Burn survivors injured as children exhibit resilience in long-term community integration outcomes: A life impact burn recovery evaluation (LIBRE) study |
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| Affiliation: | 1. Spaulding Rehabilitation Hospital, Harvard Medical School, United States;2. Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, United States;3. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada;4. Massachusetts General Hospital, Shriners Hospitals for Children-Boston, Harvard Medical School, United States;5. Bentley University, Department of Mathematical Sciences, Waltham, MA, United States;6. Phoenix Society for Burn Survivors, United States;1. Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts;2. University of Washington, Seattle, Washington;3. Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts;4. Brigham and Women’s Hospital, Boston, Massachusetts;5. University of Texas Medical Branch, Shriners Hospitals for Children-Galveston, Galveston, Texas;6. Harborview Medical Center, University of Washington, Seattle, Washington;7. University of Texas Southwestern Medical Center, Dallas, Texas;8. Shriners Hospitals for Children-Boston, Boston, Massachusetts;1. Pontifical Catholic University of Minas Gerais at Poços de Caldas, Department of Nursing, Poços de Caldas, MG, Brazil;2. Psychiatric Nursing program, University of São Paulo at Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil;3. Maternal-Infant and Public Health Nursing Department, University of São Paulo at Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil;4. General and Specialized Nursing Department, University of São Paulo at Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil;5. Utrecht University, Department of Psychology, Utrecht, The Netherlands;6. Association of Dutch Burn Centers, Utrecht University, Department of Clinical & Health Psychology, Beverwijk, Utrecht, The Netherlands;1. Division of Plastic Surgery, Brigham and Women’s Hospital, Boston, MA, United States;2. Division of Plastic Surgery, University of California, San Francisco, CA, United States;3. Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States;4. Department of Surgery, University of Washington Harborview, Seattle, WA, United States;5. Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX, United States;6. Department of Psychiatry, University of Texas Medical Branch, Galveston, TX, United States;7. Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, United States;8. Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States;9. Shriners Hospitals for Children – Boston, Boston, MA, United States;10. Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, United States;1. Centre for Children''s Burns and Trauma Research, Child Health Research Centre, Level 4, Foundation Building, Royal Children''s Hospital, Herston Rd, Herston, Brisbane, Queensland 4006, Australia;2. Central Queensland Hospital and Health Service, East St, Rockhampton, Queensland 4700, Australia;3. School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, Queensland 4067, Australia;4. Department of Occupational Therapy, Lady Cilento Children''s Hospital, 501 Stanley St, South Brisbane, Queensland 4101, Australia;5. Department of Paediatric Surgery, Urology, Neonatal Surgery, Burns and Trauma, Lady Cilento Children''s Hospital, Brisbane, Queensland 4101, Australia;6. School of Medicine, The University of Queensland, St Lucia, Brisbane, Queensland 4067, Australia;7. Physiotherapy Department, Royal Brisbane and Women''s Hospital, Butterfield St, Herston, Brisbane, Queensland 4006, Australia;8. Occupational Therapy Department, Royal Brisbane and Women''s Hospital, Butterfield St, Herston, Brisbane, Queensland 4006, Australia;1. Association of Dutch Burn Centres, Postbus 1015, 1940 EA Beverwijk, The Netherlands;2. Utrecht University, Department of Psychology, Heidelberglaan 1, 3508 TC Utrecht, The Netherlands;3. Dutch Association of Burn Survivors, Postbus 1015, 1940 EA Beverwijk, The Netherlands;1. Department for Hand Surgery and Plastic Surgery, Burn Center, BG Trauma Center Duisburg, Klinikum Duisburg, Germany;2. Division of Plastic Surgery, Department of Surgery, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA;3. Department for Plastic and Aesthetic Surgery, St. Vinzenz Hospital, Cologne, Germany |
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| Abstract: | IntroductionThere is limited understanding of how burn injuries at different ages are associated with normal growth and development as well as the burn recovery process. This study provides new useful insights by comparing social participation outcomes among burn survivors injured in childhood compared with injuries sustained in middle age, and older adulthood.MethodsItems from the development of the LIBRE profile were administered to 601 adult burn survivors with ≥5% TBSA burned or burns to critical areas (hands, feet, face, or genitals). Each item was answered on a 5-point Likert scale with higher scores denoting better outcomes. Mean scores for the 6 LIBRE profile scales (sexual relationships, family and friends, social interactions, social activities, work and employment, and romantic relationships) were compared between those burned as children (<18 years) and those burned as adults (≥18 years). Regression analyses were used to assess differences between groups with adjustment for demographic and clinical characteristics.ResultsOf the 597 burn survivors having complete data on age at injury, 165 (27.6%) sustained burn injuries as a child. Those burned as children were more frequently female than those burned as adults (57% vs 47%) and were also more frequently white non-Hispanic (89% vs 77%). Marital status and education level were similar in the two groups. Those who were burned as children had slightly higher scores on the social activities, work and employment and romantic relationships scales. However, these differences did not persist in adjusted regression analyses.ConclusionsBurn survivors who sustained injuries as a child fared at least as well as those burned as adults in a broad range of long-term social participation outcomes. The impact on long-term social participation outcomes of burn survivors was not significantly different between individuals with burns sustained during important developmental stages at young ages and those injured later in life. |
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| Keywords: | Burn injury Psychosocial outcomes Pediatrics Developmental stages Resilience |
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