Using a Biopsychosocial Model to Understand Long-term Outcomes in Persons with Burn Injuries

Publication date: Available online 2 March 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Shelley Wiechman, Michael A. Hoyt, David R. Patterson
ObjectiveTo determine the importance of preburn adjustment, injury related variables and selection of coping style on various outcome measures using a biopsychosocial model.DesignLongitudinal. Setting: Outpatient burn clinics. Participants: A total of 231 burn survivors participated in this study as part of a larger burn model system study of 645 patients with major burn injuries.InterventionsN/A/. Main Outcome Measures: The SF-36 was used to assess pre burn adjustment. Other outcome measures entered into the model included the ways of Coping Checklist-revised, the Brief Symptom Inventory, the Beck Depression Inventory-II, the Davidson Trauma Scale.ResultsCorrelational and mediational analysis revealed that preburn emotional health predicted better adjustment at year one and more PTSD symptoms at year two. Better preburn emotional health was also related to less use of avoidant coping strategies, which was also found to be a mediator of the effect of preburn emotional health and PTSD symptoms. Burn injury characteristics were not significantly associated with psychological adjustment at either year one or year two.ConclusionsThe results indicate that there is a complex relation between premorbid mental health and the selection of coping strategies that impact long term adjustment in persons recovering from a burn injury. This relation seems to have more impact on long-term outcome than preburn emotional or physical health alone or the severity of the burn.



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