Assessment of health-related quality of life in the first year after burn

Echevarría-Guanilo, Maria Elena; Gonçalves, Natália; Farina, Jayme Adriano; Rossi, Lídia Aparecida

doi:10.5935/1414-8145.20160021

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RESEARCH • Esc. Anna Nery 20 (1) • Jan-Mar 2016 • https://doi.org/10.5935/1414-8145.20160021 copy

Assessment of health-related quality of life in the first year after burn^* * Article extracted from a Doctoral Thesis title in English is "Validation of the Burns Specific Pain Anxiety Scale - BSPAS and the Impact of Event Scale - IES for Brazilians who suffered burns".

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To compare the perception of quality of life for burn victims between the 4^th and 6^th and between the 9^th and 12^th months after hospital discharge, according to gender, body surface burned and visibility of scars.

Methods:

A longitudinal study. The study participants were adults admitted to a burn unit. A socio-demographic data form and the Medical Outcomes Study 36-Item Short-Form Survey were applied.

Results:

There was an improvement in the perception of quality of life, highlighting the domains: Role physical and Role emotional. Men showed better results in the domain Bodily pain; and also those who classified their scars as not visible in the domains: General Health, Vitality, Social Functioning and Role emotional, between the 9^th and 12^th month.

Conclusion:

Patients reported worse quality of life at an early phase and improvement in a late phase, mainly in the domains of Role physical and Role emotional, among men. The visible scars represented negative rating in the late phase.

Keywords:
Burns; Adult; Quality of Life; Rehabilitation

Variable/Measures	n (%)	Mean (SD)	Median (variation)
Sex
Female	18 (24.7)
Male	55 (75.3)
Age (years)		35.2 (12.9)	33.0 (16-70)
Education level
≤ primary school	37 (50.7)
≥ high school diploma	30 (41.1)
higher grade	6 (8.2)
Accident location
Home	40 (54.8)
Work	26 (35.6)
Recreation/out of home	7 (9.6)
Burn etiology
Alcohol/flammable	46 (63.0)
Electrical	12 (16.4)
Scalds	9 (12.3)
Hot surfaces	3 (4.1)
Chemical	1 (1.4)
TBSA (%)		17.0 (12.4)	14.0 (1-60)
≤ 20	52 (71.2)
> 20	21 (28.8)
Body burn area
Head/face/neck	42 (57.5)
Front/back chest	49 (67.1)
Upper limbs	62 (84.9)
Lower members	35 (47.9)
Buttocks/genitals	12 (16.4)

Values Domains	Mean Rank	SD	Median	Min-Max	*Changes in scores ^ * Changes in HRQOL (SF-36) when compared both measures (M1 and M2);**	n	z	*p ^ * Changes in HRQOL (SF-36) when compared both measures (M1 and M2);**	Effect size ^ Effect size between M1 and M2 † p < 0.05.
Physical function_M1	73.8	26.2	80.0	0-100	Negative	12	-4.55	0.00	0.55
Physical function _M2	87.1	16.2	90.0	10-100	Positive	39
					Ties	22
Role physical _M1	35.3	42.5	0.0	0-100	Negative	10	-3.98	0.00	0.60
Role physical _M2	61.6	44.9	100.0	0-100	Positive	32
					Ties	31
Bodily pain _M1	60.8	27.1	62.0	0-100	Negative	11	-4.51	0.00	0.59
Bodily pain _M2	76.3	26.2	84.0	10-100	Positive	45
					Ties	17
General health _M1	75.5	17.8	72.0	32-100	Negative	15	-2.93	0.00	0.32
General health _M2	81.4	18.9	87.0	5-100	Positive	39
					Ties	19
Vitality_M1	73.0	20.3	75.0	15-100	Negative	18	-2.46	0.01	0.24
Vitality_M2	77.6	19.0	85.0	15-100	Positive	40
					Ties	15
Social functioning _M1	72.4	24.7	75.0	0-100	Negative	14	-2.43	0.01	0.28
Social functioning _M2	79.5	25.8	87.5	0-100	Positive	36
					Ties	23
Role emotional _M1	46.6	44.7	33.3	0-100	Negative	5	-4.92	0.02	0.79
Role emotional _M2	78.5	35.7	100.0	0-100	Positive	34
					Ties	34
Mental health _M1	71.4	22.3	72.0	8-100	Negative	22	-2.41	0.02	0.21
Mental health _M2	76.1	22.3	80.0	8-100	Positive	43
					Ties	8

Measures Domains		TBSA		Visible scars		Sex
Measures Domains	*Changes in scores^ * Changes in HRQOL (SF-36) when compared both measures M1 (4th - 6th month) and M2 (9th - 12th month).**	< 20 (n = 52)	> 20 (n = 21)	Yes (n = 48)	No (n = 25)	Female (n = 18)	Male (n = 55)
Physical function _M1	Negative	10	2	10	2	6	6
Physical function _M2	Positive	26	13	27	12	6	36
	Ties	16	6	11	11	6	16
z		-3.66	-2.70	-3.45	-3.02	-0.83	-4.53
p		0.00	0.01	0.00	0.00	0.41	0.00
Role physical _M1	Negative	8	2	8	2	4	6
Role physical _M2	Positive	19	13	21	11	5	27
	Ties	25	6	19	12	9	22
z		-2.66	-3.15	-2.95	-2.92	-0.72	-3.88
p		0.01	0.00	0.00	0.00	0.47	0.00
Bodily pain _M1	Negative	7	4	9	2	5	6
Bodily pain _M2	Positive	31	14	26	19	9	36
	Ties	14	3	13	4	4	13
z		-3.62	-2.72	-3.02	-3.45	-1.01	-4.62
p		0.00	0.01	0.00	0.00	0.32	0.00
General health _M1	Negative	9	6	14	1	3	12
General health _M2	Positive	26	13	20	19	10	29
	Ties	17	2	14	5	5	14
z		-2.19	-1.89	-0.85	-3.33	-0.88	-2.84
p		0.03	0.06	0.40	0.00	0.38	0.00
Vitality_M1	Negative	17	1	15	3	7	11
Vitality_M2	Positive	27	13	23	17	8	32
	Ties	8	7	10	5	3	12
z		-1.25	-2.74	-0.85	-3.05	-0.23	-2.83
p		0.21	0.01	0.39	0.00	0.82	0.01
Social functioning _M1	Negative	10	4	12	2	3	11
Social functioning _M2	Positive	26	10	21	15	10	26
	Ties	16	7	15	8	5	18
z		-2.06	-1.32	-1.02	-2.70	-0.88	-2.19
p		0.04	0.18	0.31	0.01	0.38	0.03
Role emotional _M1	Negative	3	2	3	2	3	2
Role emotional _M2	Positive	21	13	24	10	7	27
	Ties	28	6	21	13	8	26
z		-3.9	-2.89	-4.22	-2.56	-1.79	-4.41
p		0.00	0.00	0.12	0.05	0.07	0.00
Mental health_M1	Negative	16	6	15	7	6	17
Mental health_M2	Positive	30	13	27	16	11	32
	Ties	6	2	6	2	2	6
z		-1.84	-1.53	-1.54	-2.00	-1.17	-2.12
p		0.06	0.12	0.12	0.45	0.24	0.03

9-12 month 4-6 month	Physical function	Role physical	Bodily pain	General health	Vitality	Social functioning	Role emotional	Mental health
Physical function	0.55^ p < 0.01.	0.29^ p < 0.01.	0.29^* * p < 0.05;	0.09	0.17	0.20	0.24^* * p < 0.05;	0.09
Role physical	0.29^* * p < 0.05;	0.38^ p < 0.01.	0.31^ p < 0.01.	0.29^* * p < 0.05;	0.25^* * p < 0.05;	0.29^* * p < 0.05;	0.23	0.07
Bodily pain	0.35^* * p < 0.05;	0.28^* * p < 0.05;	0.49^* * p < 0.05;	0.18	0.23	0.26^* * p < 0.05;	0.16	0.01
General health	0.18	0.07	0.27^* * p < 0.05;	0.35^ p < 0.01.	0.28^* * p < 0.05;	0.35^ p < 0.01.	0.26^* * p < 0.05;	0.22
Vitality	0.28^* * p < 0.05;	0.09	0.33^* * p < 0.05;	0.24^* * p < 0.05;	0.51^ p < 0.01.	0.26^* * p < 0.05;	0.30^* * p < 0.05;	0.34^ p < 0.01.
Social functioning	0.18	0.05	0.27^* * p < 0.05;	0.20	0.27^* * p < 0.05;	0.47^ p < 0.01.	0.36^ p < 0.01.	0.36^ p < 0.01.
Role emotional	0.30^* * p < 0.05;	0.12	0.37^* * p < 0.05;	0.08	0.78^* * p < 0.05;	0.14	0.34^ p < 0.01.	0.17
Mental health	0.28	0.16	0.37^ p < 0.01.	0.30^* * p < 0.05;	0.45^ p < 0.01.	0.26^* * p < 0.05;	0.31^ p < 0.01.	0.44^ p < 0.01.
TBSA	-0.14	-0.23	0.29	0.75	0.29	0.44	-0.09	0.03

Domains SF-36 (M2)	Covariables (M1)	Adjusted means	SD	CI 95%		gL	f	p-value
Domains SF-36 (M2)	Covariables (M1)	Adjusted means	SD	Below	Higher	gL	f	p-value
Physical function	Physical function							0.00
	Sex							0.39
	Male	87.49	2.18	83.13	91.86	1	0.74
	Female	84.17	3.53	77.12	91.22	1	0.74
	Visible scars							0.16
	Yes	83.20	2.34	78.58	87.93	1	2.05
	No	88.41	3.29	81.84	94.98	1	2.05
	TBSA (%)							0.15
	< 20	88.64	2.19	84.27	93.01	1	2.12
	> 20	83.02	3.54	75.96	90.07	1	2.12
Role physical	Role physical							0.01
	Sex							0.33
	Male	67.89	6.73	54.45	81.33	1	0.98
	Female	56.15	10.77	34.67	77.64	1	0.98
	Visible scars							0.12
	Yes	53.41	7.16	39.12	67.70	1	2.45
	No	70.63	10.02	50.64	90.63	1	2.45
	TBSA (%)							0.81
	< 20	60.52	6.83	46.89	74.15	1	0.06
	> 20	63.52	10.94	41.70	85.34
Bodily pain	Bodily pain							0.00
	Sex							0.03
	Male	81.16	3.34	74.50	87.83	1	5.27
	Female	67.70	5.41	56.90	78.50	1	5.27
	Visible scars							0.97
	Yes	69.77	3.59	62.62	76.93	1	2.85
	No	79.09	5.06	69.00	89.17	1	2.85
	TBSA (%)							0.97
	< 20	74.32	3.31	67.73	80.92	1	0.00
	> 20	74.54	5.42	63.72	85.36	1	0.00
General health	General health							0.00
	Sex							0.54
	Male	85.38	2.76	79.87	90.88	1	0.38
	Female	82.38	4.45	73.50	91.25
	Visible scars							0.02
	Yes	78.22	3.00	72.24	84.19	1	5.87
	No	89.53	4.18	81.19	97.88
	TBSA (%)							0.17
	< 20	80.55	2.71	75.14	85.95	1	1.96
	> 20	87.21	4.42	78.39	96.03
Vitality	Vitality							0.00
	Sex							0.07
	Male	82.80	2.49	77.83	87.77	1	3.45
	Female	74.67	4.05	66.59	82.75		3.45
	Visible scars							0.02
	Yes	73.73	2.67	68.40	79.06	1	5.87
	No	83.74	3.80	76.16	91.32		5.87
	TBSA (%)							0.09
	< 20	74.94	2.46	70.03	79.84	1	2.96
	> 20	82.53	4.09	74.37	90.69		2.96
Social functioning	Social functioning							0.01
	Sex							0.93
	Male	81.81	3.78	74.27	89.35	1	0.01
	Female	81.18	6.13	68.95	93.42	1	0.01
	Visible scars							0.05
	Yes	75.35	4.07	67.23	83.46	1	3.87
	No	87.65	5.72	76.24	99.00	1	3.87
	TBSA (%)							0.85
	< 20	80.87	3.74	73.41	88.34	1	0.04
	> 20	82.12	6.11	69.93	94.31
Role emotional	Role emotional							0.01
	Sex							0.72
	Male	79.57	5.24	69.12	90.02	1	0.13
	Female	76.18	8.47	59.28	93.09	1	0.13
	Visible scars							0.05
	Yes	74.29	5.66	63.00	85.58	1	0.67
	No	81.47	7.92	65.65	97.28	1	0.67
	TBSA (%)
	< 20	80.08	5.29	69.52	90.65	1	0.22	0.64
	> 20	75.68	8.50	58.72	92.64	1	0.22
Mental health	Mental health							0.00
	Sex							0.20
	Male	76.83	3.15	70.55	83.11	1	1.70
	Female	69.55	5.15	59.27	79.82	1	1.70
	Visible scars							0.87
	Yes	72.75	3.40	65.96	79.55	1	0.03
	No	73.62	4.78	64.10	83.15	1	0.03
	TBSA (%)							0.31
	< 20	76.04	3.12	69.83	82.26	1	1.07
	> 20	70.34	5.13	60.10	80.58	1	1.07

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[1] Corresponding author: Maria Elena Echevarría-Guanilo. E-mail: elena_meeg@hotmail. com

Brasil

Brasil

Assessment of health-related quality of life in the first year after burn* * Article extracted from a Doctoral Thesis title in English is "Validation of the Burns Specific Pain Anxiety Scale - BSPAS and the Impact of Event Scale - IES for Brazilians who suffered burns".

Abstract

Objective:

Methods:

Results:

Conclusion:

Assessment of health-related quality of life in the first year after burn^* * Article extracted from a Doctoral Thesis title in English is "Validation of the Burns Specific Pain Anxiety Scale - BSPAS and the Impact of Event Scale - IES for Brazilians who suffered burns".