437 Quality of Life and Behavioral Health Outcomes in Military Burn Survivors

Abstract

Military burn survivors treated in the Military Burn Center are typically not included in other national burn studies. The purpose of this study was to examine the quality of life (QOL), post-traumatic stress, depression, and community integration outcomes of military burn survivors for a period of 18 months after burn center discharge. This study consisted of a descriptive longitudinal design. Data were collected using the Burn Specific Health Scale-Abbreviated (BSHS-A), the Short-Form -36, the Post-traumatic Stress Checklist-Military, the Centers for Epidemiologic Studies Depression Scale, the Community Integration Questionnaire (CIQ), and demographic/clinical questionnaires. Data were collected from the patients and their medical records at burn center discharge, 3, 6, 12, and 18 months post-discharge. Measures of central tendency and multilevel modeling were used to analyze the data. There were 77 participants; they were primarily active duty Army, Caucasian males, with at least a high school education and an average income between $20,000–40,000 per year. The burn survivors had a total body surface area burned of 24% (median = 17%) with full thickness burns accounting for 14% (median = 6%); their average length of stay in the burn center was 44 days (median = 17 days). The participants demonstrated improved QOL on most measures over time. The BSHS-A physical, mental, and general health domain scores showed statistically significant improvement over time but the affective and social domain scores did not significantly improve. The SF-36 PCS and MCS means scores were better than those of the normed scores for the U.S. healthy population and above the 75th percentile in both cases. The CIQ scores showed significant, albeit slight change over time and patients did not return to their pre-burn perceptions of their community integration. Post-traumatic stress and depression scores did not improve over time but none of the mean scores indicated positive screening for post-traumatic stress or depression, although scores did fluctuate slightly over time. Although the QOL and behavioral health outcomes of the military burn survivors did improve over time, there were fluctuations in some of the instrument scores that indicated a possible need for psychosocial interventions at various time points to facilitate continued rehabilitation. Psychiatric clinical nurse specialists and case managers should provide ongoing assessments. Longitudinal research with military burn survivors should continue in the outpatient setting. Return to work status should be included in subsequent research. Qualitative research should be integrated into the studies to better determine the patients’ perspectives about the quantitative results.