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  • 51.
    Willebrand, Mimmie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience. Psykiatri, UAS.
    Psykiska faktorer i anpassningen efter svår kroppsskada2005Other (Other academic)
  • 52.
    Willebrand, Mimmie
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Neuroscience. Psykiatri, UAS.
    Andersson, Gerhard
    Ekselius, Lisa
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Neuroscience. psykiatri, UAS.
    Prediction of Psychological Health After an Accidental Burn2004In: The journal of Trauma injury, infection,and critical care, Vol. 57, no 2, p. 367-374Article in journal (Refereed)
  • 53.
    Willebrand, Mimmie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Kildal, Morten
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    A simplified domain structure of the Burn-Specific Health Scale-Brief (BSHS-B): A tool to improve its value in routine clinical work2008In: Journal of Trauma, ISSN 0022-5282, E-ISSN 1529-8809, Vol. 64, no 6, p. 1581-1586Article in journal (Refereed)
    Abstract [en]

    Background:

    Injury-specific instruments with good psychometric properties are valuable in the assessment of health status after trauma. Previous studies of burn-specific health have attempted to create broad domains such as physical and psychological health, but these domains have not been validated. In this study, burn-specific health domains were explored and validated by a factor analytic approach.

    Methods:

    Participants were 334 former burn patients injured between 1980 and 2000. Data were collected from medical charts and by a postal questionnaire, the Burn Specific Health Scale-Brief (BSHS-B). The nine subscales of the BSHS-B were subjected to second-order factor analysis. The sample was split into two subsamples that were equal with respect to burn severity.

    Results:

    The factor structure was well replicated in each of the subsamples and in the total sample. Three internally consistent and well separated domains were derived: affect and relations (BSHS-B subscales interpersonal relationships, affect, sexuality), function (simple abilities, hand function), and skin involvement (heat sensitivity, treatment regimens, body image). The work subscale of the BSHS-B was excluded from the analysis because of consistent double loadings. The three domains had intelligible associations with injury-specific and sociodemographic variables.

    Conclusion:

    The underlying structure of the BSHS-B comprises three clinically meaningful health domains. The work subscale is not part of these domains and can be considered a separate outcome domain. The domain scores increase the understanding of outcome after burn injury and could prove useful in clinical use of the BSHS-B.

  • 54.
    Willebrand, Mimmie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Kildal, Morten
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Burn Specific Health up to 24 Months After the Burn: A Prospective Validation of the Simplified Model of the Burn Specific Health Scale-Brief2011In: Journal of Trauma, ISSN 0022-5282, E-ISSN 1529-8809, Vol. 71, no 1, p. 78-84Article in journal (Refereed)
    Abstract [en]

    Background: Outcome after burn injury is a multidimensional concept, but few multidimensional, injury-specific outcome measures have been psychometrically evaluated. A recent cross-sectional study using the Burn Specific Health Scale-Brief (BSHS-B) found three psychometrically sound health domains: function, skin involvement, and affect and relations. The aim of this study was to reexamine the psychometric properties of the BSHS-B using a prospective study design. Methods: Ninety-four consecutive adult patients with burns were included and asked to fill in questionnaires, the BSHS-B, the Hospital Anxiety and Depression Scale, and the short-form 36 (SF-36), at 6 months, 12 months, and 24 months postburn. Results: The factor structure was replicated and the three domains, function, skin involvement, and affect and relations, had excellent internal consistency. Over time the scores of function and skin involvement increased, indicating health improvement, whereas the domain affect and relations did not change over time. At 6 months and 12 months postburn, all domains were associated with burn severity. The function domain was highly associated with the SF-36 subscales physical functioning and role-physical, the affect and relations domain was highly associated with the Hospital Anxiety and Depression Scale and the SF-36 subscales denoting psychological health, and the domain skin involvement was highly associated with subscales indicating role-concerns, social functioning, vitality, and mental health. Conclusion: The psychometric properties of the BSHS-B domains were excellent and they had intelligible concurrent associations with other measures. Thus, the simplified model of the BSHS-B is a reliable, valid, and useful tool in describing postburn health over time.

  • 55.
    Willebrand, Mimmie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Kildal, Morten
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Andersson, Gerhard
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Ekselius, Lisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Long-term assessment of personality after burn trauma in adults2002In: Journal of Nervous and Mental Disease, ISSN 0022-3018, E-ISSN 1539-736X, Vol. 190, no 1, p. 53-56Article in journal (Refereed)
  • 56. Willebrand, Mimmie
    et al.
    Kildal, Morten
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Ekselius, Lisa
    Gerdin, Bengt
    Andersson, Gerhard
    Development of the coping with burns questionnaire2001In: Personality and Individual Differences, Vol. 30, p. 1059-1072Article in journal (Refereed)
  • 57.
    Willebrand, Mimmie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Low, Aili
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Dyster-Aas, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Kildal, Morten
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Andersson, Gerhard
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Ekselius, Lisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Gerdin, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Pruritus, personality traits and coping in long-term follow-up of burn-injured patients2004In: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, Vol. 84, no 5, p. 375-80Article in journal (Other academic)
    Abstract [en]

    Pruritus is a major problem after burn injury; however, prevalence and predictors of prolonged pruritus are not known. The aims were to assess frequency of pruritus and the role of personality traits and coping in prolonged pruritus. The participants were burn patients injured 1-18 years earlier (n=248). Pruritus was assessed with an item from the Abbreviated Burn Specific Health Scale, personality was assessed with the Swedish universities Scales of Personality, and coping with the Coping with Burns Questionnaire. In all, 60% of the participants had pruritus at follow-up, however as the time after injury increased, the number of patients with persistent itch decreased. In logistic regression, 39% of the likelihood of having persistent pruritus was explained by greater extent of burn, less time after injury, and psychological features (being less assertive, and using more instrumental but less emotional support). In summary, chronic burn-related pruritus is rather common and psychological factors such as anxiety-related traits and coping are significantly associated with its presence.

  • 58.
    Willebrand, Mimmie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Norlund, Fredrika
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Kildal, Morten
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Gerdin, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Ekselius, Lisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Andersson, Gerhard
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Cognitive distortions in recovered burn patients: the emotional Stroop task and autobiographical memory test2002In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 28, no 5, p. 465-471Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to explore cognitive distortions in recovered burn patients. Previous studies in trauma patients have shown trauma-specific attentional bias, long response latencies, and deficits in memory specificity. Eighteen former patients, burn injured 5-19 years ago and 18 matched controls performed the emotional Stroop task, including burn and general trauma-related words, and the autobiographical memory test (AMT). In addition, verbal fluency, life events, and current mood were assessed. Regarding the Stroop task, the recovered patients had longer response latencies to burn words than to neutral and trauma words, a difference not seen in the control subjects. Regarding the AMT, the memory specificity did not differ between the groups. Overall, the former patients had longer latencies than the controls and poorer verbal fluency. The present study showed that recovered burn patients display a moderate Stroop effect, i.e. an attentional bias, in spite of the fact that the injury occurred several years before the testing. This may imply that the recovered burn patients consider the burn an important issue in life. The post-burn patients also presented signs of a slight cognitive slowness as compared to the controls. This finding deserves further attention in the rehabilitation of burn patients.

  • 59.
    Willebrand, Mimmie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital. Uppsala Univ Hosp, Burn Ctr, Dept Plast & Maxillofacial Surg, S-75185 Uppsala, Sweden.
    Sjöberg, Folke
    Linkoping Univ, Dept Clin & Expt Med, S-58183 Linkoping, Sweden.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery. Uppsala Univ Hosp, Burn Ctr, Dept Plast & Maxillofacial Surg, S-75185 Uppsala, Sweden.
    Sveen, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Parents' perceived quality of pediatric burn care.2018In: Journal of critical care, ISSN 0883-9441, E-ISSN 1557-8615, Vol. 43, p. 256-259Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To describe parents' perceived quality of pediatric burn care and evaluate factors associated with differences in perceived quality among parents.

    METHODS: 62 parents of children with burns were recruited on a Swedish national basis 0.8 to 5.6years after the child's injury. Measures were an adaptation of the Quality of Care Indices - Parent questionnaire consisting of 8 subscales and one overall question, the Impact of Event Scale -Revised, Montgomery Åsberg Depression Rating Scale, and Injury-specific fear-avoidance.

    RESULTS: Ratings of quality of care were high, especially regarding Staff Attitudes, Medical Treatment, and Caring Processes. Overall satisfaction rated from 1 to 10 was on average 9.1 (SD=1.2). Overall satisfaction and specific indices of Quality of care were not associated with burn severity, parent gender, or parent age. However, Quality of care was associated with current symptoms of posttraumatic stress and depression, and parents of girls expressed being less satisfied with Participation.

    CONCLUSIONS: Parents' perceived quality of care is associated with psychological health, but not with characteristics of the child's injury or age. The results suggest that burn care can improve by involving parents of girls more and by being more attentive towards parents who themselves appear stressed or worried.

  • 60.
    Willebrand, Mimmie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Sveen, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Injury-related fear-avoidance and symptoms of posttraumatic stress in parents of children with burns2016In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 42, no 2, p. 414-420Article in journal (Refereed)
    Abstract [en]

    Parents of children with burns experience a range of psychological reactions and symptoms, and parents’ health is known to impact children's health. So far, there is little research into potential mechanisms that maintain parents’ symptoms. The aim was to investigate parental injury-related fear-avoidance, and its associations with injury severity and health measures. Parents (n = 107) of children aged 0.4–18 years that sustained burns 0.1–9.0 years previously completed questionnaires on fear-avoidance, posttraumatic stress, and health of the child. Analyses showed that the average level of fear-avoidance was low and positively associated with measures of injury severity and parents’ symptoms of posttraumatic stress, and negatively associated with parents’ ratings of their child's health. In two separate multiple regressions with parents’ symptoms of PTSD and the child's health as dependent variables, fear-avoidance made the largest contribution in both models while injury severity was non-significant. Results were not related to comorbid conditions of the child, scarring, or parent-related socio-demographic variables. In summary, injury-related fear-avoidance is more likely among parents whose children sustain more severe burns. In turn, fear-avoidance contributes significantly to parents’ symptoms of PTSD and to poorer health ratings regarding the child, irrespective of injury severity or child comorbidity.

  • 61.
    Willebrand, Mimmie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Sveen, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Perceived support in parents of children with burns2016In: General Hospital Psychiatry, ISSN 0163-8343, E-ISSN 1873-7714, Vol. 38, no 1, p. 105-108Article in journal (Refereed)
    Abstract [en]

    Objective

    Children sustaining burns that require treatment in a burn center have a need for multiprofessional aftercare services over a prolonged time. So far, there is little research into satisfaction with care and support after pediatric burns. The aim was to investigate parents’ perception of support after pediatric burn and associations with parent, child and injury characteristics.

    Method

    Parents (n= 101) of children aged 0.4–17.8 years completed questionnaires on support, parent’s psychological symptoms and health of the child. Time since injury was 0.1–9.0 years.

    Results

    Perceived lack of psychosocial, medical, societal or family support was reported by 21% of the parents. Lack of support was not associated with injury or sociodemographic characteristics, but it was significantly associated with parents’ symptoms of general anxiety, depression and injury-related fear avoidance, as well as parents’ ratings of their child’s general health and heat sensitivity.

    Conclusion

    Perceived support did not differ on account of burn severity or sociodemographic status. However, care providers should be more attentive to and supportive of parents signaling poorer general health in their child and cognitive beliefs that the child is at risk for harm when active and parents who themselves show signs of psychological symptoms.

  • 62.
    Willebrand, Mimmie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Sveen, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Ramklint, Mia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Bergquist, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Sjöberg, Folke
    Psychological problems in children with burns: Parents' reports on the Strengths and Difficulties Questionnaire2011In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 37, no 8, p. 1309-1316Article in journal (Refereed)
    Abstract [en]

    Burns may have a devastating effect on psychological health among children, although previous studies report difficulties as well as positive findings. The aims were to describe the rate of psychological problems in children with burns using a standardised instrument and to explore statistical predictors of these problems. Parents (n = 94) of children aged 3-18 years who sustained burns 0.3-9.0 years previously answered the Strengths and Difficulties Questionnaire (SDQ) covering Emotional symptoms, Conduct problems, Hyperactivity/Inattention, Peer relationship problems, Prosocial behaviour, and a Total difficulties score. Questions regarding parental psychological health and family situation were also included. The results for three of the SDQ subscales were close to the norm (10%) regarding the rate of cases where clinical problems were indicated, while the rate of cases indicated for Conduct, Peer problems and Total difficulties was 18-20%. Statistical predictors of the SDQ subscales were mainly parents' psychological symptoms, father's education, and changes in living arrangements. Visible scars were relevant for the Total difficulties score and Hyperactivity/Inattention. In summary, a slightly larger proportion of children with burns had psychological problems than is the case among children in general, and family variables exerted the most influence on parental reports of children's psychological problems.

  • 63.
    Willebrand, Mimmie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Wikehult, Björn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Ekselius, Lisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Acceptance of a trauma-focused survey: Do personality and health matter?2004In: General Hospital Psychiatry, ISSN 0163-8343, E-ISSN 1873-7714, Vol. 26, no 1, p. 70-77Article in journal (Refereed)
    Abstract [en]

    Health evaluations after trauma are often performed by postal surveys, although previous studies show that some participants experience distress reactions afterwards. The aim was to explore how former burn patients react to filling in a trauma-related survey and whether the reactions are related to individual factors. The survey contained 307 questions, of which one was an open question to elicit reactions to participation. Personality was measured with the Swedish universities Scales of Personality, health with the Burn Specific Health Scale-Brief, and psychological health with the Hospital Anxiety and Depression Scale and Impact of Event Scale-Revised. Participants were 78 (67%) adult burn patients, injured on average 3.9 years previously. Three groups of reactions were identified: positive/beneficial (55%), effort/time-consuming (32%), and negative/intrusive (13%). Only four participants expressed that the survey had been intrusive. Negative reactions were associated with maladaptive personality traits, poorer relationships, and more stress symptomatology, but not with burn severity or sociodemographic variables. Patients with self-inflicted injuries were evenly spread across the groups, but those with negative reactions were responsible for most of the group differences in individual factors. While a small subgroup reacted negatively, the majority accepted the trauma-focused survey and even found it beneficial.

  • 64.
    Willebrand, Mimmie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Wikehult, Björn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Ekselius, Lisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Social desirability, psychological symptoms and perceived health in burn injured patients2005In: Journal of Nervous and Mental Disease, ISSN 0022-3018, E-ISSN 1539-736X, Vol. 193, no 12, p. 820-824Article in journal (Refereed)
    Abstract [en]

    Social desirability was previously seen as a nuisance in assessment, but today it is regarded as a personality trait with an influence on health. The aim was to explore relations between social desirability and health in former burn patients. Eighty-four burn patients injured on average 3.8 years ago responded to a questionnaire booklet. Social desirability was assessed with the social desirability subscale of the Swedish universities Scales of Personality, which is standardized in a normative sample. The results showed that a subgroup with high degree of social desirability displayed significantly poorer perceived health on the burn-specific health subscales heat sensitivity, work, and body image than normal responders did. There were no differences regarding age, education, injury-related variables, sick leave, or symptoms of anxiety and depression. In conclusion, participants with high social desirability were characterized by postburn problems in outdoor and work-related situations, and more self-consciousness about appearance.

  • 65.
    Öster, Caisa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Hensing, Ida
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Löjdström, Therese
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Sjoberg, Folke
    Willebrand, Mimmie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Parents' perceptions of adaptation and family life after burn injuries in children2014In: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 29, no 6, p. 606-613Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore parents' experiences after their child's burn injury, focusing on how the burn had influenced family life and child adjustment. Six semi-structured interviews with parents of children treated at burn centers 2 to 7years previously revealed the theme, "Feeling quite alone in striving to regain family wellbeing". Identification of difficulties perceived by the parents during rehabilitation and up until the present is useful when developing pediatric burn care and support for parents of children with burns.

  • 66.
    Öster, Caisa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Kildal, Morten
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Willebrand, Mimmie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Dyster-Aas, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Ekselius, Lisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Validation of the EQ-5D questionnaire in burn injured adults2009In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 35, no 5, p. 723-732Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Health-related quality of life (HRQoL) is an important aspect of adaptation after burn. The EQ-5D is a standardized generic instrument for assessing HRQoL. Its psychometric properties in a group of burn injured individuals are, however, not known.

    METHODS: Seventy-eight consecutive patients admitted to a burn unit were included in a prospective longitudinal study. The participants completed the EQ-5D during acute care, and at 3, 6, and 12 months after the burn. At 6 and 12 months after the burn they also completed the Short-Form 36 Health Survey (SF-36) and the Burn Specific Health Scale-Brief (BSHS-B).

    RESULTS: High feasibility of the EQ-5D was demonstrated through a high response rate and a low proportion of missing or invalid answers. The floor and ceiling effects were small. Construct validity was demonstrated through good differentiation between health states and good discrimination of health states over time. The EQ-5D was associated with burn severity and discriminated between clinical subgroups in an expected manner. Criterion validity was demonstrated through significant correlations between the EQ-5D and subscales of the SF-36 and the BSHS-B.

    CONCLUSIONS: The EQ-5D has good psychometric properties, it is short and easy to administer and thus useful in assessment of HRQoL after burn.

  • 67.
    Öster, Caisa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Willebrand, Mimmie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Ekselius, Lisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Burn-specific health 2 to 7 years after burn injury2013In: Journal of Trauma and Acute Care Surgery, ISSN 2163-0755, Vol. 74, no 4, p. 1119-1124Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Knowledge concerning the pattern of recovery and predictors of burn-specific health years after burn injury is limited, and these factors were therefore assessed with a disease-specific instrument, the Burn Specific Health Scale-Brief. METHODS: Consecutive adult burn patients were prospectively included during hospitalization and assessed at 3, 6, and 12 months as well as at 2 years to 7 years (4.6 years on average) after burn. Data concerning injury characteristics, sociodemographic variables, psychiatric disorders, and burn-specific health were obtained. RESULTS: Burn-specific health improved over time, from 6 months to the final assessment after burn. At 2 years to 7 years after burn, most problems were reported in the subscales heat sensitivity, body image, and work. The regression analyses revealed that length of stay, any preburn psychiatric disorder, major depression, and posttraumatic stress disorder 12 months after burn were predictors of long-term burn-specific health in the affect and relations domain, whereas time since injury, length of stay, and major depression 12 months after burn predicted outcome in the skin involvement domain. Predictors for the subscale work were length of stay, working at the time of injury, and posttraumatic stress disorder at 12 months. CONCLUSION: This study underscores that significant improvement in postburn health can be expected even later than 2 years after injury. Furthermore, the results imply that both preburn factors and factors identified 1 year after burn have impact on burn-specific health after several years.

  • 68.
    Öster, Caisa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Willebrand, Mimmie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Ekselius, Lisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Health-related quality of life 2 years to 7 years after a severe burn2011In: Journal of Trauma, ISSN 0022-5282, E-ISSN 1529-8809, Vol. 71, no 5, p. 1435-1441Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Knowledge concerning the trajectory andpredictors of health-related quality of life (HRQoL) years after burninjury is fragmentary and these factors were therefore assessed usingthe EQ-5D questionnaire.

    METHODS:

    Consecutive adult burnpatients were included during hospitalization and assessed at 3 months, 6months, and 12 months. In addition, an interview was performed at 2years to 7 years postburn. Data concerning injury characteristics,sociodemographic variables, psychiatric disorders, and HRQoL wereobtained.

    RESULTS:

    The EQ-5D dimension Mobility improvedbetween hospitalization and 3 months, while Anxiety/Depression improvedbetween 12 months and 2 years to 7 years. Other dimensions improvedgradually. At 2 years to 7 years, only the dimensions Pain/Discomfortand Usual activities were lower than in the general population. Inaddition, overall HRQoL was lower than in the general population whenmeasured by EQ VAS but not by EQ-5D index. EQ-5D index at 2 years to 7years was predicted by EQ-5D index at 12 months and concurrent workstatus and pain. EQ VAS at 2 years to 7 years was predicted by previousassessments of work status, posttraumatic stress disorder and EQ VAS,and concurrent work status and substance abuse. Total amount ofexplained variance ranged between 17% and 57%.

    CONCLUSIONS:

    HRQoLafter burn is conveniently screened by EQ VAS. Impairment after 2 yearsto 7 years is mainly reflected in the EQ dimensions Pain/Discomfort andUsual activities and can be predicted in part by information availablebefore or at 12 months.

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