63 The Relation Between Satisfaction with Appearance and Ethnicity

Abstract

Although the general research on body image has shown that there are associations between ethnicity and perceptions of body image, to our knowledge, no studies have examined the relation between satisfaction with appearance and ethnicity after a burn injury. The purpose of the study was to determine the impact that ethnicity has on satisfaction with appearance; and to determine the impact of satisfaction with appearance on community integration. All participants were part of a larger Burn Model System (BMS) national database. Adult participants completed the Satisfaction with Appearance Scale (SWAP) and the Community Integration Questionnaire (CIQ) at discharge, 6 months, 12 months and 24 months post burn injury. Higher scores on the SWAP indicate lower satisfaction with appearance and higher scores on the CIQ indicate greater integration into the community. A total of 1220 participated in the study but may not have completed the measures at each timepoint. Mean age was 40.1 (sd=13), mean burn size TBSA = 19.5% (sd=18), mean length of stay = 29.5(sd=37), 53% had a head/neck burn and 73% were male. Three sets of linear regression models were completed after adjusting for ethnicity (white, non-Hispanic versus non-white), age, sex and % TBSA. SWAP and CIQ scores between white and non-white participants are significantly different at all three time points (see table 1). On average, white participants reported more satisfaction with their appearance and integrated better into the community than non-white participants. The regression results also indicate that SWAP is significantly associated with CIQ after adjusting for race, sex, age, and burn size at 6, 12, and 24 months. For example, at 12 months, every one unit increase in CIQ was associated with a decrease in SWAP scores of 0.039 points. These results show that burn survivors who identify as non-White are more dissatisfied with their appearance. This dissatisfaction can also affect other outcomes, such as integrating back into the community. Research has shown that those with darker pigmented skin tend to produce more hypertrophic scarring, which may contribute to dissatisfied appearance and impact community re-integration. Cultural differences and degree of acceptance by communities may also impact satisfaction. Interventions on improving body image need to account for the unique ethnic differences of our population and the impact that body image has on other important functional outcomes.