title: A systematic review of the psychometric properties of self-reported scales assessing burn contractures reveals the need for a new tool to measure contracture outcomes.
abstract: Approximately 40% of burn patients develop scar contractures. It is unknown which scar contracture therapy best optimizes activities of daily living (ADL).The appropriateness of self-reported outcome tools in measuring anti-scar contracture therapies has not been assessed. We conducted a systematic review to determine the quality of existing self-reported scales in measuring ADL among burn patients by analyzing and comparing psychometric properties-factor analysis, validity, reliability, and responsiveness. EMBASE, LILACS, American Psychological Association PsycNET databases were searched for relevant articles. Forty-one articles discussing 10 burn and non-burn-specific scales met eligibility criteria of ADL assessment, and available psychometric analyses. A common strength in most scales was good overall reliability. Common weaknesses were insufficient data on factor analyses, content validity specific to ADL assessment, and responsiveness. The psychometric analyses studies on these scales had poor sample variability. There is insufficient data on the dimensionality and responsiveness of existing scales to support their use for measuring ADL in burn patients. Existing scales do not comprehensively measure ADLs as an isolated parameter. A psychometrically valid, comprehensive self-reported burn contracture scale that measures ADLs among a diverse group of burn patients needs to be developed to optimize burn contracture treatments and develop new therapies.
authors.affiliation: Duke University School of Medicine, Durham, NC 27710, USA.
authors.forename: Tosan
authors.initials: T
authors.lastname: Ehanire
authors.forename: Joao Ricardo Nickenig
authors.initials: JR
authors.lastname: Vissoci
authors.forename: Keimun
authors.initials: K
authors.lastname: Slaughter
authors.forename: Rafael
authors.initials: R
authors.lastname: Coêlho
authors.forename: Jennifer
authors.initials: J
authors.lastname: Bond
authors.forename: Clarissa
authors.initials: C
authors.lastname: Rodrigues
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pietrobon
authors.forename: Howard
authors.initials: H
authors.lastname: Levinson
mesh_terms: D000203:Activities of Daily Living; D002056:Burns / Q000150:complications / Q000175:diagnosis*; D002921:Cicatrix / Q000150:complications / Q000175:diagnosis*; D003286:Contracture / Q000175:diagnosis* / Q000209:etiology; D005163:Factor Analysis, Statistical; D006801:Humans; D011594:Psychometrics; D015203:Reproducibility of Results; D057566:Self Report; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires