General Outcomes
Study
Main
Purpose
Research
Design
Sample
Outcome
Measures
Results
Cross-sectional with
patients matched to
non-injured, healthy
controls on age, sex,
and education.
49 adult patients
in burn sample.
82% male. Mean
TBSA 35%.
Mean 64 months
post-burn.
Symptom Checklist90-Revised (SCL-90R). Short Form Health
Survey (SF-36).
22% of burn patients with Diagnostic
T-score ≥ 63 on General
Severity Index of SCL-90
as compared to 12% of
controls. On the SF-36,
burn patients scored lower
on all 8 subscales,
suggesting poorer health
(none significant, likely due
to small sample size).
IV
110 adult
patients at 2
months, 97
(88% follow-up)
at 6 months, 69
(63% follow-up)
at 12 months.
Mean TBSA
24%.
Burn Specific Health
Scale (BSHS), Brief
Symptom Inventory
(BSI),
Functional
Assessment
Screening
Questionnaire,
Functional
Independence
Measure,
Pain VAS,
Community Integration
Questionnaire (CIQ),
Satisfaction With Life
Scale.
BSHS subscale scores physical domain improved
significantly from 2 – 6
months, then stabilized,
the BSHS total, general,
social and psychological
domain scores did not
change over time.
II
Altier,
2002329
To assess
psychological
functioning
and quality of
life in burned
patients as
compared to
unburned
matched
subjects.
Cromes,
2002350
To examine
Prospective cohort.
the quality of
life during the
1st year after
burn injury and
identify
predictors.
Study
Level of
Category Evidence
Prognostic
Daltroy,
2000338
To evaluate
the reliability
and validity of
the Burns
Outcomes
Questionnaire
(BOQ) for
children and
adolescents.
Cross-sectional.
Parents filled out
measure for all
children. Children 11
or older also filled
out questionnaire as
self-report.
Parents of 186
pediatric
patients ages 5
to 18 from 8
burn clinics.
71% male. Mean
TBSA 22%.
Mean age 10. 86
adolescents also
completed the
measure. No
data on time
since burn.
BOQ Social and
Behavioral Domains
(12 total subscales of
2 to 7 items each),
Child Health
Questionnaire.
Internal reliability of parent Diagnostic
report subscales was good Prognostic
(.86 to .88), for child
adequate to good (.76
to.92). Convergent validity
between parent and
adolescent scores on
subscales moderate (.42
to .73). Subscale testretest reliability over 2
days ranged from .70 to
.90. Moderate levels of
convergent validity
evidence for most
subscales, although not
all, and Child Health
Questionnaire subscales.
TBSA and # days since
discharge significantly
correlated with 2 of 4
parent-related social and
behavioral subscales
(family disruption, parental
concern), but not
compliance and school
reentry.
IV
Fauerbach,
1999330
To examine
the impact of
in-hospital
symptoms of
posttraumatic
stress on
health-related
quality of life
at 2 months
postdischarge.
Prospective cohort.
86 adult
patients. 78%
male. Mean
TBSA 17%.
Davidson Trauma
Scale, Beck
Depression Inventory,
Satisfaction with
Appearance Scale,
Life Orientation Test,
SF-36 Health Survey.
Traumatic stress
Prognostic
symptoms at baseline
significantly predicted both
physical function and
psychosocial domains of
SF-36 at 2 months after
controlling for baseline
levels.
IV
Fauerbach,
2000331
To examine
Prospective cohort.
the impact of
in-hospital
symptoms of
body image
dissatisfaction
on healthrelated quality
of life at 2
months postdischarge.
86 adult
patients. 78%
male. Mean
TBSA 17%.
Davidson Trauma
Scale, Beck
Depression Inventory,
Satisfaction with
Appearance Scale,
Life Orientation Test,
Short Form Health
Survey (SF-36).
Traumatic stress
Prognostic
symptoms at baseline
significantly predicted both
physical function and
psychosocial domains of
SF-36 at 2 months after
controlling for baseline
levels.
IV
Gorga,
1999339
To examine
the impact of
burn injury on
physical,
functional, and
developmental
abilities.
Prospective,
longitudinal, cohort
study of pediatric
patients from a
single US burn
center.
51 pediatric
patients. 61%
male. Mean
TBSA 6%.
Vancouver Scar Scale,
Goniometric Range of
Motion (ROM),
Vineland Adaptive
Behavior Scales,
Denver II (D2)
subscales for Home
Screening Test,
Peabody
Developmental Motor
Skills (PDMS).
Mean scar scores for most Diagnostic
body areas increased from
1 month to 6 months, and
then dropped at 12
months.
The majority of patients
displayed “normal” ROM in
activities at 1, 6, and 12
month follow-up.
Significant improvement
was observed in fine and
gross motor abilities from
1-month to 12- month
follow-up on the PDMS.
D2 summary scores
indicated that 38%, 47%
and 44% had possible
developmental delays at 1,
6, and 12 month followups, respectively.
IV
Kazis,
2002344
To develop a
health
outcomes
questionnaire
for use with
young
children.
Cross-sectional,
repeated measures,
scale development.
184 pediatric
The Health Outcomes
burn patients
Burn Questionnaire for
from 8 burn
Infants and Children
centers. 72%
follow-up rate at
6- months.
The questionnaire
Diagnostic
subscales demonstrated
adequate internal
consistency reliability
ranging from α = .74 - .94.
Test-retest reliability
ranged widely from α = .35
- .84. Factor analysis
yielded 10 distinct factors.
Evidence was provided for
adequate criterion-related
validity.
IV
Kent,
2000340
Prospective,
longitudinal, casecontrol study of
pediatric patients
with burns and 3
control groups.
40 pediatric burn Child Behavior
patients. 55%
Checklist (CBCL)
male. Mean
TBSA 9%. 83%
follow-up rate at
6- months.
There were no significant Diagnostic
psychological or
behavioral differences
reported by parents of
children with visible (n =
17) vs. non-visible (n = 16)
burn scars.
IV
Cross-sectional.
248 adult
patients from
Swedish burn
centers. 80%
male. Mean
TBSA 23%.
Burn Specific Health
Scale – Abbreviated
(BSHS-A).
Factor analysis supported Diagnostic
a nine-factor structure
(heat sensitivity, affect,
hand function, treatment
regimens, work, sexuality,
interpersonal relationships,
simple abilities, body
image. Adequate to good
internal consistency
reliabilities.
III
Kildal,
2002337
To test three
Cross-sectional.
versions of the
Burn Specific
Health Scale.
248 adult
patients from
Swedish burn
centers. 80%
male. Mean
TBSA 23%.
Abbreviated version
(80 item BSHS-A),
Revised version (31
item BSHS-R), Brief
version (BSHS-B).
III
Landolt,
2002342
To identify
predictors of
psychological
adjustment in
pediatric burn
survivors.
105 parents of
pediatric burn
patients. 65%
male. Mean
TBSA 18%.
Correlations between three Diagnostic
instruments’ total scores
ranged from .81 (A & R) to
.86 (A & B) to .98 (R & B).
Great deal of overlap
between scales (not
entirely specified).
Child Behavior
Based on parent ratings, in Diagnostic,
Checklist (CBCL),
comparison to normative
Prognostic
Questionnaire for
data, pediatric burn
Child Health-Related
survivors experienced
Quality of Life – Parent significantly fewer positive
Form (CH-QOL).
emotions, but did not differ
on physical symptoms,
autonomy, cognitive
functioning, or, social
functioning.
Kildal,
2001336
To examine
psychological
and behavioral
outcomes of
accidental
burn injury
among
children.
To derive a
40-item Burn
Specific
Health ScaleBrief (BSHSB).
Cross-sectional
survey of parents of
pediatric burn
patients 1-13 years
post-burn from a
single burn center in
Switzerland.
IV
Landolt,
2000341
To investigate
predictors of
psychological
adjustment in
pediatric burn
survivors with
and without
face/head/
neck region
burns.
Litlere Moi,
2003332
Meyer,
2000313
Cross-sectional
survey study of a
cohort of parents of
patients 1-13 years
post-burn from a
single Swiss burn
center.
104 parents of
pediatric burn
patients. With
head burns:
n = 27, 74%
male, Mean
TBSA 25%.
Without Head
Burns:
n = 77, 62%
male, Mean
TBSA 16%.
Child Behavior
Checklist (CBCL).
Parent reported CBCL
summary scores did not
differ significantly for
pediatric patients with vs.
without face/head/neck
region burns.
Prognostic
IV
To evaluate
Cross-sectional.
the reliability
and validity of
a translation of
the
Abbreviated
Burn Specific
Health Scale.
95 adult
patients. 82%
male. Mean
TBSA 19%.
Mean 47 months
post-burn.
80-item Norwegian
Burn Specific Health
Scale (N-BSHS), Short
Form Health Survey
(SF-36).
Internal consistency
reliability α ≥ .86 for all
subscale except sexual
(.77). Strong convergent
validity with SF-36
subscales (.61 to .81) and
test reliability (.80 to .95)
across subscales.
Diagnosis
IV
To assess the
behavioral
adjustment of
pediatric burn
patients
relative to a
non-clinical,
normative
sample of
similar age
children.
33 pediatric
patients. 58%
male. Mean
TBSA 50%.
Child Behavior
Checklist (CBCL).
Children with burns,
relative to data from a
CBCL normative sample,
were rated higher by their
mothers on the
internalizing, but not the
externalizing, summary
scale. The patient group
scored significantly higher
on the behavioral
subscales of social
withdrawal, depression,
sleep problems, and
somatic complaints.
Diagnostic
IV
Cross-sectional
follow-up survey of a
“stratified, random
sampling of acute
burn admissions” to
a burn center.
Meyer,
2004343
To assess the
behavioral and
social
adjustment of
young adults
who were
burned as
children
relative to a
non-clinical,
normative
sample of
similar age
peers.
Cross-sectional
follow-up of a cohort
of adult survivors of
pediatric burn
injuries treated at a
single burn center.
101 adult
Young Adult Selfsurvivors of
Report (YASR).
pediatric burn.
57% male. Mean
TBSA 54%.
Mean time since
burn 14 years.
In comparison to a
Diagnostic
normative sample, young
adult males who were
burned as children were
within the non-clinical
range on the YASR.
Young adult females who
had been burned as
children reported
significantly more total
problems and externalizing
concerns. 33% of young
women reported
psychosocial concerns,
and 25% reported
continued physical
concerns.
IV
Patterson,
2000333
To compare
distress and
satisfaction
with life with
general
population
norms and to
test medical
and
psychological
predictors.
Prospective cohort.
295 adult
patients. 82%
male. Mean
TBSA 18%. Only
included
subjects with
baseline and 6
month data. No
report of followup rates.
Burn patients significantly Diagnostic
lower life satisfaction than Prognostic
norms at discharge and 6months postburn on SWL.
SWL decreased from
baseline to 6 months, but
small effect size, predicted
by marriage status,
premorbid psych
treatment, length of stay in
ICU, amputation. Also
significantly higher BSIGSI than norms at both
time points, decreased
from baseline to 6 months,
predicted by psych
treatment, alcohol use,
pulmonary complications.
IV
Satisfaction With Life
Scale (SWL). Brief
Symptom Inventory,
Global Severity Index:
(BSI-GSI).
Sheridan,
2000345
To investigate
the long term
quality of life in
patients who,
as children,
survived
massive
burns.
Walker,
2003335
Williams,
2003334
Retrospective,
cross-sectional
follow-up of a cohort
of adult survivors of
pediatric burn
injuries treated at a
single burn center.
60 adult burn
SF-36 Health Survey.
survivors who
were burned as
children. 69%
male. Mean
TBSA 82%.
Mean time since
burn 15 years.
Median SF-36 domain
Diagnostic
scores were generally
Prognostic
similar between burn
patients and scale norms.
15% and 20% of burn
patients, however, were >2
standard deviations below
the mean for physical
functioning and physical
role.
Craig Handicap
Burn patients had highest Diagnostic
Assessment Reporting overall participation rates.
Technique (CHART). Strong test-retest
Functional
intraclass correlations for
Independence
total score and all six
Measure (FIM).
subscales for burn patients
and combined sample,
good convergent validity
with the FIM.
IV
To assess the Cross-sectional.
efficacy,
across a range
of disability
groups, of the
Craig
Handicap
Assessment
and Reporting
Technique, a
measure of
societal
participation.
1,110 total
communitybased patients
(SCI, TBI, MS,
stroke, burn,
amputation). 70
burn patients.
IV
To compare
Prospective cohort.
health
outcomes of
burn survivors
with general
population and
medical /
surgical
samples.
304 adult
Sickness Impact
patients.
Profile (SIP).
81% male. Mean
TBSA 14%. 1month follow-up
rate 78%, 1-year
follow-up rate
60%, 2-year
follow-up rate
39%.
The Mean total SIP scores Diagnostic
were improved across
Prognostic
each time period. Both
baseline TBSA and length
of stay in hospital
predicted total SIP scores,
as well as Physical and
Psychosocial composites.
IV