This prospective, longitudinal study examined the influence of baseline physical and psychological burden on serial assessments of health-related quality of life among adults with major burns from three regional burn centers (n = 162). Physical burden groups were defined by % TBSA burned: <10%, 10% to 30%, or >30%. Psychological burden groups were defined by in-hospital distress using the Brief Symptom Inventory Global Severity Index T-score with scores of < 63 or > or = 63. Analyses compared groups across level of burden and with published normative data. Assessments reflected health and function (Short Form 36) during the month before burn, at discharge, and at 6 and 12 months after burn. Physical functioning was significantly more impaired and the rate of physical recovery slower among those with either large physical burden or large psychological burden. Notably, psychosocial functioning also was more impaired and the rate of psychosocial recovery slower among those with greater psychological burden. These results suggest that, in addition to aggressive wound closure, interventions that reduce in-hospital distress may accelerate both physical and psychosocial recovery.

To determine 1) change over time in Quality of Life (QOL) and 2) functional, community reentry, and psychosocial predictors of QOL, data were prospectively collected from adults with major burn injury 2 months after hospital discharge (n = 110) and 6 (n = 97) and 12 (n = 69) months after injury. The dependent QOL variable was the Burn Specific Health Scale (BSHS) and the predictor variables were Brief Symptom Inventory, Functional Assessment Screening Questionnaire, Functional Independence Measure, Pain Analog Scale, and Community Integration Questionnaire. BSHS global scores were unchanged across the measurement periods. Stepwise multiple-regression analyses resulted in statistically significant multiple Rs of.79 at 2 months,.81 at 6 months, and.76 at 12 months. Variables predicting more favorable BSHS global score were less emotional distress and pain at 2 months, less emotional distress and pain and better community reentry at 6 months, and less emotional distress and better community reentry at 12 months.

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Evaluation of community integration is a meaningful outcome criterion after major burn injury. The Community Integration Questionnaire (CIQ) was administered to 463 individuals with major burn injuries. The CIQ results in Total, Home Integration, Social Integration, and Productivity scores. The purposes of this study were to determine change in CIQ scores over time and what burn injury and demographic factors predict CIQ scores. The CIQ scores did not change significantly from 6 to 12 to 24 months postburn injury. Home integration scores were best predicted by sex and living situation; Social Integration scores by marital status; and Productivity scores by functional outcome, burn severity, age, and preburn work factors. The data demonstrate that individuals with burn injuries have significant difficulties with community integration due to burn and nonburn related factors. CIQ scores did not improve over time but improvement may have occurred before the initial 6-month postburn injury follow-up in this study.

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