Adolescent survivors of burn injuries and their parents' perceptions of recovery outcomes: Do they agree or disagree?
ABSTRACT This study analyzed the concordance of parent and child in assessing the progress of child and adolescent survivors of burn injuries using health outcomes.
The American Burn Association/Shriners Hospitals for Children Burn Outcomes Questionnaire (BOQ) was completed by 355 pairs of parents and their 11- to 18-year-old adolescents who experienced a burn injury. These patients completed BOQ child/parent questionnaire pairs at four regional pediatric burn care centers nationally during the first 4 years postburn. The BOQ includes 12 scales that range from physical to emotional health. Predicted recovery curves for each scale (dependent variable) were obtained from generalized linear models, with the independent variables the logarithmic transformation of the time since burn and parent/child as the principal indicator. Covariates included sociodemographics and clinical severity.
Mean differences between the parent and adolescent scale scores were small, with few insignificant exceptions. Most of the recovery curves over time for the parent and the adolescent were undifferentiated, except for the outcome of appearance where the adolescent rating was better than that of the parent (p < 0.01) and itch was judged as worse than that of the parent (p < 0.01). School reentry was rated higher by the adolescent initially (p < 0.001), but after 18 months, it was rated higher by the parent (p = 0.012).
Analysis of the BOQ completed by adolescents and their parents reveal similar estimates of recovery following the burn injury. These results suggest that the adolescent's reported outcomes can be used interchangeably with the parent's assessments, with the exception of appearance, itch, and school reentry, where there are some differences.
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ABSTRACT: Although data exist on burn survival, there are little data on long-term burn recovery. Patient-centered health outcomes are useful in monitoring and predicting recovery and evaluating treatments. An outcome questionnaire for young adult burn survivors was developed and tested. This 5-year (2003-2008) prospective, controlled, multicenter study included burned and nonburned adults ages 19 to 30 years. The Young Adult Burn Outcome Questionnaires were completed at initial contact, 10 days, and 6 and 12 months. Factor analysis established construct validity. Reliability assessments used Cronbach α and test-retest. Recovery patterns were investigated using generalized linear models, with generalized estimating equations using mixed models and random effects. Burned (n = 153) and nonburned subjects (n = 112) completed 620 questionnaires (47 items). Time from injury to first questionnaire administration was 157 ± 36 days (mean ± SEM). Factor analysis included 15 factors: Physical Function, Fine Motor Function, Pain, Itch, Social Function Limited by Physical Function, Perceived Appearance, Social Function Limited by Appearance, Sexual Function, Emotion, Family Function, Family Concern, Satisfaction With Symptom Relief, Satisfaction With Role, Work Reintegration, and Religion. Cronbach α ranged from 0.72 to 0.92, with 11 scales >0.8. Test-retest reliability ranged from 0.29 to 0.94, suggesting changes in underlying health status after burns. Recovery curves in five domains, Itch, Perceived Appearance, Social Function Limited by Appearance, Family Concern, and Satisfaction with Symptom Relief, remained below the reference group at 24 months. The Young Adult Burn Outcome Questionnaire is a reliable and valid instrument for multidimensional functional outcomes assessment. Recovery in some domains was incomplete.Journal of burn care & research: official publication of the American Burn Association 03/2013; 34(3). DOI:10.1097/BCR.0b013e31827e7ecf · 1.55 Impact Factor
Article: The year in burns 2012[Show abstract] [Hide abstract]
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.Burns: journal of the International Society for Burn Injuries 11/2013; 39(8). DOI:10.1016/j.burns.2013.11.001 · 1.84 Impact Factor
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ABSTRACT: Although many children with burns recover well and have a satisfying quality of life after the burn, some children do not adjust as well. Health-related quality of life (HRQoL) focuses on the impact health status has on quality of life. The aim of this study was to assess HRQoL with the American Burn Association/Shriners Hospitals for Children Burn Outcomes Questionnaire (BOQ) in a nationwide Swedish sample of children with burns 0.3-9.0 years after injury. Participants were parents (n=109) of children aged up to 18 years at the time of investigation who were treated at the Linköping or Uppsala Burn Center between 2000 and 2008. The majority of children did not have limitations in physical function and they did not seem to experience much pain. However, there were indications of psychosocial problems. Parents of preschool children reported most problems with the children's behavior and family disruption, whereas parents of children aged 5-18 years reported most problems with appearance and emotional health. There were mainly burn-related variables associated with suboptimal HRQoL in children aged 5-18 years, while family-related variables did not contribute as much.Burns: journal of the International Society for Burn Injuries 11/2013; 40(5). DOI:10.1016/j.burns.2013.10.005 · 1.84 Impact Factor