Citation

Schulz JT, Shapiro GD, Acton A, Fidler P, Marino ME, Jette A, Schneider JC, Kazis LE, Ryan CM. J. Burn Care Res. 2019; 40(5): 696-702.

Affiliation

Massachusetts General Hospital, Shriners Hospital Boston, Harvard Medical School, Boston MA.

Copyright

(Copyright © 2019, American Burn Association, Publisher Lippincott Williams and Wilkins)

DOI

10.1093/jbcr/irz074

PMID

31067572

Abstract

INTRODUCTION: Social and emotional recovery from burn injury is a complex process impacted by both clinical and social factors. Because level of education (LOE) has been correlated to overall health, health outcomes, and life expectancy, we questioned whether LOE might be associated with successful social recovery after burn injury. The LIBRE (Life Impact Burn Recovery Evaluation) dataset served as a novel tool to explore this question.

METHODS: The Life Impact Burn Recovery Evaluation (LIBRE) project is a collaborative effort designed to provide a clinical yardstick for social reintegration among burn survivors. After IRB approval, 601 burn survivor respondents, age 18 or over with >5% TBSA burn were surveyed and a 6 scale, 126-item LIBRE Profile was derived from their responses. Level of Education was collapsed into four categories ranging from less than GED to graduate degree. Impact of burn injury on subsequent LOE was examined by splitting the sample into those burned at age 30 years or less and those burned at greater than 30 years of age. Regression models were run to estimate associations between education and scale scores with adjustment for age at injury, gender, marital status, work status, TBSA and time since burn. Regression models were run on the entire cohort and then stratified by age at burn injury (≤30 vs. >30).

RESULTS: Among all subjects we found an association between LOE and social recovery as measured by LIBRE scale scores. This association was contributed entirely from the cohort burned at age 30 or less: for those burned at greater than age 30, there was no association between LOE and social recovery. Of particular interest, the distribution of LOE among those burned at
CONCLUSIONS: LOE appears to be associated with social recovery for those burned at younger ages, but not for those burned at over age 30. More importantly, burn injury during schooling may have no impact on a survivor's educational trajectory, since distribution of LOE in our ≤30 cohort mirrors that of the general population. APPLICATION TO PRACTICE: LOE and age at burn injury may provide a quick screen for survivors at risk of difficult social reintegration, allowing providers to target those at risk with additional peer support and counseling.

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Language: en