Keck School of Medicine, University of Southern California, Los Angeles, USA.
Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, USA.
J Burn Care Res. 2023 Nov 2;44(6):1400-1404. doi: 10.1093/jbcr/irad060.
There has been conflicting data on the relationship between burn severity and psychological outcomes. The present study aims to characterize the baseline psychosocial disposition of adults attending outpatient burn clinic at a large urban safety net hospital, as well as the impact of clinical course on self-reported psychosocial well-being. Adult patients attending outpatient burn clinic completed survey questions from the National Institutes of Health Patient-Reported Outcomes Measurement Information System Managing Chronic Conditions: Self-Efficacy for Managing Social Interactions (SEMSI-4) and Managing Emotions (SEME). Sociodemographic variables were collected from surveys and retrospective chart review. Clinical variables included total body surface area burned, initial hospital length of stay, surgical history, and days since injury. Poverty level was estimated by U.S. census data using patient's home ZIP code. Scores on SEME-4 and SEMSI-4 were compared to the population mean by one-sample T-test, and independent variables evaluated for associations with managing emotions and social interactions by Tobit regression while adjusting for demographic variables. The 71 burn patients surveyed had lower scores in SEMSI-4 (mean = 48.0, P = .041) but not SEME-4 (mean = 50.9, P = .394) versus the general population. Marital status and neighborhood poverty level were associated with SEMSI-4, while length of stay and % total body surface area burned were associated with SEME-4. Patients who are single or from poorer neighborhoods may have difficulty interacting with their environment after burn injury and need extra social support. Prolonged hospitalization and increased severity of burn injury may have more impact on emotional regulation; these patients may benefit from psychotherapy during recovery.
关于烧伤严重程度与心理结果之间的关系，一直存在相互矛盾的数据。本研究旨在描述在大型城市医疗服务机构的门诊烧伤诊所就诊的成年患者的基线心理社会状况，以及临床病程对自我报告的心理社会健康的影响。在门诊烧伤诊所就诊的成年患者完成了来自美国国立卫生研究院患者报告的结果测量信息系统管理慢性疾病的调查问题：管理社交互动的自我效能（SEMSI-4）和管理情绪（SEME）。从调查和回顾性图表审查中收集了社会人口统计学变量。临床变量包括全身烧伤面积、初始住院时间、手术史和受伤后天数。通过患者家庭的邮政编码，使用美国人口普查数据来估计贫困水平。通过单样本 T 检验将 SEME-4 和 SEMSI-4 的分数与总体平均值进行比较，并通过 Tobit 回归评估独立变量与管理情绪和社交互动的关联，同时调整人口统计学变量。接受调查的 71 名烧伤患者的 SEMSI-4 评分较低（平均值=48.0，P=0.041），但 SEME-4 评分无差异（平均值=50.9，P=0.394）与一般人群相比。婚姻状况和邻里贫困水平与 SEMSI-4 相关，而住院时间和全身烧伤面积百分比与 SEME-4 相关。单身或来自贫困社区的患者在烧伤后可能难以与环境互动，需要额外的社会支持。长时间住院和烧伤严重程度增加可能对情绪调节的影响更大；这些患者可能在康复期间受益于心理治疗。
