Conference proceeding
T3 The Impact of Adverse Childhood Experiences (ACEs) on Burn Outcomes in Adult Burn Patients
Journal of burn care & research, Vol.39(suppl_1), pp.S2-S2
American Burn Association
04/09/2018
DOI: 10.1093/jbcr/iry006.002
Abstract
Abstract
Introduction
Adverse Childhood Experiences (ACEs) are incidents that occur before 18 years of life including child maltreatment and household dysfunction (parental separation, domestic violence, substance abuse, mental illness, or criminal activity in the family). National and Iowa data show that 12.5% and 14.5% of the population respectively have ≥4 ACEs. Four or more ACEs is associated with more chronic health problems, such as cardiovascular disease, pulmonary disease, cancer and psychiatric illnesses. There is currently no research regarding the interaction between ACEs and burn injuries. The goal of this study is to examine the relationship between burn injury, outcomes, and ACE exposure.
Methods
Adult burn survivors (≥18-years of age), inpatient or treated in clinic, were enrolled. Subjects completed surveys assessing childhood trauma (ACEs-18), family needs, resiliency, pain, depression, and post-traumatic stress disorder (PTSD) within 6-weeks post injury, and again at one-month, 3-months, 6-months, one-year, and two-years. Other variables collected were demographics, burn data, and hospital course. Chi-square and student’s T-tests were used for descriptive analysis and to compare the study groups (≥4 ACE vs <4 ACE).
Results
Of the 33 adult patients, 13 had ≥4 ACEs (HIGH-ACEs, 39.4%). Burn patients were 1.2 times more likely to have HIGH-ACEs compared to the general Iowa population (14.5% vs 18.0%). Burn patients with HIGH-ACEs and those with fewer ACEs had similar demographics. Family needs revealed that patients with HIGH-ACEs were more likely to feel under extreme stress, down, depressed, or hopeless in the past month, and to have felt the need to cut back on substances in the past year (all p<0.05). The HIGH-ACEs group was also more likely to struggle “bouncing back” and to have “trouble working through difficult times” (both p<0.05). The HIGH-ACEs group rated their average daily pain higher (p<0.007) and was less likely to have controllable levels of pain during treatment at UIHC (p<0.046). This group was also more likely to screen positive for probable PTSD diagnosis and tentative depression diagnosis (both p<0.05).
Conclusions
The ACE screening may provide a powerful means to detect patients at risk for a more complicated recovery. Targeted assistance in light of former trauma using Trauma Sensitive and Trauma Specific treatment techniques may help interpret burn patient behaviors, capitalize on strengths, and identify burn patients’ needs, which may then help patients recover from their injuries more rapidly.
Applicability of Research to Practice
Employing ACE screening may identify those at risk for a more complicated recovery. Intervening earlier with these patients may help shorten length of stay, address mental health needs, and be beneficial to future health outcomes.
Details
- Title: Subtitle
- T3 The Impact of Adverse Childhood Experiences (ACEs) on Burn Outcomes in Adult Burn Patients
- Creators
- M Fassel - University of Iowa, Iowa City, IAB Grieve - University of Iowa, Iowa City, IAE Assimacopoulos - University of Iowa, Iowa City, IAR Oral - University of Iowa, Iowa City, IAL Wibbenmeyer - University of Iowa, Iowa City, IA
- Resource Type
- Conference proceeding
- Publication Details
- Journal of burn care & research, Vol.39(suppl_1), pp.S2-S2
- Conference
- American Burn Association
- DOI
- 10.1093/jbcr/iry006.002
- ISSN
- 1559-047X
- eISSN
- 1559-0488
- Publisher
- Oxford University Press; US
- Alternative title
- American Burn Association 50th Annual Meeting
- Language
- English
- Date published
- 04/09/2018
- Academic Unit
- Stead Family Department of Pediatrics; Surgery; Injury Prevention Research Center
- Record Identifier
- 9984051701002771
Metrics
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