Current Practices and Beliefs Regarding Screening Patients with Burns for Acute Stress Disorder and Posttraumatic Stress Disorder: A Survey of the American Burn Association Membership

Mallory B Smith,Samuel P Mandell,Nicole S Gibran,Shelley A Wiechman,Frederick P Rivara,Monica S Vavilala

doi:10.3390/ebj2040016

Abstract

Stress disorders are common after burn injuries and universal screening is recommended. This study describes current screening practices and provider beliefs regarding screening for stress disorders in patients with burns in the US. This was a 31-question survey distributed to the American Burn Association. Sixty-two percent of 121 respondents indicated their institution formally screened for ASD and/or PTSD. The most common reason for not screening was a lack of mental healthcare providers (46%), lack of funding (26%) and lack of time (20%). The timing of screening, the person administering the screening, and the method of screening varied for both pediatric and adult patients. Most respondents (87%) believed screening should be a standard of care, but only 32% were comfortable screening pediatric patients and 62% were comfortable screening adults. While screening for ASD and PTSD is recommended for patients with burns, our study indicates that screening is not a current standard of care. Lack of mental healthcare providers, funding, and time are contributing factors. Among those institutions that screen, a uniform screening practice does not exist.

Highlights

Mortality rates after burn injuries in the United States (US) are low and have decreased for even the most severe burns in the last twenty years [1,2,3]
Of the 31 incomplete surveys, 27 respondents indicated their institution screened for stress disorders, three indicated they did not, and one respondent was unsure if their
The questions that were incomplete included the specific questions about screening practices, and only four of the 31 respondents on incomplete surveys answered the last section on personal beliefs

Summary

Introduction

Mortality rates after burn injuries in the United States (US) are low and have decreased for even the most severe burns in the last twenty years [1,2,3]. Poor functional, social, and emotional outcomes are common among survivors of burn injuries [4,5,6,7]. Up to 20% of burn survivors have functional impairments five years after injury and 21–50%. As many as 13% of survivors report their burn prevents them from making new friends, and 25% report they are limited in what they can do for their family [5]. Scores on mental health and emotional functioning in burn survivors are below the national average up to three years after injury [9].

Methods

Results

Discussion

Conclusion