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

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.

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

Journal of Burn Care & Research ◽

10.1093/jbcr/irab032.123 ◽

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.

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Do Depressive Symptoms Shape Blacks’ Perceptions of Stress Over Time?

Innovation in Aging ◽

10.1093/geroni/igaa022 ◽

2020 ◽

Vol 4 (5) ◽

Author(s):

DeAnnah R Byrd ◽

Roland J Thorpe ◽

Keith E Whitfield

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Perceived Stress ◽

Ordinary Least Squares ◽

Community Dwelling ◽

Stressful Events ◽

Age Group ◽

The Impact ◽

Over Time

Abstract Background and Objectives Previous studies have linked stress to multiple negative mental health outcomes, including depression. This established stress–depression association is typically examined in one direction and cross-sectionally. This study examined the bidirectional relationships between depressive symptoms and changes in perceived stress over time in Blacks. Research Design and Methods The present study uses a community-dwelling sample of 450 Black adults, aged 51–96 years old, who participated in the Baltimore Study of Black Aging—Patterns of Cognitive Aging. Perceived stress—measured by the Perceived Stress Scale—and depressive symptoms—measured using the Center for Epidemiologic Studies Depression scale—were both assessed at baseline and follow-up 33 months later. Ordinary least squares regression was used to examine 2 bidirectional longitudinal relationships between (1) stress–depression and (2) depression–stress, and whether these associations are modified by age. Results Initial analyses testing the typical stress–depression relationship showed an effect in the expected direction, that is stress leading to more depressive symptoms over time, adjusting for model covariates, but the effect was not statistically significant (b = 0.014, p = .642). After accounting for baseline perceived stress level, age, sex, education, and chronic health conditions, depressive symptoms were positively associated with follow-up stress (b = 0.210, p < .000). The depression–stress association further varied by age group such that the impact of baseline depression on changes in perceived stress was greatest in Blacks in their 60s versus those in their 50s (b = 0.267, p = .001), controlling for model covariates. Discussion and Implications Contrary to previous work, the results suggest that an individual’s mental health shapes his/her perception of stressful events and this relationship varies by age group. While the typical finding (stress impacting depression) was not significant, the findings reported here highlight the importance of considering the possible bidirectional nature of the relationships between psychosocial measures of stress and mental health in later life among Blacks.

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The Impact of Pre-Operative Mental Health and Depression on Outcomes after Total Ankle Arthroplasty

Foot & Ankle Orthopaedics ◽

10.1177/2473011420s00180 ◽

2020 ◽

Vol 5 (4) ◽

pp. 2473011420S0018

Author(s):

Daniel J. Cunningham ◽

John Steele ◽

Samuel B. Adams

Keyword(s):

Mental Health ◽

Patient Reported Outcomes ◽

Total Ankle Arthroplasty ◽

Linear Regression Models ◽

Ankle Arthroplasty ◽

Change Scores ◽

Short Musculoskeletal Function Assessment ◽

Patient Reported ◽

The Impact

Category: Ankle Introduction/Purpose: Poor pre-operative mental health and depression have been shown to negatively impact patient- reported outcomes (PROMs) after a broad array of orthopaedic procedures involving the spine, hip, knee, shoulder, and hand. However, the relationship of mental health and patient-reported outcomes in foot and ankle surgery is less clear. The purpose of this study is to characterize the impact of pre-operative mental health and depression on patient-reported outcomes after total ankle arthroplasty. The study hypothesis is that depression and decreased SF36 MCS will be significantly associated with diminished improvement in PROMs after total ankle arthroplasty. Methods: All patients undergoing primary TAA between January 2007 and December 2016 who were enrolled into a prospective, observational study and who had at least 1 to 2-year minimum study follow-up were included. Patients were separated into 4 groups based on the presence or absence of SF36 MCS<35 and diagnosis of depression. Pre-operative to post- operative change scores in the SF36 physical and mental component summary scores (PCS and MCS), Short Musculoskeletal Function Assessment (SMFA) function and bother components, and visual analog scale (VAS) pain were calculated in 1 to 2-year follow-up. Multivariable, main effects linear regression models were constructed to evaluate the impact of SF36 and depression status on pre-operative to 1 to 2-year follow-up change scores with adjustment for age, sex, race, body mass index, current smoking, American Society of Anesthesiologist’s score, smoking, and Charlson-Deyo comorbidity score. Results: As in Table 1, adjusted analyses demonstrated that patients with MCS<35 and depression had significantly lower improvements in all change scores including SF36 MCS (-5.1 points) and PCS (-7.6 points), SMFA bother (6 points) and function scores (5.7 points), and VAS pain (7.5 points) compared with patients that had SF36>=35 and no depression. Patients with MCS<35 and no depression had significantly greater improvement in SF36 MCS (5.3 points) compared with patients that had MCS>=35 and no depression. Patients with MCS>=35 and depression had significantly lower improvement in SF36 MCS (-3.2 points) compared with patients that had MCS>=35 and no depression. Adjusted analyses of minimum 5-year outcomes demonstrated significantly increased improvement in MCS and SMFA function for patients with pre-operative MCS<35 and no depression. Conclusion: Presence of depression and decreased SF36 MCS are risk factors for diminished improvement in PROMs. Patients with depression and decreased MCS should be counseled about their risk of diminished improvement in outcomes compared to peers. As PROM’s become part of physician evaluations, it is becoming increasingly important to identify factors for diminished improvement outside of the physician’s control. [Table: see text]

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Examining the Impact of Psychological Factors on Hospital Length of Stay for Burn Survivors: A Systematic Review

Journal of Burn Care & Research ◽

10.1093/jbcr/iry040 ◽

2018 ◽

Vol 40 (1) ◽

pp. 12-20 ◽

Cited By ~ 6

Author(s):

Kyle H O’Brien ◽

Victor Lushin

Keyword(s):

Mental Health ◽

Hospital Stay ◽

Psychological Factors ◽

Methodological Quality ◽

Mental Health Problems ◽

Health Problems ◽

Hospital Length Of Stay ◽

Burn Patients ◽

Burn Survivors ◽

The Impact

Abstract Recovery of burn patients may be impeded by mental health problems. By gaining a better understanding of the impact that psychological factors may have on hospital length of stay, providers may be better informed to address the complex needs of burn survivors through effective and efficient practices. This systematic review summarizes existing data on the adverse psychological factors for the length of burn patients’ hospitalization, and assesses the methodological quality of the extant literature on mental health conditions of burn survivors. A literature search was conducted in four electronic databases: PubMed, PsychINFO, Science Direct, and the Cumulative Index to Nursing and Allied Health Literature. Results yielded reports published between 1980 and 2016. Methodological quality was assessed by using an 11-item methodological quality score system. Seventy-four studies were identified by search; 19 articles were eligible for analysis. Findings demonstrate paucity of evidence in the area. Reports indicate longer hospital stay among burn patients with mental health problems. Substance use was the most consistent mental-health predictor of longer hospital stay. Heterogeneity in data on mental health conditions rendered impossible estimation of effect sizes of individual psychological factors on length of hospitalization. Many studies over-relied on retrospective designs, and crude indicators of psychological factors. Findings indicate that mental health problems do have an impact on the trajectory of burn recovery by increasing the length of hospital stay for burn survivors. Inpatient mental health services for burn patients are critically needed. Prospective designs, and more sensitive psychological indicators are needed for future studies.

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Do Depressive Symptoms Shape Blacks’ Perceptions of Stress Over Time?

Innovation in Aging ◽

10.1093/geroni/igaa057.1901 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 573-573

Author(s):

DeAnnah Byrd ◽

Roland Thorpe ◽

Keith Whitfield

Keyword(s):

Mental Health ◽

Risk Factors ◽

Depressive Symptoms ◽

Cognitive Aging ◽

Community Dwelling ◽

Future Work ◽

The Impact ◽

Over Time ◽

Time Future

Abstract The established association between stress and depression is typically examined only in one direction and cross-sectionally. Data from the Baltimore Study of Black Aging-Patterns of Cognitive Aging was used to longitudinally examine the bi-directional relationships between (1) stress-depression and (2) depression-stress, and age as a modifier. The sample consisted of 602 community-dwelling Blacks, aged 48-92 years at baseline and 450 at follow-up 33 months later. While the stress-depression relationship was non-significant; the depression-stress was (b= 0.236, p< 0.000) and this association varied by age with the impact of baseline depression on changes in stress greatest among Blacks in their 60’s versus those in their 50’s (b= 0.257, p= 0.002), controlling for model covariates. Findings highlight the importance of depression in shaping Blacks’ perception of stress over time. Future work should continue to identify stress and mental health risk factors that contribute to poor health and health disparities in older Blacks.

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Fibromyalgia Outcomes Over Time: Results from a Prospective Observational Study in the United States

The Open Rheumatology Journal ◽

10.2174/1874312901610010109 ◽

2016 ◽

Vol 10 (1) ◽

pp. 109-121 ◽

Cited By ~ 3

Author(s):

Caroline P. Schaefer ◽

Edgar H. Adams ◽

Margarita Udall ◽

Elizabeth T. Masters ◽

Rachael M. Mann ◽

...

Keyword(s):

Longitudinal Research ◽

Short Form ◽

The United States ◽

Chronic Widespread Pain ◽

Pain Interference ◽

Online Questionnaire ◽

Time Points ◽

Patient Reported ◽

Over Time

Background:Longitudinal research on outcomes of patients with fibromyalgia is limited.Objective:To assess clinician and patient-reported outcomes over time among fibromyalgia patients.Methods:At enrollment (Baseline) and follow-up (approximately 2 years later), consented patients were screened for chronic widespread pain (CWP), attended a physician site visit to determine fibromyalgia status, and completed an online questionnaire assessing pain, sleep, function, health status, productivity, medications, and healthcare resource use.Results:Seventy-six fibromyalgia patients participated at both time points (at Baseline: 86.8% white, 89.5% female, mean age 50.9 years, and mean duration of fibromyalgia 4.1 years). Mean number of tender points at each physician visit was 14.1 and 13.5, respectively; 11 patients no longer screened positive for CWP at follow-up. A majority reported medication use for pain (59.2% at Baseline, 62.0% at Follow-up). The most common medication classes were opioids (32.4%), SSRIs (16.9%), and tramadol (14.1%) at Follow-up. Significant mean changes over time were observed for fibromyalgia symptoms (modified American College of Rheumatology 2010 criteria: 18.4 to 16.9;P=0.004), pain interference with function (Brief Pain Inventory-Short Form: 5.9 to 5.3;P=0.013), and sleep (Medical Outcomes Study-Sleep Scale: 58.3 to 52.7;P=0.004). Patients achieving ≥2 point improvement in pain (14.5%) experienced greater changes in pain interference with function (6.8 to 3.4;P=0.001) and sleep (62.4 to 51.0;P=0.061).Conclusion:Fibromyalgia patients reported high levels of burden at both time points, with few significant changes observed over time. Outcomes were variable among patients over time and were better among those with greater pain improvement.

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Associations between depressive complaints and indicators of labour participation among older Dutch employees: a prospective cohort study

International Archives of Occupational and Environmental Health ◽

10.1007/s00420-020-01584-9 ◽

2020 ◽

Author(s):

Jacqueline G. M. Jennen ◽

N. W. H. Jansen ◽

L. G. P. M. van Amelsvoort ◽

J. J. M. Slangen ◽

I. J. Kant

Keyword(s):

Mental Health ◽

Cohort Study ◽

Cox Regression ◽

Depression Scale ◽

Older Employees ◽

Labour Participation ◽

The Impact ◽

Over Time ◽

Work Contexts

Abstract Purpose European policy measures have led to an increased net labour participation of older employees. Yet, via different routes (for instance disability schemes) employees still often leave the labour market early. Mental health may be an important factor hindering labour participation. Aims of this study are twofold: first, to examine the relationship between mental health—particularly depressive complaints—and indicators of labour participation among older employees over a 2-year follow-up period and second, to explore the impact of different work contexts when studying this relation. Methods A subsample of older employees (aged > 45 years; n = 1253) from the Maastricht Cohort Study was studied. Depressive complaints were assessed using the Hospital Anxiety and Depression scale. Logistic and Cox regression analyses covered 2 years of follow-up and were also stratified for relevant work-related factors. Results Employees with mild depressive complaints showed statistically significantly higher risks for poor mental workability (HR 2.60, 95% CI 1.14–5.92) and high psychological disengagement levels (HR 2.35, 95% CI 1.21–4.57) over time compared to employees without depressive complaints. Within various work contexts, for instance in which employees perform physically demanding work or have high psychological job demands, significantly stronger associations were found between depressive complaints and poor mental workability over time. Conclusions This study shows strong longitudinal associations between depressive complaints and indicators of labour participation, also within different work contexts over time. Results provide valuable input for developing preventive measure aiming to enhance sustainable labour participation of older employees.

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Frontobiparietal remodeling with or without a widening bridge for sagittal synostosis: comparison of 2 cohorts for aesthetic and functional outcome

Journal of Neurosurgery Pediatrics ◽

10.3171/2014.12.peds14260 ◽

2015 ◽

Vol 16 (1) ◽

pp. 86-93 ◽

Cited By ~ 13

Author(s):

Marie-Lise C. van Veelen ◽

Dalibor Mihajlović ◽

Ruben Dammers ◽

Hester Lingsma ◽

Leon N. A. van Adrichem ◽

...

Keyword(s):

Surgical Technique ◽

Head Circumference ◽

Linear Regression Analysis ◽

Sagittal Synostosis ◽

Time Points ◽

Aesthetic Results ◽

The Aesthetic ◽

The Impact ◽

Over Time

OBJECT Various techniques to correct sagittal synostosis have been described. The authors of this study assess the results of 2 techniques for late complete cranial remodeling and test the hypothesis that adding a widening bridge would improve outcome. METHODS In this retrospective study, the authors evaluated patients with nonsyndromic sagittal synostosis—those who underwent frontobiparietal remodeling (FBR) and those who underwent modified FBR (MFBR) involving the introduction of a bony bridge to increase the width of the skull. Outcomes for both groups are described in terms of the aesthetic results assessed on photographs and any changes in the cranial index (CI) and head circumference over time, the presence of papilledema, and complaints of headache. The effect of the surgical technique on CI and head circumference over time was assessed using linear regression analysis, with adjustment for preoperative CI and head circumference. RESULTS Sixty-nine patients with isolated sagittal synostosis were included in this study: 35 underwent MFBR and 34 underwent the original technique of FBR. The mean follow-up period was 7 years. In the 1st year after surgery, mean CI improved by 9% in the FBR group and by 12% in the MFBR group. One year after surgery, CI in the MFBR group was on average 4.7% higher than that in the FBR group (p < 0.001). During follow-up, CI decreased in both groups; however, at all time points CI was significantly higher in the MFBR group than in the FBR group. The impact of surgical technique on CI was less important than the impact of preoperative CI (R2= 0.26 vs 0.54), and this applied at all time points during follow-up. Head circumference declined during follow-up in both groups. It was influenced by preoperative head circumference, but not by surgical technique. Aesthetic outcome, prevalence of headache (42%), and papilledema (7%) were comparable in both groups. CONCLUSIONS Adding a widening bridge to late complete remodeling significantly improved CI and helped to prevent CI from decreasing in the long term. This addition did not affect the head circumference growth curve. Despite a mean head circumference remaining at +1 SD, patients continued to develop papilledema postoperatively (7%).

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64 Temperature Sensitivity Is Associated with Lower Satisfaction with Life After Burns

Journal of Burn Care & Research ◽

10.1093/jbcr/irab032.068 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

pp. S45-S46

Author(s):

Jamie Oh ◽

Carolina Seek ◽

Stephen H Sibbett ◽

Gretchen J Carrougher ◽

Colleen M Ryan ◽

...

Keyword(s):

Mental Health ◽

Temperature Sensitivity ◽

Satisfaction With Life ◽

Burn Injury ◽

Independent Predictor ◽

Satisfaction With Life Scale ◽

Discharge Temperature ◽

Patient Reported ◽

The Impact

Abstract Introduction Temperature sensitivity is a common problem after burn injury. However, the impact of temperature sensitivity on health-related quality of life (QoL) is unknown. We aimed to describe characteristics associated with temperature sensitivity and determine its association with patient reported QoL. We hypothesized that temperature sensitivity negatively impacts both mental and physical health. Methods We reviewed a multicenter burn database for participants who had been asked about hot or cold temperature sensitivity 6, 12 and 24 months after injury. Outcomes of interest included the Satisfaction with Life Scale (SWLS) score and Veterans RAND 12 (VR-12) physical (PCS) & mental health summary (MCS) scores. Chi square and Kruskal-Wallis tests determined differences in patient and injury characteristics. Generalized linear regression models included burn size (%TBSA), graft size (%TBSA), location of burn, pruritis intensity, amputation status, study site, and review of systems questions at each follow-up visit as covariates to determine the impact of temperature sensitivity on QoL. Results The cohort was comprised of 637 participants. Prevalence of temperature sensitivity at each follow-up period ranged from 48%-54%. Those who experienced temperature sensitivity had larger burns, required more grafting, and had higher intensity of pruritus at discharge. Temperature sensitivity was associated with lower SWLS scores and lower VR-12 PCS and MCS at each follow-up period. After controlling for confounding variables, temperature sensitivity remained a significant independent predictor of lower SWLS scores (OR -3.2, 95% CI -5.4, -1.1) and VR-12 MCS (OR -4.4, 95% CI -7.4, -1.4) at 6 months follow-up. Conclusions Temperature sensitivity is a highly prevalent symptom after burn injury and an independent predictor of worse satisfaction with life and worse mental health recovery.

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Longitudinal evidence of the impact of dog ownership and dog walking on mental health

Journal of Public Health ◽

10.1093/pubmed/fdz094 ◽

2019 ◽

Author(s):

Y Cui ◽

M Russell ◽

M Davern ◽

H Christian

Keyword(s):

Mental Health ◽

Self Report ◽

Related Factors ◽

Logistic Regression Models ◽

Dog Walking ◽

Dog Ownership ◽

The Impact ◽

Longitudinal Relationships ◽

Over Time

Abstract Background Emerging evidence supports the physical health and social benefits of dog ownership. This study examined the longitudinal effect of dog ownership and dog walking on mental health. Methods Data from a cohort of 1023 participants taking part in the RESIDential Environments project, in Perth, Western Australia were collected over a 2 year period (baseline and follow-up). Self-report survey items measured mental health (stress and depression), dog ownership status and weekly minutes of dog walking. Logistic regression models accounted for potential confounding factors including socio–demographic, self-rated health and baseline mental health. Results Overall, no statistically significant effects were observed over time between dog ownership and stress (adjusted OR: 1.20; 95% CI: 0.79, 1.81) or depression (adjusted OR: 1.51; 95% CI: 0.72, 3.16). There was a small inverse but non-significant association between weekly minutes of dog walking and stress over time (adjusted OR: 0.85; 95% CI: 0.60, 1.22). Conclusion There was little evidence of prospective associations between dog ownership or dog walking and mental health. Further research is required to confirm longitudinal relationships between dog ownership and dog walking and mental health and investigate dog-related factors, such as a person’s attachment to their dog.

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