Johar, Siti Fatimah Noor Mat
(2017)
Prevalence of post major burn complications, posttraumatic stress disorder and depression among HUSM patients treated for major burn between 2006 and 2016.
Masters thesis, Universiti Sains Malaysia.
Abstract
Introduction
The goal of this study is to identify early and late burn complications among major burn
patients. This study also evaluated the effect of total body surface area (TBSA) of burn
towards posttraumatic stress disorder (PTSD) and depression. Association between
TBSA and quality of life (QoL) was also identified.
Methods
This study was a cross-sectional study involving adult major burn patients from 2006
until 2016. Validated psychometric questionnaires that were used to screen for PTSD
and depression in post major burn patients are, Malay PTSD Checklist for Civilians
(MPCL-C), Trauma Symptom Inventory-2 (TSITM-2), Beck Depression Inventory-
Malay (BDI-Malay) and Center for Epidemiological Study – Depression scale (CES-D).
A Malay translated Burn Specific Health Scale – B was used to evaluate post major
burn QoL. The difference of mean TBSA and PTSD as well as TBSA and depression
were addressed using Independent t-test. The association between TBSA and QoL was
addressed using simple linear regression.
Results
A total number of 55 patients voluntarily participated in answering the psychometric
battery. Early complications that were identified among the major burn patients were
acute stress disorder (0.72%), renal failure (0.72%), heart failure (1.08%), respiratory
failure and infection (1.44%), Systemic Inflammatory Response Syndrome (2.16%),
sepsis (2.52%) and infected wound (2.88%). Late complications that were identified
include, corneal defect (0.36%), alopecia (0.72%), keloid (0.72%), ear deformity
(1.08%), contracture (5.04%) and hypertrophic scar (10.1%). Results based on the
MPCL-C and TSI-2, indicated that there were no significant difference of mean TBSAbetween patients who has PTSD and no PTSD, MPCL-C, p > 0.05 and TSI-2, p > 0.05.
However, when the results of BDI and CES-D were compared, there were significant
difference of mean TBSA between patient who has depression and those who dont have
depression. Based on BDI, for patients with depression; the average mean TBSA is
17.1%, p < 0.05. Based on CES-D, for patients with depression; the average mean
TBSA is 14.7%, p < 0.05. There is a significant association between major burns TBSA
and QoL with p<0.05. Based on the model summary output, the variable TBSA explains
37.2% of the variability in QoL. This indicates, the higher level of TBSA leads to poor
quality of life. For TBSA more than 25% it was reported that the QoL was 45.67 lesser
when compared with TBSA less than 15%.
Conclusion
This study identified early and late burn complications among major burn patient
through a burn database and burn proforma from 2006 until 2016. This study has found
significant effect of TBSA towards depression, while no significant effect towards
PTSD. Findings provide some evidence for poor QoL post major burn in a negative
direction. It is suggested all major burn patients be screened for PTSD and depression as
original sample size was small and it carries a significant impact towards patient’s well
being beyond physical recovery from burn. All major burn patients’ quality of life
should be evaluated as well, as it reflects the final outcome of healing holistically.
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