title: Functioning, Disability, and Social Adaptation Six Months After Burn Injury.
abstract: Major injuries commonly cause long-standing functional impairment. The authors investigated the levels of and predictors for functioning, disability, and social adaptation 6 months after a burn injury. The overall level of functioning at 6 months postburn was assessed among 87 (81%) of the 107 consecutive acute adult burn patients (mean TBSA 9.7%) admitted to the Helsinki Burn Centre during an 18-month period. Social and Occupational Functioning Assessment Scale (SOFAS) was used to evaluate functioning overall, and Sheehan Disability Scale (SDS) to assess the domains of working capacity, social life, and family life. Social Adaptation Self-Evaluation Scale (SASS) was used to measure social adaptation. Structured clinical interview was used to assess mental disorders at baseline and 6 months after injury. The mean SOFAS score was 69.7 (SD = 20.8), indicating some impairment in social and occupational functioning. The strongest independent predictors of SOFAS were mental disorders during follow-up (P < .001), particularly major depressive disorder (P < .001) and delirium (P = .016), but also length of stay (P = .004) and hand burn (P = .012). Concerning disability (SDS), the authors found mild impairment in all three domains, the most in SDS work (mean 3.59, SD = 3.46). The strongest predictor of SDS was major depressive disorder during follow-up (P < .001) and of SASS personality disorders (P = .007). Six months after a burn injury, some difficulties in social and occupational functioning remained. Level of functioning was predicted strongly and consistently by mental disorders, particularly depression. Length of stay and hand burns also predicted functioning, more in a clinician's evaluation (SOFAS) than in self-reported measures (SDS and SASS).
authors.affiliation: From the *Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland; †Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland; ‡Department of Psychiatry, City of Helsinki, Department of Social Services and Health care, Helsinki, Finland; and §Helsinki Burn Centre, Department of Plastic Surgery, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Raimo
authors.initials: R
authors.lastname: Palmu
authors.forename: Timo
authors.initials: T
authors.lastname: Partonen
authors.forename: Kirsi
authors.initials: K
authors.lastname: Suominen
authors.forename: Jyrki
authors.initials: J
authors.lastname: Vuola
authors.forename: Erkki
authors.initials: E
authors.lastname: Isometsä
mesh_terms: D000328:Adult; D002056:Burns / Q000503:physiopathology* / Q000523:psychology*; D003865:Major Depressive Disorder / Q000453:epidemiology; D004185:Disability Evaluation; D005260:Female; D006230:Hand Injuries / Q000453:epidemiology; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012917:Social Adjustment