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Return to work and health-related quality of life after burn injury
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
2007 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 39, no 1, 49-55 p.Article in journal (Refereed) Published
Abstract [en]

Objective: Although severe burn injury is associated with long-term rehabilitation and disability, research on returning to work in burn patients is limited. The aims of this study were: (i) to explore injury- and personality-related predictors of returning to work, and (ii) to compare health-related quality of life and health outcome in working versus non-working individuals.Design: Cross-sectional study.Subjects: Forty-eight former patients with pre-burn employment were evaluated on average 3.8 years after the burn.Methods: Data were collected from medical records and by a questionnaire in which the patients were asked about their main activity status described in the terms: work, studies, pension, disability pension, sick leave or unemployment. It also contained the Swedish universities Scales of Personality, SF-36, Burn Specific Health Scale-Brief, items assessing fear-avoidance, Impact of Event Scale-Revised and Hospital Anxiety and Depression Scale.Results: Thirty-one percent had not returned to work. In logistic regression, returning to work was associated with time since injury, the extent of full-thickness injuries, and the personality trait embitterment. Those who did not work had lower health-related quality of life, poorer burn-specific health, more fear-avoidance and more symptoms of post-traumatic stress disorder, but they did not differ from those who were working regarding general mood.Conclusion: Returning to work was explained by both injury severity and personality characteristics. Those who did not work were characterized by low health-related quality of life and poorer trauma-related physical and psychological health.

Place, publisher, year, edition, pages
2007. Vol. 39, no 1, 49-55 p.
Keyword [en]
Adjustment, BSHS-B, Burns, Personality, SF-36, Trauma
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-95103DOI: 10.2340/16501977-0005ISI: 000244355400009PubMedID: 17225038OAI: oai:DiVA.org:uu-95103DiVA: diva2:169186
Available from: 2006-11-17 Created: 2006-11-17 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Psychiatric History and Adaptation in Burn Injured Patients
Open this publication in new window or tab >>Psychiatric History and Adaptation in Burn Injured Patients
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The intertwined relationship between physical and psychological problems is a topic of much interest in the rehabilitation of severely injured patients, e.g. after a burn. The present study aims at gaining further knowledge concerning the impact of psychological factors and psychiatric morbidity on short and long-term adaptation after burn injury.

Outcome was assessed for three main areas: pruritus, return to work and psychiatric health. Three separate samples of previous or current adult patients treated at the Uppsala Burn Unit during different time periods: 1980-1995 (n=248), 1996-2000 (n=86), and 2000-2005 (n=73), were assessed.

Chronic burn-related pruritus is more common than previously reported and psychological factors such as anxiety-related personality traits and coping are significantly associated with its presence.

Only a small group of former patients with work-related accidents were not working an average of nine years after injury. The unemployed reported more pain and worse perceived health, particularly in psychosocial domains.

Returning to work was explained by both injury severity and personality characteristics. Those who were not working had lower health-related quality of life and poorer traumarelated physical and psychological health, and more pain.

Preburn psychiatric morbidity is high in a lifetime perspective. Two thirds of the sample had at least one disorder according to the Structured Clinical Interview for DSM-IV Axis I disorders. Affective disorders were especially highly represented. A logistic regression showed that having a history of preburn disorders was associated with a higher risk of both PTSD and depression one year after the injury. In this material it was actually uncommon for a patient without a preburn psychiatric history to develop postburn psychiatric symptomatology.

The results have strengthened the overall model for adaptation after burn injury by showing that psychological factors and psychiatric history are important moderators of the adaptation process after the injury.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2006. 60 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 199
Keyword
Psychiatry, Burns, Coping, Depression, Health Status, Outcome assessment, Personality, Post-Traumatic Stress Disorder, Psychiatric Disorders, Pruritus, Rehabilitation, Injuries, Psykiatri
Identifiers
urn:nbn:se:uu:diva-7252 (URN)91-554-6711-3 (ISBN)
Public defence
2006-12-08, Enghoffsalen, Entrance 50, Akademiska sjukhuset, Uppsala, 09:15 (English)
Opponent
Supervisors
Available from: 2006-11-17 Created: 2006-11-17 Last updated: 2009-05-07Bibliographically approved

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Kildal, MortenWillebrand, Mimmie

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