Functional, Psychological and Community Integration Changes Over Time in Persons With Major Burn Injury
Grace, Sheila Ann Isom
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The purpose of the present study was to measure prospectively the functional, psychological and community integration status of individuals with major burn injury in order to determine the extent of changes over time and how functional and community integration status relates to emotional distress. This study was part of the North Texas Burn Model System Grant funded by the National Institute on Disability and Rehabilitation Research. Subjects in this study included adults over 14 years of age who met the American Burn Association's criteria for a major burn injury. The Total Body Surface Area burn across the measurement periods in these subjects ranged from 22.4 to 25.2 percent. Data was collected from 356 participants at discharge, 199 participants at 2 months, 255 participants at 6 months, 193 participants at 12 months, 114 participants at 24 months and 41 participants at 36 months. The instruments used in this study were the Brief Symptom Inventory (BSI), the Burn Specific Health Scale (BSHS), The Community Integration Questionnaire (CIQ), the Pain Analog Scale (PAS) and the Functional Assessment Screening Questionnaire (FASQ). It was hypothesized that 1) both areas of functioning and community integration would improve as emotional distress abated and that 2) the functional improvement and community integration as well as the lessening of emotional distress would continue over time. A repeated measures ANOVA was used to measure changes over time and a Bonferroni Multiple Comparison Test was used to compare results at different time intervals. FASQ and CIQ total scores for individuals exhibiting high versus low measures of emotional distress (with median split of BSI global scores) were compared at each measurement period using the Student's T-test. A statistically significant interaction was found between the variables as predicted; however, the participants in this study appeared to reach a plateau at 24 months after which little change in outcomes was noted.