionnaires and to assess the impact of the profiles obtained on long-term outcome. Methods: 229 CHD patients admitted to cardiac rehabilitation filled in self-administered MMPI-2 questionnaires early after CABG. We assessed the relation between MMPI- 2 profiles derived by cluster analysis, clinical characteristics and outcome at 3-year follow-up. Results: Among the 215 patients (76% men, median age 66 years) with valid criteria in control scales, we identified 3 clusters (G) with homogenous psychological characteristics: G1 patients (N=75) presented somatoform complaints but overall minimal psychological distress. G2 patients (N=72) presented type D personality traits. G3 subjects (N=68) showed a trend to cynicism, mild increases in anger, social introversion and hostility. Clusters overlapped for clinical characteristics such as smoking (G1 21%, G2 24%, G3 24%, p ns), previous myocardial infarction (G1 43%, G2 47%, G3 49% p ns), LV ejection fraction (G1 60 [51 – 60]; G2 58 [49- 60]; G3 60 [55-60], p ns), 3-vessel-disease prevalence (G1 69%, G2 65%, G3 71%, p ns). Three-year event rates were comparable (G1 15%; G2 18%; G3 15%) and Kaplan- Meier curves overlapped among clusters (p ns). Conclusions: After CABG, the interpretation of MMPI- 2 by cluster analysis is useful for the psychological and personological diagnosis to direct psychological assistance. Conversely, results from cluster analysis of MMPI-2 do not seem helpful to the clinician to predict long term outcome.

scholarly journals Using online blogs to explore positive outcomes after burn injuries

2016 ◽  
Vol 22 (13) ◽  
pp. 1755-1766 ◽  
Author(s):  
Kirsty Garbett ◽  
Diana Harcourt ◽  
Heather Buchanan
Keyword(s):  
Thematic Analysis ◽  
Burn Injury ◽  
Burn Injuries ◽  
Positive Outcomes ◽  
Self Perception ◽  
Vast Amount ◽  
Novel Technique ◽  
Burn Survivors ◽  
The Impact ◽  
Insight Into

This study uses blog analysis, a new and novel technique, to explore the positive outcomes experienced by burn survivors. This study examined 10 burn survivor blogs to offer a unique, longitudinal insight into burn survivor recovery. Using thematic analysis, three themes emerged: shift in self-perception, enhanced relationships and a change in life outlook. Many of these themes contained stories and experiences unique to a traumatic burn injury, suggesting that standardised trauma scales are not effectively measuring the impact of a burn in this population. Reflections on blog analysis are discussed, along with a recommendation that health researchers utilise the vast amount of data available from online blogs.

A Scoping Review on the Long-Term Outcomes in Persons with Adult-Acquired Burn Injuries

2019 ◽  
Vol 41 (3) ◽  
pp. 472-502
Author(s):  
Stephanie R Cimino ◽  
Jorge N Rios ◽  
Matthew Godleski ◽  
Sander L Hitzig
Keyword(s):  
Community Participation ◽  
Scoping Review ◽  
The United States ◽  
Community Dwelling ◽  
Burn Injuries ◽  
Computer Assisted ◽  
Long Term Outcomes ◽  
Burn Survivors ◽  
The Impact

Abstract Adult-acquired burn injuries are a life-altering event that can lead to debilitating functional or psychological impairments. With advancements in health care resulting in decreased mortality rates, survivors of burn injuries can expect to live longer. This warrants a shift in focus to better understand what happens to adults once they are discharged from the hospital into the community. Therefore, the purpose of this scoping review was to map the literature regarding the long-term outcomes of community-dwelling adult-acquired burn survivors. A computer-assisted literature search was conducted on literature from January 1, 2000 to August 31, 2018 utilizing four large databases (MEDLINE, EMBASE, CINHAL, and PsycINFO). Articles were included if they had a minimum of five individuals with a burn injury as a result of an accidental injury who were at least 18 years of age at the time of injury. Fifty-four articles were found suitable for inclusion in this review. The majority of studies were conducted in the United States and were longitudinal in design. Four themes were apparent from the articles: postburn complications, psychosocial outcomes, quality of life, and community participation. Data are lacking with respect to outcomes more than 5 years postburn as well as qualitative research. Furthermore, more literature is needed to understand the impact of postburn complications, coping strategies, and posttraumatic growth as well as barriers to community participation. Overall, there is an emerging body of literature that describes the long-term outcomes of adult-acquired burn survivors up to 5 years postburn.

Long-term health consequences of early-life exposure to substance abuse: an epigenetic perspective

2013 ◽  
Vol 4 (4) ◽  
pp. 269-279 ◽  
Author(s):  
A. M. Vaiserman
Keyword(s):  
Substance Abuse ◽  
Health Outcomes ◽  
Adult Life ◽  
Developmental Programming ◽  
Human Beings ◽  
Maternal Substance Abuse ◽  
Organ Systems ◽  
Abuse During Pregnancy ◽  
The Impact

A growing body of evidence highlights the importance of the nutritional or other environmental stimuli during critical periods of development in the long-term programming of organ systems and homeostatic pathways of the organism. The adverse influences early in development and particularly during intrauterine life have been shown to programme the risks for adverse health outcomes in adult life. The mechanisms underlying developmental programming remain still unclear. However, increasing evidence has been accumulated indicating the important role of epigenetic regulation including DNA methylation, histone modifications and non-coding RNAs in the developmental programming of late-onset pathologies, including cancer, neurodegenerative diseases, and type 2 diabetes. The maternal substance abuse during pregnancy, including smoking, drinking and psychoactive drug intake, is one of the important factors determining the process of developmental programming in modern human beings. The impact of prenatal drug/substance exposure on infant and early childhood development is currently in the main focus. The long-term programming effects of such exposures on aging and associated pathologies, however, have been reported only rarely. The purpose of this review is to provide a summary of recent research findings which indicate that maternal substance abuse during pregnancy and/or neonatal period can programme not only a child's health status, but also can cause long-term or even life-long health outcomes via mechanisms of epigenetic memory.

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