Highlights
- •A model for dissatisfaction with appearance after burn injury is proposed.
- •After an initial increase, dissatisfaction with appearance follows a stable path for 2 years postdischarge.
- •Women and individuals with larger burns are more dissatisfied with their appearance.
- •Dissatisfaction with appearance predicts 5-year postdischarge depression scores.
Abstract
Objectives
To use latent growth curve and longitudinal structural equation modeling to examine
the 2-year trajectory of satisfaction with appearance in adults with burn injury,
and that trajectory's effect on depression 5 years after burn injury.
Design
Data were collected at discharge after burn injury hospitalization and at 6 months,
1 year, 2 years, and 5 years postdischarge.
Setting
The Burn Model Systems (BMS) program consisted of a data center and 5 participating
burn centers.
Participants
The sample consisted of adults (N=720) who were hospitalized for a burn injury, enrolled
in the BMS database, and completed measures at least once throughout the 5-year study
duration.
Interventions
Not applicable.
Main Outcome Measures
Satisfaction With Appearance Scale and Patient Health Questionnaire-9 (depression).
Results
Women with burn injury reported higher levels of dissatisfaction with their appearance
in comparison to their male counterparts over the 2 years after discharge. Individuals
with a larger total body surface area (TBSA) affected by a burn also reported greater
body dissatisfaction across the postdischarge 2-year period. Results did not support
significant gender or TBSA differences in the rate of change of body dissatisfaction
trajectories across these 2 years. Individuals with greater body dissatisfaction at
6 months postdischarge tended to have higher depressive symptoms at 5 years. Six month
postdischarge, body dissatisfaction scores also mediated the effects of gender and
TBSA on depressive symptoms 5 years later.
Conclusions
It is recommended that individuals with heightened body image dissatisfaction after
a burn, particularly women and those with larger TBSA, participate in evidence-based
psychosocial interventions to improve long-term adjustment.
Keywords
List of abbreviations:
BMS (Burn Model Systems), CFI (comparative fit index), CI (confidence interval), RMSEA (root-mean-square error of approximation), SWAP (Satisfaction With Appearance Scale), TBSA (total body surface area), TLI (Tucker-Lewis Index)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 05, 2017
Footnotes
Support for the Burn Model System National Database is by the U.S. Department of Health and Human Services, National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) in collaboration with the NIDILRR-funded Burn Model System (BMS) centers. However, these contents do not necessarily reflect the opinions or views of the BMS centers, NIDILRR, or the U.S. Department of Health and Human Services.
Disclosures: none.
Identification
Copyright
© 2017 by the American Congress of Rehabilitation Medicine
