Recovery Curves for Pediatric Burn Survivors: Advances in Patient-Oriented Outcomes.

Importance: Patient-reported outcomes serving as benchmarks for recovery of pediatric burn survivors are lacking, and new approaches using longitudinal cohorts for monitoring their expected recovery based on statistical models are needed for patient management during the early years following the burn.

Objective: To describe multidimensional patient-reported outcomes among pediatric burn survivors younger than 5 years to establish benchmarks using recovery curve methods.

Design, Setting, And Participants: Prospective cohort study of pediatric burn survivors younger than 5 years at 12 burn centers.

Self-perceptions of young adults who survived severe childhood burn injury.

The transition of pediatric burn survivors into adulthood is accompanied by a reformulation of their self-concept. To anticipate the need for and guide development of appropriate psychosocial interventions, this study examines how young adults who were burned as children perceive themselves and how this perception might affect their self-esteem. Eighty-two young adult burn survivors (45 male, 37 female) were assessed using the Tennessee Self-Concept Scale, 2nd edition (TSCS2) to determine how the participants perceive themselves and their interaction with society.

Personality disorders in young adult survivors of pediatric burn injury.

Objective: Life experience shapes personality and chronic trauma in childhood has been associated with risk for development of subsequent personality disorder. The purpose of this study is to determine the prevalence and character of personality disorders and traits in young adult survivors of severe pediatric burn injury. METHOD.

Psychosocial impact of childhood face burns: a multicenter, prospective, longitudinal study of 390 children and adolescents.

Introduction: This two-year longitudinal study of the health-related quality of life (HRQoL) of children with face burns was conducted in three regional pediatric burn care centers. Subjects were 390 children less than 18 years old at injury, admitted for burn treatment from September 2001 to December 2004.

Methods: HRQoL was assessed using the age-specific Burn Outcomes Questionnaire (BOQ) administered at scheduled time points following discharge up to 24 months thereafter.

Psychiatric disorders in long-term adjustment of at-risk adolescent burn survivors.

This study investigated the point prevalence of psychiatric disorders among adolescent long-term burn survivors. Psychiatric symptoms and diagnoses were assessed in 50 youth (30 males, 20 females) characterized as troubled by their parent or guardian on the Child Behavior Checklist from a sample of 93 adolescent burn survivors. Those selected for further evaluation had a mean age at time of burn injury of 4.

Differences in behavioral perceptions between young adult burn survivors and cross-informants.

The purpose of this study is to gain insight into the level of agreement, in terms of personal problems, between burn survivors and an informant with whom they have a close personal relationship. Participants in the study were 72 young adult burn survivors between the ages of 18 and 28 with a mean age of 20.9 +/- 2.

Relationships between the Quality of Life Questionnaire (QLQ) and the SF-36 among young adults burned as children.

Objective: To examine the relationship between two measures that can be used to examine quality life among pediatric burn survivors.

Design: Prospective, correlational study.

Setting: Acute and rehabilitation pediatric burn care facility.

Sleep onset insomnia symptoms during hospitalization for major burn injury predict chronic pain.

Both cross-sectional studies of chronic pain and sleep deprivation experiments suggest a bi-directional relationship between sleep and pain. Few longitudinal studies, however, have assessed whether acute insomnia following traumatic injury predicts the development of persistent pain. We sought to evaluate (1) whether in-hospital insomnia independently predicts long-term pain after burn injury and (2) whether in-hospital pain predicts future insomnia symptoms.

Psychosocial care of persons with severe burns.

Treatment of people with burn injuries includes recovery of optimal function for survivors to fully participate in society, psychologically and physically. Increased likelihood of physical survival has led to greater concern for potential psychological morbidity for the burn survivor. Based on research and on many years of clinical experience in providing psychosocial care to burned children and adults, the authors outline their approach to assisting burn survivors and their families through the arduous process of recovery from admission through critical care, inpatient recuperation and reintegration upon hospital discharge.

Physical and psychologic rehabilitation outcomes for young adults burned as children.

Objective: To report physical and psychologic outcomes for young adult survivors of pediatric burns.

Design: Prospective, correlational study.

Setting: Acute and rehabilitation pediatric burn care facility.

Symptoms of depression and anxiety as unique predictors of pain-related outcomes following burn injury.

Background: The adverse consequences of burn injuries include pain and psychological distress, which show bidirectional associations. However, much of the existing research has relied on global measures of distress that do not separate distinct symptoms of anxiety and depression.

Purpose: The purpose is to assess the prospective effects of anxiety and depression on pain and functional outcomes following burn injury.

Psychological distress after major burn injury.

Objective: To track the prevalence and stability of clinically significant psychological distress and to identify potentially modifiable in-hospital symptoms predictive of long-term distress (physical, psychological, and social impairment).

Method: We obtained data from the Burn Model Systems project, a prospective, multisite, cohort study of major burn injury survivors. The Brief Symptom Inventory (BSI) was used to assess symptoms in-hospital (n = 1232) and at 6 (n = 790), 12 (n = 645), and 24 (n = 433) months post burn.

The importance of family environment for young adults burned during childhood.

This study examined the role of family environment for young adult burn survivors making the transition from adolescence to adulthood. Ninety-three young adults who sustained large burns as children were asked to describe their families using the Family Environment Scale (FES). When examining the difference between burn survivors and the normative sample of the FES, burn survivors did not perceive their current family environment different than the normative group.

Prevalence of major psychiatric illness in young adults who were burned as children.

Objective: To determine the prevalence of major psychiatric illness in a group of young adults who suffered significant burn injury as children.

Method: A total of 101 persons (58 males, 43 females), aged 21 +/- 2.6 years, 14.

Quality of life of young adults who survived pediatric burns.

Ninety-five young adult pediatric burn survivors, ages 18 to 28, who were an average of 14 years after massive burn, were questioned about their quality of life. The Quality of Life Questionnaire (QLQ) by Evans and Cope was used to assess their long-term adjustment in diverse environmental settings. Results revealed burn survivors as a group rated their overall quality of life lower than the normal population.

PTSD symptoms among men and women survivors of intimate partner violence: the role of risk and protective factors.

The purpose of this cross-sectional analysis of the National Violence Against Women Survey was to characterize current symptoms of posttraumatic stress disorder (PTSD) among 185 men and 369 women survivors of intimate partner violence (IPV). In this subsample, 24% of women and 20% of men had current moderate-to-severe PTSD symptoms. PTSD scores were higher for women than men.

Efficacy of a short-term, intensive social skills training program for burned adolescents.

This study examined the efficacy of an intensive, short-term social skills training program in improving the psychosocial adjustment of burned adolescents. Sixty-four adolescents who had suffered a burn injury 2 years previously or longer and who were identified as having psychosocial difficulties (elevated behavioral problems and/or diminished competence) were assigned randomly to receive the treatment intervention or to serve as controls (32 in each group). The intervention was a social skills training curriculum provided in a small group residential format.

Reported stress of parents of burned children differs on the Spanish and English versions of the parenting stress inventory.

The Parenting Stress Inventory (PSI) is a 101-item self-report questionnaire measuring stress in children and their parents. For several years, we have been administering the English and Spanish versions of the PSI to parents of children with >40% total body surface area burn at discharge, 6 months, 1 year, and every year at followup at clinic. The aim of the present study was to evaluate differences between Spanish- and English-speaking families with respect to stress and to further examine potential psychometric differences between the instruments that may contribute to these differences.

Burden of burn: a norm-based inquiry into the influence of burn size and distress on recovery of physical and psychosocial function.

This prospective, longitudinal study examined the influence of baseline physical and psychological burden on serial assessments of health-related quality of life among adults with major burns from three regional burn centers (n = 162). Physical burden groups were defined by % TBSA burned: <10%, 10% to 30%, or >30%. Psychological burden groups were defined by in-hospital distress using the Brief Symptom Inventory Global Severity Index T-score with scores of < 63 or > or = 63.

A double-blind study of the analgesic efficacy of oral transmucosal fentanyl citrate and oral morphine in pediatric patients undergoing burn dressing change and tubbing.

Burn wound care is extremely painful. The pain leads to added anxiety and therefore a distressing treatment that can negatively impact healing. Pain and anxiety management with oral transmucosal fentanyl citrate was compared with this institution's standard procedural pain medication, morphine.

Impact on the family: psychosocial adjustment of siblings of children who survive serious burns.

This study examined the psychosocial adjustment of 79 siblings of children suffering from burn injuries. Nonparametric statistics were used to compare psychosocial adjustment of the study group, as measured by the Child Behavior Checklist with an age-matched and gender-matched reference groups. Analyses found that the study group was better adjusted than the normative group on psychological dimensions; however, the study group fared worse than the normative group on overall competence, particularly social competence.