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Connell K.M.,Curtin University Australia | Coates R.,Curtin University Australia | Wood F.M.,Fiona Wood Foundation | Wood F.M.,University of Western Australia
Sexuality and Disability | Year: 2014

Burn injuries are associated with significant changes to physical and psychological function. Little is known regarding the impact that burn injuries have on females’ sexuality and how this in turn affects their relationships and body image. This qualitative study aims to add narratives of the lived experiences of female burn survivors to provide evidence that sexuality and body image changes are important indicators of post burn adjustment and quality of life, which should be included as important components of post burn rehabilitation. This study included a phenomenological approach incorporating semistructured interviews of five women with varying size of burn. The data collection and analysis was guided by Kvale’s seven stages of interview inquiry. Burn injuries are life changing events that result in behavioural changes that impact engagement in sexual and social participation for females. These changes result in alterations to ones internalized concept of body image and attractiveness that have the potential to impact all facets of life. Findings from the thematic analysis in this study lead to the development of the Adjustment to Sexuality and Body Image Changes Post Burn Injury Model. This model conceptualizes potential body image and sexuality changes post traumatic injury and identifies possible areas for targeted interventions that could be incorporated into rehabilitation services. Burn injuries are correlated with behavioral changes that have a potential adverse impact on sexual and social engagement for female burn survivors. Further research investigating treatment strategies for post burn adjustment is required to translate to improvements in clinical service provision. © 2014, Springer Science+Business Media New York.

Connell K.M.,Curtin University Australia | Coates R.,Curtin University Australia | Doherty-Poirier M.,Curtin University Australia | Wood F.M.,Fiona Wood Foundation | Wood F.M.,University of Western Australia
Sexuality and Disability | Year: 2013

The purpose of this study was to perform a review of the existing literature to (a) determine the impact of sexuality and body image changes following burn injuries in an adult population and (b) identify if there is a relationship between the two variables and the impact this potentially has on burns survivors' quality of life. A total of 16 research articles; sexuality (n = 5) and body image (n = 8), sourced from online databases were reviewed. Both quantitative and qualitative studies that investigated adult burn survivors in both inpatient and outpatient settings were included in this review. The literature suggests there is an interaction between body image dissatisfaction, sexual satisfaction and long-term psychological adjustment, particularly for female burn survivors. However, methodological limitations of the studies reviewed limits the transferability of the findings to clinical practice. Three themes were identified throughout the literature; satisfaction/dissatisfaction, adjustment issues and stigmatisation. Changes in body image and sexuality have a potential negative effect on burn survivors' long-term quality of life. Further collaborative empirical research is required to understand the incidence and prevalence of these issues as well as intervention studies evaluating treatment programs for best practice. © 2013 Springer Science+Business Media New York.

Connell K.M.,Curtin University Australia | Phillips M.,University of Western Australia | Coates R.,Curtin University Australia | Doherty-Poirier M.,Curtin University Australia | And 2 more authors.
Burns | Year: 2014

Methods: A total of 1846 observations from 865 Western Australian burn patient BSHS-B questionnaires were analyzed. Descriptive statistical methods included dichotomous and ordinal scale variables and medians, as well at the range for continuous variables. Infer-ential statistical methods used longitudinal linear mixed-effects models and random effects models with the BSHS-B total and its sub-scales as dependent variables.Results: The four BSHS-B domains of interest all showed no significant change over time, indicating that the psychological and psychosocial impact of burns does not significantly improve for burn survivors, regardless of good physical and functional recovery.Conclusions: Burn survivors experience sexuality, body image and relationship changes following a burn, which may affect their quality of life (QoL) over time. Rehabilitation services need to be aware of these issues and create rehabilitation programs that specifically and meaningfully address these issues for burn survivors.Background: The Burns Specific Health Scale Brief (BSHS-B) was analyzed to investigate the longitudinal impact of burns on sexuality and body image. Four sub-domains of the BSHS-B domains were of particular interest: sexuality, body image, affect and relationships, and as such were investigated for correlation between all of the sub-scales of the BSHS-B. © 2014 Elsevier Ltd and ISBI. All rights reserved.

Cassidy J.T.,Royal Perth Hospital | Phillips M.,University of Western Australia | Fatovich D.,University of Western Australia | Duke J.,University of Western Australia | And 3 more authors.
Burns | Year: 2014

Background There is limited research validating the injury severity score (ISS) in burns. We examined the concordance of ISS with burn mortality. We hypothesized that combining age and total body surface area (TBSA) burned to the ISS gives a more accurate mortality risk estimate. Methods Data from the Royal Perth Hospital Trauma Registry and the Royal Perth Hospital Burns Minimum Data Set were linked. Area under the receiver operating characteristic curve (AUC) measured concordance of ISS with mortality. Using logistic regression models with death as the dependent variable we developed a burn-specific injury severity score (BISS). Results There were 1344 burns with 24 (1.8%) deaths, median TBSA 5% (IQR 2-10), and median age 36 years (IQR 23-50). The results show ISS is a good predictor of death for burns when ISS ≤ 15 (OR 1.29, p = 0.02), but not for ISS 15 (ISS 16-24: OR 1.09, p = 0.81; ISS 25-49: OR 0.81, p = 0.19). Comparing the AUCs adjusted for age, gender and cause, ISS of 84% (95% CI 82-85%) and BISS of 95% (95% CI 92-98%), demonstrated superior performance of BISS as a mortality predictor for burns. Conclusion ISS is a poor predictor of death in severe burns. The BISS combines ISS with age and TBSA and performs significantly better than the ISS. © 2013 Elsevier Ltd and ISBI.

Cassidy T.J.,Fiona Wood Foundation | Cassidy T.J.,University College Dublin | Edgar D.W.,Fiona Wood Foundation | Edgar D.W.,Burn UnitWA | And 11 more authors.
Burns | Year: 2015

Background In Australia and New Zealand (ANZ), health care is provided for ∼26 million people dispersed across the eight million square kilometres of the two countries. Providing optimal care prior to and during transfer across such vast distances is challenging. Lengthening the time taken to definitive burn care has a negative impact on burn outcome. The aims of this study were to determine if transfer time and admission pathway influenced burn mortality and to identify the factors predicting burn mortality in ANZ. Method The study included all adult burn patient admission data from 15 of 17 burn services submitted to the Australian and New Zealand Burn Association bi-national registry (2010-2012). Multivariate logistic regression analyses were conducted to address the study aims. Results Of the 2892 patients, 69 (2.4%) died following burn. Time to admission and direct admission to a burn centre did not independently influence burn mortality except when patients with inhalation injury took >16 h to transfer to definitive care. The risk of death was increased 5.7 times in the presence of inhalation injury. Burn size and age amplified the risk of death while gender did not. Conclusion In ANZ, pre-hospital transport systems and peripheral hospital stabilisation were not associated with an increased risk of death due to burn except when inhalation injury was present. The results of this study indicate that burn patients with inhalation injury should be stabilised and transferred to a burn service within 16 h of burn. © 2014 Elsevier Ltd and ISBI. All rights reserved.

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