Elsevier

Burns

Volume 32, Issue 2, March 2006, Pages 159-164
Burns

Quality of life and return to work following electrical burns

https://doi.org/10.1016/j.burns.2005.08.022Get rights and content

Abstract

To investigate the psychosocial outcomes following electrical burns, a cross-sectional survey of electrical burn patients was done using three outcome tools: the Burn Specific Health Scale brief version (BSHS-B), the Coping with Burns Questionnaire (CBQ), and the Pain Patient Profile (P3®). Questionnaires were mailed to electrical burn patients discharged from an adult regional burn centre, and also distributed to attendants of an electrical utility conference in Toronto. Twenty-six of 88 patients who were discharged from the regional burn centre during the study period with updated residential information were contacted and 14 (54%) completed the questionnaires. Twenty questionnaires were also distributed at the conference and 8 (40%) were completed; leaving a total of 22 (48%) patients for the study. The average patient age was 44.0 ± 11.7 years; 21 (96%) were men, and the average time from injury to survey completion was 5.3 ± 4.9 years. Five (23%) of the 22 patients returned to the same work duties, 10 (45%) changed duties, and 7 (32%) did not return to work. BSHS-B scores were low for all patients. Participants with high voltage burns (>1000 V) had worse sexuality scores (p < 0.05), while those with larger burns (>10% TBSA) had worse physical scores (p < 0.05). Patients surveyed >5 years from injury showed improvement in physical scores. CBQ scores indicated that optimism was the most commonly used coping strategy. P3® showed significant levels of emotional distress in all patients, with anxiety being more common in high voltage injuries (p < 0.05). The data suggests that electrical burn patients may have a limited ability to return to work and an overall poor quality of life. Emotional distress is the dominant feature influencing long-term outcome in these patients. Further studies are warranted to validate these findings.

Introduction

Severe burns are known to be associated with significant quality of life impairments, low rates of return to previous employment and an overall poor prognosis [1]. Electrical burn injuries in particular are capable of inducing more morbidity than burns of other etiologies [2], [3].

A variety of neurologic, cardiac, renal, gastrointestinal, ophthalmologic and psychiatric disturbances can occur in the immediate and long term [4]. In addition, these patients can suffer from cognitive disturbances including slower thinking, impaired concentration, language and memory problems, as well as emotional distress [5], [6], [7]. Given the severity of electrical burns and their unique pathophysiology, it would be expected for these patients to have a poor outcome. However, the literature is deficient in studies investigating psychosocial outcomes and return to work of patients suffering from electrical burn injuries. In the current study, the quality of life and return to work characteristics of patients suffering electrical burns is investigated.

Section snippets

Methods

Ethics approval was obtained from the Sunnybrook and Women's College Health Sciences Centre Research Ethics Board. A cross-sectional mail survey was conducted among patients suffering severe electrical burns in the province of Ontario. This included electrical burn patients discharged from a regional adult burn centre between January 1998 and May 2003, who were contacted by telephone and their postal addresses were confirmed, and electrical workers attending the Hydro One Health & Safety

Results

Of 88 electrical burn patients discharged during the study period, 60 were not eligible for this study either because they were not reachable due to a change in their telephone number or address recorded on hospital admission (n = 59), or died after hospital discharge (n = 1). Twenty-eight patients were contacted by telephone, and two refused to participate. Thus, we sent the survey to 26 of them and 14 (54%) completed and returned the survey. Of 20 surveys distributed at the conference, 8 (40%)

Discussion

In the current study, electrical burn was associated with significant difficulty in returning to work. Only 23% of patients were able to return to their previous employment and perform the same duties, with a mean time off work of 17 weeks, and 32% of patients did not return to work at all. The others did return to work but either took on modified duties with the same employer or worked in an entirely new setting altogether. The return to work characteristics reported in this study are worse

Conclusions

This study suggests that patients suffering severe electrical burns may have a poor quality of life during rehabilitation and beyond, perhaps being worse than certain non-electrical burns. This suggests that the treatment of a severe electric burn does not end with wound healing. Patients may require strong support from family and healthcare professionals to aid in their adjustment to their new lives. Long-term follow up patients suffering severe electrical burns is critical in order to

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