THE “UNSEEN SCAR”

Oral Presenter:

Dr. Fatimah M.N

Research Team:

Dr S.Fatimah M.J, Dr. Geshina A. M.S., Dr. Arman, M. S., Assoc Prof. Wan

Azman W. S, Mohd Fuad H., Seri Haryati A.

Universiti Sains Malaysia

INTRODUCTION

• Burn management has improved

tremendously that survival rates

increased significantly.

• Burn injury does not only change a

person physically, but invariably causes

mental distress or psychological

impairment (1).

*Thomas CR. Psychiatric disorders associated with burn injury. In: Herndon DN, editor. Total burn care.

3rd ed2007. p. 824 - 5

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OBJECTIVES

TBSA

PTSD

QoL Depression

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METHOD

Inclusion criteria:

• Age ≥ 18

• Understand and conversant

in Bahasa Malaysia

• Major burns that were

treated in HUSM

Exclusion criteria:

• Patients that refused to

consent

• Patients with preexisting:

acute psychotic

schizophrenia

major depression

dementia

cognitive problems

substance abuse

• Deceased at the time of field

study

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METHOD

Case notes

Burn proforma

Burn database

Patient contact tracing

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METHOD

55 patients

5 Q’s Scoring process

Statistical analysis

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METHOD

Actuarial instruments:

QoL

• The Burn Specific Health Scale (BSHS-B), includes four

domains: physical, mental, social and general health (QOL)

PTSD

• Malay PTSD Checklist for Civilians(MPCL-C)

• Malay Version Trauma Checklist TSI-2 (Senarai Semak

Trauma)

Depression

• Malay-translated version of Depression scale (CES-D)

• Beck Depression Inventory for Malays (BDI-Malay)

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RESULTS

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TBSA

PTSD

p<0.05

*MPCL-C

QoL

p<0.05

Depression

p<0.05

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TBSA & PTSD

Correlation between TBSA and PTSD p<0.05*

Mean TBSA for patients with PTSD are 15%

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TBSA & depression

Correlation between TBSA and depression p<0.05

Mean TBSA is 17.1%, t (53) = -3.834 (BDI-Malay)

Mean TBSA is 14.7%, t (53) = -2.546 (CES-D)

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TBSA & QoL

Association between TBSA and QoL, p<0.05

1 unit change in TBSA we expect a change of QOL by -16.5

Quality of Life = 164.5 -16.5TBSA

Mean TBSA 9% and above poor QoL

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SUGGESTION

MAJOR BURN

TBSA 14% and above

PTSD

screening

Depression screening

TBSA 9% and above

QoL assessment

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CONCLUSION

Paradigm shift in burn management, whereby to treat patient holistically beyond the physical presentation of the scar

Physical Psychological QoL

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Thank you (c) Fatimah 2017

17

fatimahjoelee83@gmail.com

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