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Patient perception of long-term burn-specific health and congruence with the Burn Specific Health Scale-Brief
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
(English)In: Burns, ISSN 0305-4179, E-ISSN 1879-1409Article in journal (Refereed) In press
Abstract [en]

Introduction: This qualitative study aims to explore former burn patients’ perception of burn-specific health and investigate how these experiences correspond to the subscales in the Burn Specific Health Scale-Brief (BSHS-B).

Method: Respondents were former burn patients, admitted to the Uppsala Burn Centre between 2000 and 2007. A total of 20 respondents with a Total Body Surface Area (TBSA) of 20% or larger, were approached at 10 to 17 years post-burn and interviewed using a semi-structured guide. Data was analyzed using thematic analysis.

Results: Despite extensive burn injuries, respondents said they led a close-to-normal life. Their descriptions validated the significance of the existing themes of BSHS-B. Additional themes of importance for post-burn health were skin related problems, morphine de-escalation, the importance of work, stress and avoidance, mentality and the healthcare system.

Conclusion: The BSHS-B alone may not be sufficient in providing a comprehensive picture of former burn patients’ self-perceived health in the long-term perspective. Investigating supplementary areas reflecting former patients’ sociocultural and attitudinal environment, as well as personal factors, may be of great importance. 

Keywords [en]
Health Related Quality of Life, Burn Specific Health Scale-Brief (BSHS-B), Qualitative analysis, Burns
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-380413OAI: oai:DiVA.org:uu-380413DiVA, id: diva2:1299671
Funder
Swedish Research CouncilForte, Swedish Research Council for Health, Working Life and WelfareAvailable from: 2019-03-28 Created: 2019-03-28 Last updated: 2019-04-12
In thesis
1. Long-term outcome after burn: Pruritus, pain, personality and perceived health
Open this publication in new window or tab >>Long-term outcome after burn: Pruritus, pain, personality and perceived health
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis investigated the role of burn-specific and individual-related factors for long-term outcome after burn with emphasis on pruritus, pain, personality and perceived health.

Consecutive adult patients, admitted to the Uppsala University Burn Center between 2000 and 2009, were included. Patients were assessed during hospitalization, at 3, 6, 12 and 24 months and finally at 2-7 and 10-17 years post-burn.

Pruritus was prevalent in half of the patients 2-7 years post-burn. Of the patients with pruritus, half had severe pruritus, which was independently related to full thickness burn and health-related quality of life (HRQoL) at 3 months post-burn. One third scratched to the point of bleeding. Such scratching was independently related to full thickness burns and the personality trait Impulsiveness, but did not necessarily imply more severe pruritus. Results suggest that many patients lack adequate treatment.

 Pain was prevalent in one third of the patients 2-7 years post-burn. Severity levels generally decreased over time and was at follow-up mostly regarded as mild to moderate. Post-burn pain has a negative effect on HRQoL and at 3 months post-burn, HRQoL was independently related to the reporting of post-burn pain at 2-7 years.

Personality trait scores in burn patients deviated little from norm values. Personality traits remained largely stable the first year after burn injury, except for an increase in the trait Stress Susceptibility, which was scored lower during the acute care phase but normalized at 12 months post-burn.

In qualitative interviews 10-17 years post-burn, participants reported living a near normal life. The subscales of the burn-specific health scale brief were in general still applicable at this time point. Additional areas playing an important role for post-burn health and outcome were skin-related problems, morphine de-escalation, the importance of work, stress and avoidance, mentality and the healthcare system.

Certain subgroups of burn patients are more vulnerable and likely to develop post-burn sequalae and this is dependent on both burn severity and individual characteristics. In general, however, many former burn patients recover well in the long run.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2019. p. 65
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1569
Keywords
Burns, Pruritus, Pain, Personality, Quality of Life, Health Status, Wounds and injuries, Patient Reported Outcome Measures, Rehabilitation
National Category
Medical and Health Sciences
Research subject
Psychiatry; Surgery
Identifiers
urn:nbn:se:uu:diva-381618 (URN)978-91-513-0643-8 (ISBN)
Public defence
2019-06-05, Gunnesalen, Entrance 10, Akademiska sjukhuset, Uppsala, 13:00 (English)
Opponent
Supervisors
Available from: 2019-05-15 Created: 2019-04-12 Last updated: 2019-06-17

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Gauffin, EmelieÖster, Caisa

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