title: Burden of burn: a norm-based inquiry into the influence of burn size and distress on recovery of physical and psychosocial function.
abstract: 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. Analyses compared groups across level of burden and with published normative data. Assessments reflected health and function (Short Form 36) during the month before burn, at discharge, and at 6 and 12 months after burn. Physical functioning was significantly more impaired and the rate of physical recovery slower among those with either large physical burden or large psychological burden. Notably, psychosocial functioning also was more impaired and the rate of psychosocial recovery slower among those with greater psychological burden. These results suggest that, in addition to aggressive wound closure, interventions that reduce in-hospital distress may accelerate both physical and psychosocial recovery.
authors.affiliation: Johns Hopkins University School of Medicine, c/o Baltimore Regional Burn Center, 4940 Eastern Avenue, Baltimore, MD 21224, USA.
authors.forename: James A
authors.initials: JA
authors.lastname: Fauerbach
authors.forename: Dennis
authors.initials: D
authors.lastname: Lezotte
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Hills
authors.forename: G Fred
authors.initials: GF
authors.lastname: Cromes
authors.forename: Karen
authors.initials: K
authors.lastname: Kowalske
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: de Lateur
authors.forename: Cleon W
authors.initials: CW
authors.lastname: Goodwin
authors.forename: Patricia
authors.initials: P
authors.lastname: Blakeney
authors.forename: David N
authors.initials: DN
authors.lastname: Herndon
authors.forename: Shelley A
authors.initials: SA
authors.lastname: Wiechman
authors.forename: Loren H
authors.initials: LH
authors.lastname: Engrav
authors.forename: David R
authors.initials: DR
authors.lastname: Patterson
mesh_terms: D000328:Adult; D002053:Burn Units / Q000706:statistics & numerical data; D002056:Burns / Q000473:pathology / Q000523:psychology* / Q000534:rehabilitation*; D017281:Cost of Illness; D005260:Female; D006304:Health Status; D006801:Humans; D007297:Inpatients; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D012919:Social Behavior; D013315:Stress, Psychological; D014945:Wound Healing