TitleGrowth curve trajectories of distress in burn patients.
Publication TypeJournal Article
Year of Publication2010
AuthorsMason ST, Corry N, Gould NF, Amoyal N, Gabriel V, Wiechman-Askay S, Holavanahalli R, Banks S, Arceneaux L, Fauerbach JA
JournalJ Burn Care Res
Volume31
Issue1
Pagination64-72
Date Published2010 Jan-Feb
ISSN1559-0488
KeywordsAdult, Burns, Cohort Studies, Female, Humans, Male, Middle Aged, Models, Psychological, Psychological Tests, Recovery of Function, Risk Factors, Sensitivity and Specificity, Severity of Illness Index, Stress, Psychological, Survivors, Time Factors
Abstract

Psychological adjustment after a major burn injury is a significant concern to providers and patients alike. Although efforts have been made to identify associated risk factors, little is known about heterogeneity in the levels or trajectories of adjustment in this population. This study used a novel application of Growth Mixture Modeling to identify subgroups of patients based on their longitudinal self-reported distress using the Brief Symptom Inventory (BSI). Data were drawn from the database of the Burn Model Systems project, a prospective, multisite, cohort study of major burn injury survivors. The BSI was used to assess symptoms in-hospital and at 6, 12, and 24 months postburn. Participants' T scores on the BSIs Global Severity Index provided a continuous measure of psychological distress. Analyses were conducted using participants' Global Severity Index T scores to discern distinct classes of respondents with similar trajectories across the 2-year follow-up. Results from the Growth Mixture Modeling analysis produced an ordered four-class model of psychological recovery from a major burn. Groups represented the equivalent of high, subthreshold, mild, and minimal symptom severity. Covariates significantly affected the intercept and slope of each class, as well as prediction of group assignment. These analyses demonstrate differences between individual recoveries after a major burn. Psychological distress symptoms remain largely stable over time and highlight the psychological vulnerability of this patient population.

DOI10.1097/BCR.0b013e3181cb8ee6
Alternate JournalJ Burn Care Res
PubMed ID20061839