10 Quality of Life and Community Integration in Military and Civilian Burn Survivors

Abstract

Little is known about the long-term effects of physical and psychological factors on quality of life (QOL) and community integration outcomes in burn survivors. The purpose of this study was to examine changes in perceptions of QOL and community integration in the first 18 months post-discharge from the Military Burn Center. Within one week of discharge from the Military Burn Center, patients were enrolled in this descriptive longitudinal study. Data were gathered from 137 participants at discharge, 3, 6, 12, and 18 months post-discharge. The Short Form-36 (SF-36), the Community Integration Questionnaire (CIQ), demographic, and clinical data sheets were completed. Data were analyzed using descriptive statistics and Multilevel Modeling (MLM). The military participants were younger (M = 30.84) than the civilian participants (M = 40.86). Most of the service members were Caucasian, single, and had an income of ≤ $40,000. Most of the civilians were Hispanic, married, and had an income of ≤ $19,000. At 18 months post-burn center discharge, both groups had improved SF-36 physical component scores (PCS), but they were below the normed mean of the US healthy population (USHP) and below the 25th percentile. At discharge, military participants’ SF-36 mental component scores (MCS) were above the normed mean for the USHP and did not improve over time. By 18 months the military MCS were between the 25th and 50th percentile when compared to the USHP. At discharge, the civilian MCS were slightly lower than the normed mean for the USHP but the scores improved by 3% over 18 months resulting in scores that were higher than the normed mean for the USHP and slightly the below the 50th percentile. The military CIQ scores did not improve over time and at 18 months were slightly below patients’ pre-burn perceptions. The civilians’ CIQ scores were lower than the military scores at all time points but they improved over time and were slightly below their pre-burn estimates at 18 months. The MLM results indicated that time was the only predictor of the SF-36 PCS and MCS QOL scores whereas time, group, and marital status were predictors of CIQ scores. Although military and civilian participants had similar SF-36 QOL and CIQ outcomes by 18 months, it may take longer than 18 months for survivors to fully rehabilitate from their burn injury and return to their pre-burn state. Contrary to the burn literature, total body surface area burned, full thickness burn, age, and length of stay were not predictors of QOL or CIQ outcomes in this study. Developing a better understanding of burn survivors’ post-discharge perceptions of QOL and community integration allows for optimal burn rehabilitation that promotes improvements in QOL and community integration.