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Colleen M. Ryan - One of the best experts on this subject based on the ideXlab platform.
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Sexual activity and romantic relationships after Burn injury: A Life Impact Burn Recovery Evaluation (LIBRE) study
Burns : journal of the International Society for Burn Injuries, 2020Co-Authors: Emily A. Ohrtman, Lewis E Kazis, Colleen M. Ryan, Gabriel D. Shapiro, Audrey E Wolfe, Nhi-ha Trinh, Amy Acton, Mary D. Slavin, Jeffrey C. SchneiderAbstract:BACKGROUND Engaging in healthy sexual activity and romantic relationships are important but often neglected areas of post-Burn rehabilitation. The degree to which persons with Burn injuries engage in sexual activity and romantic relationships is not well understood. This study examined demographic and clinical characteristics predicting engagement in sexual activity and romantic relationships in a sample of Adult Burn survivors compared to a general United States sample. METHODS Data for the Adult Burn survivor sample were from 601 Adult Burn survivors who participated in field-testing for the calibration of the Life Impact Burn Recovery Evaluation (LIBRE) Profile, a Burn-specific instrument assessing social participation on six scales including sexual activity and romantic relationships. Comparison data were obtained from a general population sample of 2000 Adults through sample matching. Demographic predictors of sexual activity and romantic relationship status were examined in each sample using modified Poisson regression analyses. Clinical predictors of engaging in sexual activity and romantic relationships were also examined in the LIBRE sample. RESULTS Participants were slightly more likely to report being sexually active in the Adult Burn survivor sample than in the general sample (65% vs. 57%, p
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The Impact of Adverse Childhood Experiences on Burn Outcomes in Adult Burn Patients.
Journal of burn care & research : official publication of the American Burn Association, 2019Co-Authors: Mikenzy Fassel, Lewis E Kazis, Colleen M. Ryan, Brian Grieve, Sameen Hosseini, Resmiye Oral, Colette Galet, Ni Pengsheng, Lucy WibbenmeyerAbstract:Adverse childhood experiences (ACEs), including child maltreatment and household dysfunction, define adverse events that occur before 18 years of age. National and state data show that between 12.5 and 14.5% of the Adult population report ≥4 ACEs (HIGH-ACE), respectively. HIGH-ACEs are associated with more chronic health problems. To date, the interaction between ACEs and Burn injuries has not been studied. Herein, we sought to define the ACE exposure in our Burn patients and its impact on early outcomes. Inpatient and outpatient Adult Burn survivors (≥18 years of age) were enrolled. Subjects completed surveys assessing adverse experiences (ACEs-18), needs, strengths, and resiliency at consent, and pain, depression, post-traumatic stress disorder (PTSD), and social participation surveys at 2 weeks to 3 months postinjury. Demographics, Burn, and hospital course data were also collected. Chi-square and student's t-tests were used for descriptive analysis and to compare the groups (HIGH-ACE vs LOW-ACE). The HIGH-ACE group (n = 24; 45.3%) reported more depressive symptoms (P < .04) than the LOW-ACE group (n = 29, 54.7%). HIGH-ACE patients were less resilient when facing stressful events (P ≤ .02) and more likely to screen positive for probable PTSD (P = .01) and to score lower on the Life Impact Burn Recovery Evaluation Profile (LIBRE Profile), which assesses for social participation, in the domain of Family and Friends (P = .015). Our exploratory study suggests that ACE screening may help detect Burn patients at risk for a more complicated recovery, thereby promoting personalized assistance in recovery.
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The Development and Validity of the Adult Burn Outcome Questionnaire Short Form
Journal of burn care & research : official publication of the American Burn Association, 2017Co-Authors: Liang Chen, Lewis E Kazis, Austin Lee, Gabriel D. Shapiro, Jeremy Goverman, Nicholas Faoro, Jeffrey C. Schneider, Colleen M. RyanAbstract:Patient Reported Outcome Measures (PROMs) are useful for understanding the health needs and outcomes of the general public. We aim to develop a Burn-specific metric-Adult Burn Outcome Questionnaire (ABOQ)-that is brief and can be administered electronically to all Burn survivors over the age of 18. The 14-item ABOQ was developed from the already validated Young Adult Burn Outcome Questionnaire (YABOQ) long form. The ABOQ questionnaire, along with Patient-Reported Outcomes Measurement System-10 (PROMIS-10), was administered to 120 outpatient Burn survivors at three hospitals. Clinical validity of the ABOQ was measured by testing associations between ABOQ items and Burn size, the PROMIS-10 generic items and composite scales using correlational analysis including multivariate canonical analysis. Nine out of 14 ABOQ items were significantly correlated with Burn size (correlations ranging from -0.25 to -0.46, P < .01). The canonical correlation between ABOQ and Burn size was 0.68 (P = .0002). The overall canonical correlation between two instruments was also significant (P < .0001). At the item level, at least 25% of the variation in each of the five ABOQ items could be explained by PROMIS-10 items and composite scores, while six other items could only be accounted for by less than 15% of the variation. ABOQ short form assessment can be used to efficiently measure Burn outcomes across a range of relevant clinical domains with credible validity. A large proportion of the variation in ABOQ scores was not accounted for by PROMIS-10, suggesting that ABOQ provided additional health-related information specifically for the Burn population beyond the generic instrument.
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Is real-time feedback of Burn-specific patient-reported outcome measures in clinical settings practical and useful? A pilot study implementing the Young Adult Burn Outcome Questionnaire
Journal of burn care & research : official publication of the American Burn Association, 2016Co-Authors: Colleen M. Ryan, Lewis E Kazis, Austin Lee, Gabriel D. Shapiro, Jeremy Goverman, Jeffrey C. Schneider, Shawn P. Fagan, Chao Wang, Julia Kim, Robert L. SheridanAbstract:Long-term follow-up care of survivors after Burn injuries can potentially be improved by the application of patient-reported outcome measures (PROMs). PROMs can inform clinical decision-making and foster communication between the patient and provider. There are no previous reports using real-time, Burn-specific PROMs in clinical practice to track and benchmark Burn recovery over time. This study examines the feasibility of a computerized, Burn-specific PROM, the Young Adult Burn Outcome Questionnaire (YABOQ), with real-time benchmarking feedback in a Burn outpatient practice. The YABOQ was redesigned for formatting and presentation purposes using images and transcribed to a computerized format. The redesigned questionnaire was administered to young Adult Burn survivors (ages 19-30 years, 1-24 months from injury) via an ipad platform in the office before outpatient visits. A report including recovery curves benchmarked to a nonBurned relatively healthy age-matched population and to patients with similar injuries was produced for the domains of physical function and social function limited by appearance. A copy of the domain reports as well as a complete copy of the patient's responses to all domain questions was provided for use during the clinical visit. Patients and clinicians completed satisfaction surveys at the conclusion of the visit. Free-text responses, included in the satisfaction surveys, were treated as qualitative data adding contextual information about the assessment of feasibility. Eleven patients and their providers completed the study for 12 clinical visits. All patients found the ipad survey and report "easy" or "very easy" to use. In nine instances, patients "agreed" or "strongly agreed" that it helped them communicate their situation to their doctor/nurse practitioner. Patients "agreed" or "strongly agreed" that the report helped them understand their course of recovery in 10 visits. In 11 visits, the patients "agreed" or "strongly agreed" that they would recommend this feedback to others. Qualitative comments included: "it helped organize my thoughts of recovery," "it opened lines of communication with the doctor," "it showed me how far I have come, and how far I need to go," and "it raised questions I would not have thought of." Only four of 12 provider surveys agreed that it helped them understand a patient's condition; however, in two visits, the providers stated that it helped identify a pertinent clinical issue. During two visits, providers stated that a treatment plan was discussed or recommended based on the survey results. Separately, qualitative comments from the providers included "survey was not sensitive enough to identify that this patient needed surgery for their scars." This is the first report describing clinical use of a Burn-specific patient reported outcome measure. Real-time feedback using the ipad YABOQ was well received for the most part by the clinicians and Burn survivors in the outpatient clinic setting. The information provided by the reports can be tested in a future randomized controlled clinical study evaluating impacts on physician decisions.
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validation of the community integration questionnaire in the Adult Burn injury population
Quality of Life Research, 2015Co-Authors: Paul Gerrard, Vivian Shie, R Holavanahalli, Lewis E Kazis, Peter C. Esselman, James A Fauerbach, Colleen M. Ryan, Alan M Jette, David N HerndonAbstract:Purpose With improved survival, long-term effects of Burn injuries on quality of life, particularly community integration, are important outcomes. This study aims to assess the Community Integration Questionnaire’s psychometric properties in the Adult Burn population.
Martina De Zwaan - One of the best experts on this subject based on the ideXlab platform.
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validation of the german version of the perceived stigmatization questionnaire social comfort questionnaire in Adult Burn survivors
Burns, 2016Co-Authors: Astrid Müller, Dirk Smits, Laurence Claes, Stefanie Jasper, Lea Berg, Ramin Ipaktchi, Peter M. Vogt, Martina De ZwaanAbstract:Abstract Objective To investigate the factor structure, reliability, and validity of the German version of the Perceived Stigmatization Questionnaire/Social Comfort Questionnaire (PSQ/SCQ) in Burn victims. Methods The PSQ/SCQ was answered by 139 Adult Burn survivors (age M = 49.69, SD = 15.16 years). Factor structure was examined using a confirmatory factor analysis (CFA). Validity was investigated through correlations between the PSQ/SCQ scales and questionnaires assessing perceived social support, Burn-specific health-related quality of life, symptoms of anxiety/depression, and percent of total body surface area (TBSA) Burned. Additionally, the link between perceived stigmatization/social comfort and current partnership status was investigated. Results The four-factor model showed the best fit to the data with three PSQ factors (Absence of Friendly Behavior, Confused/Staring Behavior, and Hostile Behavior) and one single SCQ factor. All PSQ/SCQ scales showed good internal consistency. Higher PSQ/lower SCQ means were related to less perceived social support, less Burn-specific quality of life, and more symptoms of anxiety/depression. With the exception of a positive correlation with the PSQ subscale Confused Behavior and Staring, no other significant correlations were found between the PSQ/SCQ subscales and TBSA Burned. While PSQ/SCQ scores were not linked to age or gender, less perceived social stigmatization/more social comfort was reported by participants who were currently living with a partner. Conclusions The results indicate a four-factor structure and a good validity of the PSQ/SCQ which is in line with prior research. Further studies should investigate the application of the PSQ/SCQ in individuals with appearance distinctions that are not related to Burns.
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Validation of the German version of the Perceived Stigmatization Questionnaire/Social Comfort Questionnaire in Adult Burn survivors
Burns : journal of the International Society for Burn Injuries, 2016Co-Authors: Astrid Müller, Dirk Smits, Laurence Claes, Stefanie Jasper, Lea Berg, Ramin Ipaktchi, Peter M. Vogt, Martina De ZwaanAbstract:Abstract Objective To investigate the factor structure, reliability, and validity of the German version of the Perceived Stigmatization Questionnaire/Social Comfort Questionnaire (PSQ/SCQ) in Burn victims. Methods The PSQ/SCQ was answered by 139 Adult Burn survivors (age M = 49.69, SD = 15.16 years). Factor structure was examined using a confirmatory factor analysis (CFA). Validity was investigated through correlations between the PSQ/SCQ scales and questionnaires assessing perceived social support, Burn-specific health-related quality of life, symptoms of anxiety/depression, and percent of total body surface area (TBSA) Burned. Additionally, the link between perceived stigmatization/social comfort and current partnership status was investigated. Results The four-factor model showed the best fit to the data with three PSQ factors (Absence of Friendly Behavior, Confused/Staring Behavior, and Hostile Behavior) and one single SCQ factor. All PSQ/SCQ scales showed good internal consistency. Higher PSQ/lower SCQ means were related to less perceived social support, less Burn-specific quality of life, and more symptoms of anxiety/depression. With the exception of a positive correlation with the PSQ subscale Confused Behavior and Staring, no other significant correlations were found between the PSQ/SCQ subscales and TBSA Burned. While PSQ/SCQ scores were not linked to age or gender, less perceived social stigmatization/more social comfort was reported by participants who were currently living with a partner. Conclusions The results indicate a four-factor structure and a good validity of the PSQ/SCQ which is in line with prior research. Further studies should investigate the application of the PSQ/SCQ in individuals with appearance distinctions that are not related to Burns.
Walter J. Meyer - One of the best experts on this subject based on the ideXlab platform.
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Benchmarks for multidimensional recovery after Burn injury in young Adults: the development, validation, and testing of the American Burn Association/Shriners Hospitals for Children young Adult Burn outcome questionnaire.
Journal of burn care & research : official publication of the American Burn Association, 2013Co-Authors: Colleen M. Ryan, Lewis E Kazis, Jeffrey C. Schneider, Austin F. Lee, Michelle I. Hinson, Helena Bauk, Michael Peck, Walter J. Meyer, Tina L. PalmieriAbstract:Abstract Although data exist on Burn survival, there are little data on long-term Burn recovery. Patient-centered health outcomes are useful in monitoring and predicting recovery and evaluating treatments. An outcome questionnaire for young Adult Burn survivors was developed and tested. This 5-year (2003-2008) prospective, controlled, multicenter study included Burned and nonBurned Adults ages 19 to 30 years. The Young Adult Burn Outcome Questionnaires were completed at initial contact, 10 days, and 6 and 12 months. Factor analysis established construct validity. Reliability assessments used Cronbach α and test-retest. Recovery patterns were investigated using generalized linear models, with generalized estimating equations using mixed models and random effects. Burned (n = 153) and nonBurned subjects (n = 112) completed 620 questionnaires (47 items). Time from injury to first questionnaire administration was 157 ± 36 days (mean ± SEM). Factor analysis included 15 factors: Physical Function, Fine Motor Function, Pain, Itch, Social Function Limited by Physical Function, Perceived Appearance, Social Function Limited by Appearance, Sexual Function, Emotion, Family Function, Family Concern, Satisfaction With Symptom Relief, Satisfaction With Role, Work Reintegration, and Religion. Cronbach α ranged from 0.72 to 0.92, with 11 scales >0.8. Test-retest reliability ranged from 0.29 to 0.94, suggesting changes in underlying health status after Burns. Recovery curves in five domains, Itch, Perceived Appearance, Social Function Limited by Appearance, Family Concern, and Satisfaction with Symptom Relief, remained below the reference group at 24 months. The Young Adult Burn Outcome Questionnaire is a reliable and valid instrument for multidimensional functional outcomes assessment. Recovery in some domains was incomplete.
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Impact of obesity on body image dissatisfaction and social integration difficulty in adolescent and young Adult Burn injury survivors
Journal of burn care & research : official publication of the American Burn Association, 2013Co-Authors: Maria Chondronikola, David N Herndon, Labros S. Sidossis, Lisa M. Richardson, Jeffrey Temple, Patricia Van Den Berg, Walter J. MeyerAbstract:Burn injury deformities and obesity have been associated with social integration difficulty and body image dissatisfaction. However, the combined effects of obesity and Burn injury on social integration difficulty and body image dissatisfaction are unknown. Adolescent and young Adult Burn injury survivors were categorized as normal weight (n = 47) or overweight and obese (n = 21). Burn-related and anthropometric information were obtained from patients’ medical records, and validated questionnaires were used to assess the main outcomes and possible confounders. Analysis of covariance and multiple linear regressions were performed to evaluate the objectives of this study. Obese and overweight Burn injury survivors did not experience increased body image dissatisfaction (12 ± 4.3 vs 13.1 ± 4.4; P = .57) or social integration difficulty (17.5 ± 6.9 vs 15.5 ± 5.7; P = .16) compared with normal weight Burn injury survivors. Weight status was not a significant predictor of social integration difficulty or body image dissatisfaction (P = .19 and P = .24, respectively). However, mobility limitations predicted greater social integration difficulty (P = .005) and body image dissatisfaction (P < .001), whereas higher weight status at Burn was a borderline significant predictor of body image dissatisfaction (P = .05). Obese and overweight adolescents and young Adults, who sustained major Burn injury as children, do not experience greater social integration difficulty and body image dissatisfaction compared with normal weight Burn injury survivors. Mobility limitations and higher weight status at Burn are likely more important factors affecting the long-term social integration difficulty and body image dissatisfaction of these young people. (J Burn Care Res 2013;34:102–108)
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Differences in behavioral perceptions between young Adult Burn survivors and cross-informants
Journal of burn care & research : official publication of the American Burn Association, 2008Co-Authors: William Russell, Charles E. Holzer, Rhonda S. Robert, Christopher R. Thomas, Patricia Blakeney, Walter J. MeyerAbstract:The purpose of this study is to gain insight into the level of agreement, in terms of personal problems, between Burn survivors and an informant with whom they have a close personal relationship. Participants in the study were 72 young Adult Burn survivors between the ages of 18 and 28 with a mean age of 20.9 +/- 2.6 years. There were 37 males and 35 females in the group. The mean total Burn surface area was 55.34 +/- 19.9% with injuries occurring before the age of 18, a minimum of 2 years prior to the study with a mean of 14.3 +/- 4.9 years since Burned. To assess this issue the participants completed The Young Adult Self-Report (YASR), and the informants completed The Young Adult Behavior Checklist (YABCL). In relationship to Burn survivors, the informant group comprised 67% mothers, 3% fathers, and 30% domestic partners. Paired t-test and Pearson Correlations Coefficients were calculated to compare the differences and variance of the Total Problems Scale, Internalizing Scale and Externalizing Scale for the YABCL and YASR results. The family members of Burn survivors reported more problems for their young Adult relatives than did the informants of the reference population. In general, the YACBL scores were higher than and highly correlated to the YASR scores. Although there were not ethic differences in the YABCL and the YASR measures, the correlation between the YABCL and the YASR was excellent for Caucasian families but not good for Black and Hispanic families. This study supports concerns about the need for routine follow-up into Adulthood for those individuals who were Burned as children. This would seem to be especially critical for the female population.
Lewis E Kazis - One of the best experts on this subject based on the ideXlab platform.
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Sexual activity and romantic relationships after Burn injury: A Life Impact Burn Recovery Evaluation (LIBRE) study
Burns : journal of the International Society for Burn Injuries, 2020Co-Authors: Emily A. Ohrtman, Lewis E Kazis, Colleen M. Ryan, Gabriel D. Shapiro, Audrey E Wolfe, Nhi-ha Trinh, Amy Acton, Mary D. Slavin, Jeffrey C. SchneiderAbstract:BACKGROUND Engaging in healthy sexual activity and romantic relationships are important but often neglected areas of post-Burn rehabilitation. The degree to which persons with Burn injuries engage in sexual activity and romantic relationships is not well understood. This study examined demographic and clinical characteristics predicting engagement in sexual activity and romantic relationships in a sample of Adult Burn survivors compared to a general United States sample. METHODS Data for the Adult Burn survivor sample were from 601 Adult Burn survivors who participated in field-testing for the calibration of the Life Impact Burn Recovery Evaluation (LIBRE) Profile, a Burn-specific instrument assessing social participation on six scales including sexual activity and romantic relationships. Comparison data were obtained from a general population sample of 2000 Adults through sample matching. Demographic predictors of sexual activity and romantic relationship status were examined in each sample using modified Poisson regression analyses. Clinical predictors of engaging in sexual activity and romantic relationships were also examined in the LIBRE sample. RESULTS Participants were slightly more likely to report being sexually active in the Adult Burn survivor sample than in the general sample (65% vs. 57%, p
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The Impact of Adverse Childhood Experiences on Burn Outcomes in Adult Burn Patients.
Journal of burn care & research : official publication of the American Burn Association, 2019Co-Authors: Mikenzy Fassel, Lewis E Kazis, Colleen M. Ryan, Brian Grieve, Sameen Hosseini, Resmiye Oral, Colette Galet, Ni Pengsheng, Lucy WibbenmeyerAbstract:Adverse childhood experiences (ACEs), including child maltreatment and household dysfunction, define adverse events that occur before 18 years of age. National and state data show that between 12.5 and 14.5% of the Adult population report ≥4 ACEs (HIGH-ACE), respectively. HIGH-ACEs are associated with more chronic health problems. To date, the interaction between ACEs and Burn injuries has not been studied. Herein, we sought to define the ACE exposure in our Burn patients and its impact on early outcomes. Inpatient and outpatient Adult Burn survivors (≥18 years of age) were enrolled. Subjects completed surveys assessing adverse experiences (ACEs-18), needs, strengths, and resiliency at consent, and pain, depression, post-traumatic stress disorder (PTSD), and social participation surveys at 2 weeks to 3 months postinjury. Demographics, Burn, and hospital course data were also collected. Chi-square and student's t-tests were used for descriptive analysis and to compare the groups (HIGH-ACE vs LOW-ACE). The HIGH-ACE group (n = 24; 45.3%) reported more depressive symptoms (P < .04) than the LOW-ACE group (n = 29, 54.7%). HIGH-ACE patients were less resilient when facing stressful events (P ≤ .02) and more likely to screen positive for probable PTSD (P = .01) and to score lower on the Life Impact Burn Recovery Evaluation Profile (LIBRE Profile), which assesses for social participation, in the domain of Family and Friends (P = .015). Our exploratory study suggests that ACE screening may help detect Burn patients at risk for a more complicated recovery, thereby promoting personalized assistance in recovery.
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The Development and Validity of the Adult Burn Outcome Questionnaire Short Form
Journal of burn care & research : official publication of the American Burn Association, 2017Co-Authors: Liang Chen, Lewis E Kazis, Austin Lee, Gabriel D. Shapiro, Jeremy Goverman, Nicholas Faoro, Jeffrey C. Schneider, Colleen M. RyanAbstract:Patient Reported Outcome Measures (PROMs) are useful for understanding the health needs and outcomes of the general public. We aim to develop a Burn-specific metric-Adult Burn Outcome Questionnaire (ABOQ)-that is brief and can be administered electronically to all Burn survivors over the age of 18. The 14-item ABOQ was developed from the already validated Young Adult Burn Outcome Questionnaire (YABOQ) long form. The ABOQ questionnaire, along with Patient-Reported Outcomes Measurement System-10 (PROMIS-10), was administered to 120 outpatient Burn survivors at three hospitals. Clinical validity of the ABOQ was measured by testing associations between ABOQ items and Burn size, the PROMIS-10 generic items and composite scales using correlational analysis including multivariate canonical analysis. Nine out of 14 ABOQ items were significantly correlated with Burn size (correlations ranging from -0.25 to -0.46, P < .01). The canonical correlation between ABOQ and Burn size was 0.68 (P = .0002). The overall canonical correlation between two instruments was also significant (P < .0001). At the item level, at least 25% of the variation in each of the five ABOQ items could be explained by PROMIS-10 items and composite scores, while six other items could only be accounted for by less than 15% of the variation. ABOQ short form assessment can be used to efficiently measure Burn outcomes across a range of relevant clinical domains with credible validity. A large proportion of the variation in ABOQ scores was not accounted for by PROMIS-10, suggesting that ABOQ provided additional health-related information specifically for the Burn population beyond the generic instrument.
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Is real-time feedback of Burn-specific patient-reported outcome measures in clinical settings practical and useful? A pilot study implementing the Young Adult Burn Outcome Questionnaire
Journal of burn care & research : official publication of the American Burn Association, 2016Co-Authors: Colleen M. Ryan, Lewis E Kazis, Austin Lee, Gabriel D. Shapiro, Jeremy Goverman, Jeffrey C. Schneider, Shawn P. Fagan, Chao Wang, Julia Kim, Robert L. SheridanAbstract:Long-term follow-up care of survivors after Burn injuries can potentially be improved by the application of patient-reported outcome measures (PROMs). PROMs can inform clinical decision-making and foster communication between the patient and provider. There are no previous reports using real-time, Burn-specific PROMs in clinical practice to track and benchmark Burn recovery over time. This study examines the feasibility of a computerized, Burn-specific PROM, the Young Adult Burn Outcome Questionnaire (YABOQ), with real-time benchmarking feedback in a Burn outpatient practice. The YABOQ was redesigned for formatting and presentation purposes using images and transcribed to a computerized format. The redesigned questionnaire was administered to young Adult Burn survivors (ages 19-30 years, 1-24 months from injury) via an ipad platform in the office before outpatient visits. A report including recovery curves benchmarked to a nonBurned relatively healthy age-matched population and to patients with similar injuries was produced for the domains of physical function and social function limited by appearance. A copy of the domain reports as well as a complete copy of the patient's responses to all domain questions was provided for use during the clinical visit. Patients and clinicians completed satisfaction surveys at the conclusion of the visit. Free-text responses, included in the satisfaction surveys, were treated as qualitative data adding contextual information about the assessment of feasibility. Eleven patients and their providers completed the study for 12 clinical visits. All patients found the ipad survey and report "easy" or "very easy" to use. In nine instances, patients "agreed" or "strongly agreed" that it helped them communicate their situation to their doctor/nurse practitioner. Patients "agreed" or "strongly agreed" that the report helped them understand their course of recovery in 10 visits. In 11 visits, the patients "agreed" or "strongly agreed" that they would recommend this feedback to others. Qualitative comments included: "it helped organize my thoughts of recovery," "it opened lines of communication with the doctor," "it showed me how far I have come, and how far I need to go," and "it raised questions I would not have thought of." Only four of 12 provider surveys agreed that it helped them understand a patient's condition; however, in two visits, the providers stated that it helped identify a pertinent clinical issue. During two visits, providers stated that a treatment plan was discussed or recommended based on the survey results. Separately, qualitative comments from the providers included "survey was not sensitive enough to identify that this patient needed surgery for their scars." This is the first report describing clinical use of a Burn-specific patient reported outcome measure. Real-time feedback using the ipad YABOQ was well received for the most part by the clinicians and Burn survivors in the outpatient clinic setting. The information provided by the reports can be tested in a future randomized controlled clinical study evaluating impacts on physician decisions.
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validation of the community integration questionnaire in the Adult Burn injury population
Quality of Life Research, 2015Co-Authors: Paul Gerrard, Vivian Shie, R Holavanahalli, Lewis E Kazis, Peter C. Esselman, James A Fauerbach, Colleen M. Ryan, Alan M Jette, David N HerndonAbstract:Purpose With improved survival, long-term effects of Burn injuries on quality of life, particularly community integration, are important outcomes. This study aims to assess the Community Integration Questionnaire’s psychometric properties in the Adult Burn population.
John W Lawrence - One of the best experts on this subject based on the ideXlab platform.
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Validation of the Perceived Stigmatization Questionnaire for Brazilian Adult Burn patients
PloS one, 2018Co-Authors: Noélle De Oliveira Freitas, John W Lawrence, Carlos G. Forero, Marina Paes Caltran, Jordi Alonso, Rosana Aparecida Spadoti Dantas, Monica Sarto Piccolo, Jayme Adriano Farina, Lídia Aparecida RossiAbstract:Currently, there is no questionnaire to assess perceived stigmatization among people with visible differences in Brazil. The Perceived Stigmatization Questionnaire (PSQ), developed in the United States, is a valid instrument to assess the perception of stigmatizing behaviours among Burn survivors. The objective of this cross-sectional and multicentre study was to assess the factor structure, reliability and validity of the Brazilian Portuguese version of the PSQ in Burn patients. A Brazilian version of the 21-item PSQ was answered by 240 Adult Burn patients, undergoing rehabilitation in two Burns units in Brazil. We tested its construct validity by correlating PSQ scores with depression (Beck Depression Index-BDI) and self-esteem (Rosenberg Self-Esteem Scale-RSE), as well as with two domains of the Revised Burn Specific Health Scale—BSHS-R: affect and body image, and interpersonal relationships. We used Confirmatory Item Factor Analysis (CIFA) to test whether the data fit a measurement model involving a three-factor structure (absence of friendly behaviour; confusing/staring behaviour; and hostile behaviour). We conducted Exploratory Factor Analyses (EFA) of the subscale in a 50% random sample of individuals (training split), treating items as ordinal categorical using unweighted least squares estimation. To assess discriminant validity of the Brazilian version of the PSQ we correlated PSQ scores with known groups (sex, total body surface area Burned, and visibility of the scars) and assessed its reliability by means of Cronbach's alpha and using test-retest. Goodness-of-fit indices for confirmatory factor analysis were satisfactory for the PSQ, but not for the hostile behaviour subscale, which was modified to improve fit by eliminating 3 items. Cronbach’s alphas for the PSQ refined version (PSQ-R) ranged from 0.65 to 0.88, with test-retest reliability 0.87 for the total score. The PSQ-R scores correlated strongly with depression (0.63; p < 0.001), self-esteem (-0.57; p < 0.001), body image (-0.63; p < 0.001), and interpersonal relationships (-0.55; p < 0.001). PSQ-R total scores were significantly lower for patients with visible scars (effect size = 0.51, p = 0.029). The PSQ-R showed reliability and validity comparable to the original version. However, the cross-cultural structure of the subscale “hostile behaviour” and sensitivity to change of the PSQ should be further evaluated.
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a test of the moderating role of importance of appearance in the relationship between perceived scar severity and body esteem among Adult Burn survivors
Body Image, 2006Co-Authors: John W Lawrence, James A Fauerbach, Brett D. ThombsAbstract:Abstract This study tested the hypothesis that the relationship between subjective Burn scar severity and body-esteem is moderated by importance of appearance. Three hundred and forty-six Adult Burn survivors completed a mailed or online survey. The three subscales of the Body-Esteem Scale for Adolescents and Adults (BE-Appearance [satisfaction with general appearance], BE-Weight [weight satisfaction], BE-Others [others’ evaluations of one's body and appearance]) were regressed onto sex, subjective Burn scar severity, importance of appearance and their two- and three-way interactions. With one exception, the hypothesized main effects were significant in each of the regression equations. As hypothesized, importance of appearance moderated the relationship between subjective Burn scar severity and body-esteem for BE-Appearance and BE-Other but not BE-Weight. The results of this study are consistent with the cognitive model of body-esteem. Clinical implications are discussed.
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The reliability and validity of the Perceived Stigmatization Questionnaire (PSQ) and the Social Comfort Questionnaire (SCQ) among an Adult Burn survivor sample.
Psychological assessment, 2006Co-Authors: John W Lawrence, James A Fauerbach, Leslie J. Heinberg, Marion Doctor, Brett D. ThombsAbstract:In this study, 361 Adult Burn survivors completed the Perceived Stigmatization Questionnaire (PSQ), the Social Comfort Questionnaire (SCQ), and other measures. Both the PSQ and SCQ had good internal consistency indices. Factor analysis of the PSQ yielded 3 factors (absence of friendly behavior, confused/staring behavior, and hostile behavior). The SCQ had 1 factor. Conjoint factor analysis with measures of related constructs (body esteem, body-esteem importance, depression, social support) suggested that PSQ and SCQ measure distinct constructs. Correlations with the related psychosocial constructs and Burn characteristics suggested the PSQ and SCQ have good convergent and discriminant validity. Limitations of the study are discussed.
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personality coping chronic stress social support and ptsd symptoms among Adult Burn survivors a path analysis
Journal of Burn Care & Rehabilitation, 2003Co-Authors: John W Lawrence, James A FauerbachAbstract:: This paper presents a longitudinal study of the relationship between personality, coping, chronic stress, social support and posttraumatic stress disorder (PTSD). A hypothesized model of the relationship between the predictor variables and PTSD symptoms was proposed. Path analyses was completed to test the model. One hundred fifty-eight Adult Burn survivors completed questionnaires measuring each of the variables in the hospital. Of those 124 and 94 completed the PTSD measure at 1 month and 6 months postdischarge, respectively. The hypothesized model fit the data at each time point with slight variations. The model accounted for 46 and 29% of the variance of PTSD symptoms at hospitalization and 1 month. Neuroticism was the most important personality dimension in predicting PTSD. Avoidant Coping and Social Support mediated a high percentage of the relationship between Neuroticism and PTSD. The best predictor of PTSD symptoms at 1 and 6 months was PTSD symptoms at hospitalization.
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preinjury psychiatric illness and postinjury adjustment in Adult Burn survivors
Psychosomatics, 1996Co-Authors: James A Fauerbach, Andrew M. Munster, John W Lawrence, Jennifer A Haythornthwaite, Marsden McguireAbstract:The impact of preinjury DSM-III-R anxiety, mood, and alcohol and substance abuse disorders, determined by using the Structured Clinical Interview for DSM-III-R, nonpatient version (SCID-NP), on postinjury adjustment was examined prospectively in a consecutive series of 98 Adult patients admitted to a regional Burn center and followed for 1 year. The subjects were grouped according to SCID diagnoses: 1) any preBurn mood and/or anxiety diagnosis; 2) preBurn alcohol abuse or dependence diagnosis; or 3) any preBurn diagnosis (i.e., any of the above diagnoses). These groups showed greater impairment in many functional domains at discharge than the subjects who had no preBurn disorder. By 4 months postinjury, the "no diagnosis" and the preBurn diagnosis groups had comparable levels of adjustment, and this comparability was maintained at the 1-year follow-up. Similarly, trait neuroticism had an early negative impact on adjustment, while trait extroversion had both an early and late positive effect on adjustment.
