Adolescents with and without head and neck burns: comparison of long-term outcomes in the burn model system national database

Adults With Head and Neck Burns Experience Worse Long-Term Outcomes and Require More Reconstructive Surgeries: A Burn Model System Study

BACKGROUND

Adults living with head and neck burn injuries experience psychosocial consequences due to scarring as well as functional disabilities. However, the impact of head and neck burns on long-term self-reported psychosocial outcomes, return to work, and need for reconstructive surgery has not been well described. This study investigates the unique longitudinal problems in psychosocial and functional recovery faced by adults with head and neck burn injuries.

METHODS

Utilizing the multicenter Burn Model System (BMS) National Database, long-term psychosocial and functional outcomes as well as postdischarge reconstructive surgery rates between adult participants with and without head and neck burns injured after 2014 were compared.

RESULTS

Of 1247 participants, 579 had head and neck burns and 668 had non-head and neck burns. Head and neck burn was a significant predictor of worse anxiety (β = 1.63, P = 0.049) and body image (β = -0.30, P = 0.011) at 6 months post burn; worse anxiety (β = 2.68, P = 0.004), depression (β = 2.14, P = 0.021), and body image (β = -0.41, P = 0.001) at 12 months post burn; and worse life satisfaction (β = -1.64, P = 0.036) at 24 months post burn. Head and neck burn participants reported significantly worse anxiety ( P = 0.001), depression ( P = 0.0026), and life satisfaction ( P < 0.001) at 12 months post burn and worse body image at 6 ( P < 0.001), 12 ( P < 0.001), and 24 ( P < 0.001) months post burn. The head-and-neck group had a significantly greater proportion of participants who had undergone contracture surgery at 12 months post burn ( P < 0.001) and a smaller proportion who had returned to work by 6 ( P < 0.001) and 12 ( P < 0.001) months post burn.

CONCLUSIONS

This study suggests that adults with head and neck burns might strongly benefit from additional counseling, psychotherapy, and greater aftercare.

Association Between Burn Location and Psychological Distress: A Burn Model System National Database Study

Burn injuries often lead to psychological distress, from depression and anxiety to adjustment concerns and posttraumatic stress. There is some evidence that the anatomical location of burn injuries (eg, head/neck, feet) has a specific negative effect on psychological functioning. The purpose of this study was to examine the associations between burn injury location and emotional distress. First, we administered self-report questionnaires to burn survivors with ≤ 5% TBSA at a single adult outpatient burn clinic. Second, we used a cross-sectional analysis of the Burn Model System National Database. The mean values of each measure of psychological distress (ie, quality of life, self-esteem, depression, posttraumatic stress, anxiety, and, for contrast, posttraumatic growth) were examined for each anatomical location for those participants with a burn in those anatomical areas against those with burn in other areas. Using Kruskal-Wallis tests to compare psychological distress, we found no significant differences in outcome measures in either sample analyzed in our study. These findings contrast with prior literature indicating the negative psychological effect of burn injuries on certain locations in the body. Further research should explore whether larger burns (ie, < 5% TBSA) affecting critical areas of the body may be associated with psychological distress.

The effectiveness of the psychosocial empowerment program in early adjustment among adult burn survivors

BACKGROUND

Burns constitute a major global health challenge, causing not only physical trauma, but also significant psychosocial and emotional disturbances. The complexity of these injuries requires comprehensive rehabilitation programs that address both the physical and psychosocial aspects of recovery. Despite advances in medical care, there is a lack of standardized, accessible, and sustainable psychosocial interventions for burn survivors, particularly in the transition from hospital to home. This study aimed to develop and evaluate a nurse-led psychosocial empowerment intervention for early adjustment among burn survivors after hospital discharge.

METHODS

The study adopted a quasi-experimental framework. A convenient sample of 80 adult burn survivors was randomly divided into an intervention group, receiving the psychosocial empowerment program, and a control group, continuing standard care from November 2022 to May 2023. The effectiveness of the program was evaluated using various tools that measure satisfaction with appearance, coping abilities, and symptoms of post-traumatic stress disorder (PTSD). The intervention focused on enhancing resilience, self-efficacy, and adaptive coping, through targeted skill building in stress management, adaptability to coping, social reintegration, emotion regulation, and problem-solving.

RESULTS

Participants in the intervention group demonstrated significant improvements in body image satisfaction, coping abilities, and symptoms of PTSD compared to the control group.

CONCLUSIONS

The psychosocial empowerment program effectively addressed the psychosocial needs of burn survivors and enhanced their early adjustment after hospital discharge. The findings highlight the critical role of psychosocial support in the rehabilitation of burn survivors and underscore the need to integrate such interventions into standard post-discharge care. Future research should focus on the long-term effects of these interventions and their applicability in diverse settings.

A systematic review of life satisfaction and related factors among burns patients

This systematic review aimed to examine the life satisfaction and related factors among burns patients. A comprehensive systematic search was conducted at the international electronic databases such as Scopus, PubMed, Web of Science, and Persian electronic databases such as Iranmedex, and Scientific Information Database using keywords extracted from Medical Subject Headings such as 'Burns', 'Life satisfaction', 'Personal satisfaction', and 'Patient satisfaction' from the earliest to the 1 October 2022. The quality of the studies included in this review was evaluated using the appraisal tool for cross-sectional studies (AXIS tool). A total of 3352 burn patients in the nine cross-sectional studies were included in this systematic review. 70.52% of burn patients were male. The mean age of burn patients was 37.47 (SD = 14.73). The mean score of life satisfaction in burn patients based on SWLS was 23.02 (SD = 7.86) out of 35, based on LSI-A was 12.67 (SD = 4.99) out of 20, and based on the life satisfaction questionnaire was 4.81 (SD = 1.67) out of 7. Factors including time since burn, religion, and constant had a positive and significant relationship with life satisfaction in burn patients. Whereas, factors such as single marital status, age at injury, length of hospital stay, presence of pain, larger total body surface area burn, head and neck burn, functional impairment, family satisfaction, satisfaction with appearance, and previous psychiatric treatment had a negative and significant relationship with life satisfaction in burn patients. In sum, this systematic review showed that burn patients were slightly satisfied with their life. Therefore, health managers and policymakers can improve the quality of life of burn victims by planning psychological counselling and behavioural therapy, and consequently increase their life satisfaction.